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Prognosis of migraine and tension-type headache

A population-based follow-up study

From the Research Centre for Prevention and Health (Drs. Lyngberg and Jørgensen), Glostrup University Hospital, Glostrup; Department of Neurology (Dr. Rasmussen), Hilleroed Hospital, Hilleroed; and Danish Headache Centre (Dr. Jensen), Department of Neurology, Glostrup University Hospital, Glostrup, Denmark.

Address correspondence and reprint requests to Dr. Ann Christine Lyngberg, Research Centre for Prevention and Health, Glostrup University Hospital, Nordre Ringvej 57, Building 84/85, DK-2600 Glostrup, Denmark; e-mail: anchly01{at}glostruphosp.kbhamt.dk

Objective: To determine the prognosis of migraine and tension-type headache and to identify prognostic factors.

Methods: Of 740 persons (aged 25 to 64 years) examined in a 1989 Danish cross-sectional headache study, 673 were eligible for follow-up in 2001. All interviews at baseline and at follow-up were conducted by medical doctors and based on the 1988 IHS-criteria.

Results: A total of 549 persons (81.6%) participated in the follow-up study. Of 64 migraineurs at baseline, 42% had experienced remission, 38% had low migraine frequency, and 20% had more than 14 migraine days per year (poor outcome) at follow-up. Poor outcome was associated with high migraine frequency at baseline and age at onset younger than 20 years. Among 146 subjects with frequent episodic tension-type headache and 15 with chronic tension-type headache at baseline, 45% experienced infrequent or no tension-type headache (remission), 39% had frequent episodic tension-type headache, and 16% experienced chronic tension-type headache (poor outcome) at follow-up. Poor outcome was associated with baseline chronic tension-type headache, coexisting migraine, not being married, and sleeping problems.

Conclusions: The prognosis of migraine, frequent episodic tension-type headache, and chronic tension-type headache was favorable.

The study was supported by grants from the East Denmark Health Science Research Forum, the Danish Medical Association Research Fund, the Danish Health Insurance Foundation, the Danish Hospital Foundation for Medical Research, the Danish Headache Society, the Cool Sorption Foundation, GlaxoSmithKline A/S, Merck Sharp Dohme A/S, Pfizer A/S, Lundbeck Pharma A/S, and H. Lundbeck A/S.

Disclosure: The authors report no conflicts of interest.

Received January 21, 2005. Accepted in final form May 5, 2005.

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