B. Lee Peterlin

Obesity and Migraine: The Effect of Age, Gender and Adipose Tissue Distribution

(Headache 2010;50:52‐62)

Childhood Maltreatment and Migraine (Part I). Prevalence and Adult Revictimization: A Multicenter Headache Clinic Survey

(Headache 2010;50:20‐31)

Allodynia in Migraine: Association With Comorbid Pain Conditions

Background.— Cutaneous allodynia (CA) in migraine is a clinical manifestation of central nervous system sensitization. Several chronic pain syndromes and mood disorders are comorbid with migraine. In this study we examine the relationship of migraine‐associated CA with these comorbid conditions. We also evaluate the association of CA with factors such as demographic profiles, migraine characteristics, and smoking status that may have an influence on the relationships of CA to pain and mood.

Migraine and obesity: epidemiology, mechanisms, and implications.

(Headache 2010;50:631‐648)

Post‐Traumatic Stress Disorder in Episodic and Chronic Migraine

Objective.— To assess and contrast the relative frequency of self‐reported post‐traumatic stress disorder (PTSD) in patients with episodic migraine and chronic/ transformed migraine.

Childhood maltreatment and migraine (part III). Association with comorbid pain conditions.

(Headache 2010;50:42‐51)

Childhood maltreatment and migraine (part II). Emotional abuse as a risk factor for headache chronification

(Headache 2010;50:32‐41)

Defining Refractory Migraine and Refractory Chronic Migraine: Proposed Criteria From the Refractory Headache Special Interest Section of the American Headache Society

Certain migraines are labeled as refractory, but the entity lacks a well‐accepted operational definition. This article summarizes the results of a survey sent to American Headache Society members to evaluate interest in a definition for RM and what were considered necessary criteria. Review of the literature, collaborative discussions and results of the survey contributed to the proposed definition for RM. We also comment on our considerations in formulating the criteria and any issues in making the criteria operational. For the proposed definition for RM and refractory chronic migraine, patients must meet the International Classification of Headache Disorders, Second Edition criteria for migraine or chronic migraine, respectively. Headaches need to cause significant interference with function or quality of life despite modification of triggers, lifestyle factors, and adequate trials of acute and preventive medicines with established efficacy. The definition requires that patients fail adequate trials of preventive medicines, alone or in combination, from at least 2 of 4 drug classes including: beta‐blockers, anticonvulsants, tricyclics, and calcium channel blockers. Patients must also fail adequate trials of abortive medicines, including both a triptan and dihydroergotamine (DHE) intranasal or injectable formulation and either nonsteroidal anti‐inflammatory drugs (NSAIDs) or combination analgesic, unless contraindicated. An adequate trial is defined as a period of time during which an appropriate dose of medication is administered, typically at least 2 months at optimal or maximum‐tolerated dose, unless terminated early due to adverse effects. The definition also employs modifiers for the presence or absence of medication overuse, and with or without significant disability.

Depression and anxiety : Effect on the migraine-obesity relationship

Objective.—To discern the effects of depression and anxiety on the migraine–obesity relationship.

Episodic migraine and obesity and the influence of age, race, and sex

Objective: To evaluate the episodic migraine (EM)-obesity association and the influence of age, race, and sex on this relationship. Methods: We examined the EM-obesity association and the influence of age, race, and sex in 3,862 adult participants of both black and white race interviewed in the National Comorbidity Survey Replication. EM diagnostic criteria were based on the International Classification of Headache Disorders. Body mass index was classified as underweight (<18.5 kg/m2), normal (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2), or obese (≥30 kg/m2). Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for EM were estimated using logistic regression. Models were stratified by age (<50/≥50 years), race (white/black), and sex (male/female). Results: A total of 188 participants fulfilled criteria for EM. In all participants, the adjusted odds of EM were 81% greater in individuals who were obese compared with those of normal weight (OR 1.81; 95% CI: 1.27–2.57; p = 0.001), with a significant trend of increasing odds of EM with increasing obesity status from normal weight to overweight to obese (p = 0.001). In addition, stratified analyses demonstrated that the odds of EM were greater in obese as compared with normal-weight individuals who were 1) younger than 50 years of age (OR 1.86; 95% CI: 1.20–2.89; p for trend = 0.008), 2) white (OR 2.06; 95% CI: 1.41–3.01; p for trend ≤0.001), or 3) female (OR 1.95; 95% CI: 1.38–2.76; p for trend ≤0.001). Conclusion: The odds of EM are increased in those with obesity, with the strongest relationships among those younger than 50 years, white individuals, and women.