Frequency of headaches similar with, without Parkinson’s: Study
Still, migraines disappeared more often in patients vs. controls over 3 years
The frequency of headaches, including tension-type headaches and migraines, is similar among people with and without Parkinson’s disease, according to the findings of a questionnaire-based study from researchers in Italy.
Still, headaches, particularly migraines, disappeared more often in patients within three years of symptom onset than in healthy individuals over the same time frame, the data showed.
Thus, disease features and treatment “might favor migraine improvement [easing] and remission in PD [Parkinson’s disease] patients,” the researchers wrote.
Overall, the team noted, “the prevalence of headaches among PD patients is in line with that reported in the general population.”
The study, “Prevalence and features of headache in Parkinson’s disease: the role of dopamine,” was published in the journal Neurological Sciences.
Investigating prevalence of headaches among Parkinson’s patients
Parkinson’s is caused by the progressive loss of brain cells that make dopamine, a signaling molecule that nerve cells use to communicate with each other. As a result, dopamine levels drop, disrupting nerve signaling and leading to the disease’s motor and nonmotor symptoms.
Pain is a common nonmotor feature reported by Parkinson’s patients. It can emanate from bones, muscles, ligaments, and nerves, or result from sustained or repetitive muscle spasms or cramps.
Headache is a type of pain that includes tension-type headache, often described as feeling like a tight band around the head, or migraines, a neurological condition marked by throbbing head pain, often on one side, alongside nausea, vomiting, and/or sensitivity to light.
While headaches are thought to be fairly common in Parkinson’s, data about their prevalence among patients are mixed and varied. Some studies suggest a higher frequency of previous-year migraine than tension-type headaches in those with Parkinson’s, while others show fewer lifetime migraines among patients compared with unaffected individuals.
To learn more, a team of researchers at Federico II University in Naples investigated the lifetime and previous-year prevalence of headaches in people with and without Parkinson’s.
A total of 101 Parkinson’s patients — 57 men and 44 women — were recruited from the Parkinson’s Disease and Movement Disorders Center at the university. Also enrolled were 101 age- and sex-matched healthy spouses and unrelated caregivers, who served as controls.
All participants underwent a clinical interview to gauge lifestyle habits, sleep status, history of head injury, depression, current diseases, and medications. They also completed a questionnaire reporting the occurrence of headaches and associated symptoms both in their lifetime and in the previous year.
According to the data, tension-type headaches were reported more frequently than migraines among both Parkinson’s patients (41% vs. 22%) and controls (44% vs. 27%).
Although test scores for depression were significantly worse in patients than controls, the prevalence of headaches over a lifetime (63% vs. 61%) and during the past year (40% vs. 44%) were similar between the two groups.
Likewise, patients compared with controls had similar lifetime (41% vs. 35%) and 12-month (26% vs. 28%) occurrence of tension-type headache and similar lifetime (22% vs. 27%) and 12-month (14% vs. 17%) occurrence of migraine.
Disease ‘may have a positive effect’ on course of patients’ headaches
No sex-related differences in headache features were observed, except that women in the control group had significantly more migraines in the prior year than did men (41% vs. 17%). Additionally, no differences were found regarding the intensity of pain, familial history of headache, prodromal or early symptoms or triggers, and the use of symptomatic drugs.
More patients reported the disappearance of tension-type headaches (21% vs. 8%) and migraines (41% vs. 6%) within three years of motor symptoms onset than controls in the past three years. Patients, particularly those with migraines and treated with dopamine agonists — therapies that mimic the effect of dopamine — more frequently saw their headaches disappear after symptom onset versus the age-related remission seen in controls.
Depression was more severe among patients with migraines than tension-type headaches, yet headache remission was more common in patients with migraines than with tension-type headaches. Dopamine agonists were less frequently administered to patients with a headache than without (62% vs. 81%).
Regardless, patients with and without headaches were comparable for age and disease onset, as well as motor fluctuations and nonmotor features. Similarly, levodopa dose and levodopa equivalent daily dose (LEDD) — the sum of all Parkinson’s medications taken — were similar for patients with and without headaches.
We found that the lifetime and last year prevalence of headaches did not differ between [Parkinson’s disease patients] and controls. … The prevalence of headache in [Parkinson’s] follows that described in the general population.
While the number of cardiovascular risk factors, such as high blood pressure and diabetes, was similar between the two groups, patients with headaches had higher levels of blood fats than those without, a finding not seen among controls.
Tremors, as the leading Parkinson’s symptom, were reported in 69 patients, while 30 had the akinetic rigid subtype marked by stiffness and difficulty moving. Still, no significant differences were found in the prevalence of headache, tension-type headaches, and migraine, and the rate of headache remission between these two groups.
However, among patients with headaches, motor fluctuations were significantly more common among akinetic rigid patients than those with tremors (64% vs. 37%).
“We found that the lifetime and last year prevalence of headaches did not differ between PD [patients] and controls,” the researchers wrote. “The prevalence of headache in PD follows that described in the general population.”
The team noted that, while their study was note “targeted to establish a cause-effect relationship between PD/dopaminergic drugs and headache,” their results suggest that “the disease may have a positive effect on the headache course.”
Overall, the scientists concluded: “Our results have an exploratory value and should be confirmed by further research.”
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