Gerilim Tipi Başağrısı Tanısı Alan Olgularda Kognisyonun Değerlendirilmesi

Abstract

Giriş ve Amaç: Gerilim tipi başağrısı (GTBA) genel populasyonda en sık görülen başağrısıdır. Bu çalışmada GTBA saptanan olguların kognisyon durumu ve sağlıklı kontrol grubu ile kognitif fonksiyonlarının karşılaştırılması amaçlanmıştır. Gereç ve Yöntemler: Çalışma 01.10.2019 –15.06.2020 tarihleri arasında gerçekleştirilmiştir.2018 Uluslararası Başağrısı Sınıflamasına göre GTBA tanısı alan 18-55 yaş aralığındaki interiktal dönemdeki 50 hasta vaka grubu olarak; primer ve/veya sekonder başağrısı tanısı olmayan 50 kişi kontrol grubu olarak çalışmaya alınmıştır. Katılımcıların verileri sosyodemografik özellikleri, tıbbi geçmişi, başağrısı tetikleyicileri, başağrısının klinik özelliklerini sorgulayan araştırmacılar tarafından geliştirilmiş sorgulama formu ile toplanmıştır. Bireylerin ağrı düzeyleri vizüel analog ağrı skalası (VAS) ile kognisyonları ise Montreal Bilişsel Değerlendirme Testi (MoCA Test), Stroop testi, Görsel İşitsel Sayı Dizileri Testi B Formu (GİSD-B) ile değerlendirilmiştir. Bulgular: GTBA hastalarında MoCA testinin toplam skorunda, dikkat ve gecikmeli hatırlama alt ölçek skorlarında kontrol grubuna göre düşüklük saptanmıştır. Stroop testinin toplam puanı;Stroop 4, Stroop 5, ve Stroop farkı (B5-B1) puanları GTBA grubunda kontrol grubuna göre daha yüksek bulunmuştur. GİSD-B testinin toplam puanı ile duyu içi kaynaşım, duyular arası kaynaşım, görsel sözel, işitsel sözel, işitsel uyarım, görsel uyarım, sözel anlatım, yazılı anlatım alt ölçek puanları GTBA grubunda kontrol grubuna göre düşük bulunmuştur. Hastalığın süresi arttıkça kognisyonda düşüşün arttığı saptanmıştır. Sonuç: GTBA olan olgularda kontrol grubuna göre kognitif testlerde belirgin düşüş saptanmıştır. Hastalıkla geçirilen süredeki artış kognisyondaki düşüşü de artırmaktadır. Hastaların kognisyonundaki düşüşü geciktirecek veya önleyecek tedavilerle kontrol altına alınmasına yönelik planlamalar yapılmalıdır.

Keywords

• Başağrısı
• kognisyon
• gerilim tipi başağrısı

Evaluation Of Cognition In Cases Diagnosis Of Tension-Type Headache

Abstract

Introduction and Objective: Tension-type headache (TTH) is the most common headache in the general population. This study aimed to compare the cognitive status of patients with TTH and their cognitive functions with a healthy control group. Material and Methods: The study was conducted between 01.10.2019 and 15.06.2020. According to the 2018 International Headache Classification, 50 patients between the ages of 18-55 in the interictal period who were diagnosed with TTH were included as the case group; 50 people without a primary and/or secondary headache diagnosis were included as the control group. The data of the participants were collected with a questionnaire form developed by the researchers that questioned their sociodemographic characteristics, medical history, headache triggers, and clinical features of the headache. The individuals' pain levels were assessed with the visual analog pain scale (VAS) and their cognition with the Montreal Cognitive Assessment Test (MoCA Test), Stroop test, Visual Auditory Digit Span Test Form B (GISD-B). Findings: In TTH patients, the total score of the MoCA test and the attention, delayed recall subscale scores were found to be lower compared to the control group. The total score of the Stroop test; Stroop 4, Stroop 5, and Stroop difference (B5-B1) scores were found to be higher in the TTH group than in the control group. The total score of the GISD-B test and the subscale scores of intrasensory fusion, intersensory fusion, visual verbal, auditory verbal, auditory stimulation, visual stimulation, verbal expression, written expression were found to be lower in the TTH group than in the control group. It was determined that the decline in cognition increased as the duration of the disease increased. Conclusion: A significant decrease was found in cognitive tests in TTH patients compared to the control group. The increase in the time spent with the disease also increases the decline in cognition. Plans should be made to control the decline in cognition of patients with treatments that will delay or prevent it.

Keywords

• Headache
• cognition
• tension-type headache

References

1. 1. HeadacheClassificationCommittee of the International HeadacheSociety (IHS), The International classification of headachedisorders, 3rd edition, Cephalalgia, 2018, 38(1):1-211. doi: 10.1177/0333102417738202. PMID: 29368949..
2. 2. Global Burden of DiseaseCollaborative Network, Global Burden of DiseaseStudy 2021 (GBD 2021) Results, Seattle, United States: InstituteforHealthMetricsand Evaluation (IHME), 2022.Available fromhttps://vizhub.healthdata.org/gbd-results/.
3. 3. Steiner, T.J, Husøy, A, Stovner, L.J, GBD2021: headachedisordersand global losthealth – a focus on children, and a viewforward, J HeadachePain , 2024 25, 91.
4. 4. Michalos, A.C, Encyclopedia of quality of life andwell-beingresearch (Vol. 171). Dordrecht: Springer, Netherlands, 2014; pp 975.
5. 5. Braganza, D.L, Fitzpatrick, L.E, Nguyen, M.L, Crowe, S.F, Interictalcognitivedeficits in migrainesufferers: a meta-analysis, NeuropsycholRev, 2021.
6. 6. O'Bryant, S.E, Marcus, D.A, Rains, J.C, Penzien, D.B. Theneuropsychology of recurrentheadache, Headache, 2006, 46(9),1364-76. doi: 10.1111/j.1526-4610.2006.00579.x. PMID: 17040333.
7. 7. Rains, J.C, Davis, R.E, Smitherman, T.A, Tension-typeheadacheandsleep,CurrNeurolNeurosciRep, 2015,15:520. 8. Bag, B, Hacihasanoglu, R, Tufekci, F.G, Examinationofanxiety, hostilityandpsychiatricdisorders in patientswithmigraineandtension-typeheadache,Int J ClinPract, 2005, 59, 515–521.
8. 9. Nasreddine, Z.S, Phillips, N.A, Bédirian, V, Charbonneau, S, Whitehead, V, Collin, I, Chertkow, H, Themontrealcognitiveassessment, MoCA: a briefscreeningtoolformildcognitiveimpairment, Journal of theAmericanGeriatricsSociety, 2005, 53(4), 695-699.

9. 10. Selekler, K, Cangöz, B, Sait, U, Power of discrimination of montrealcognitiveassessment (MOCA) scale in turkishpatientswithmildcognitiveimpairementandalzheimer'sdisease, TurkishJournal of Geriatrics, 2010, 13(3).
10. 11. Stroop, J.R, Studies of interference in serialverbalreaction, J ExpPsychology, 1935, 18: 643-62.
11. 12. Spreen, O, Strauss, E, A compendium of neuropsychologicaltests: administration, norms, andcommentary, 1. Baskı, New York, NY, US, Oxford UniversityPress 1991.
12. 13. Karakaş, S, Erdoğan, E, Sak, L, Stroop testi TBAG formu: Türk kültürüne standardizasyon çalışmaları, güvenirlik ve geçerlik, Klinik Psikiyatri 1999, 2:75- 88.
13. 14. Koppitz, E. M, Thevisualauraldigit span test withelementaryschoolchildren, Journal of ClinicalPsychology, 1970, 26, 349–353.
14. 15. Karakaş, S, Yalın, A, Görsel işitsel sayı dizileri testi B formunun 13-54 yaş grupları üzerideki standardizasyon çalışması, Türk Psikoloji Dergisi, 1995, 10(34), 20-31.
15. 16. Waldie, K.E, Welch, D,Cognitivefunction in tension-typeheadache, Currentpainandheadachereports, 2007, 11, 454-460.
16. 17. Qu, P, Yu, J.X, Xia, L, Chen, G. H, Cognitiveperformanceandthealteration of neuroendocrinehormones in chronictension‐typeheadache, PainPractice, 2018, 18(1), 8-17.
17. 18. Waldie, K.E, Hausmann, M, Milne, B.J, Poulton, R, Migraineandcognitivefunction: a life-coursestudy, Neurology, 2002, 59(6), 904-908.
18. 19. Smith, A.P, Acutetension-typeheadachesareassociatedwithimpairedcognitivefunctionandmorenegativemood, Frontiers in neurology, 2016, 7, 42.
19. 20. Vuralli, D, Ayata, C, Bolay, H, Cognitivedysfunctionandmigraine, Thejournal of headacheandpain, 2018, 19(1), 109.
20. 21. O’Bryant, S.E, Marcus, D.A, Rains, J.C, Neuropsychology of migraine: Presentstatusandfuturedirections,ExpertRevNeurother, 2005, 5, 363–370.
21. 22. Meyer, J.S, Thornby, J, Crawford, K, Rauch, G.M, eversiblecognitivedeclineaccompaniesmigraineandclusterheadaches, Headache: TheJournal of HeadandFacePain, 2000, 40(8), 638-646.
22. 23. Qin, T, Chen, C, Cognitivedysfunction in migraineurs, Medicina, 2022, 58(7), 870.
23. 24. Kotb, M.A, Kamal, A.M, Al-Malki, D, Abd El Fatah, A.S, Ahmed, Y.M, Cognitiveperformance in patientswithchronictension-typeheadacheanditsrelationtoneuroendocrinehormones, TheEgyptianJournal of Neurology, PsychiatryandNeurosurgery, 2020, 56, 1-8.
24. 25. Martins, I.P, Gil‐Gouveia, R, Silva, C, Maruta, C, Oliveira, A.G, Migraine, headaches, andcognition, Headache: TheJournal of HeadandFacePain, 2012, 52(10), 1471-1482.
25. 26. Navarro‐Pérez, M.P, Bellosta‐Diago, E, Viloria‐Alebesque, A, Garrido‐Fernández, A, López‐Bravo, A, Santos‐Lasaosa, S, Cognitiveperformance in patientswithepisodicclusterheadacheoutsideand inside theactivecluster, Headache: TheJournal of HeadandFacePain, 2021, 61(1), 209-215.
26. 27. Esposito, M, Pascotto, A, Gallai, B, Parisi, L, Roccella, M, Marotta, R, Lavano, S.M, Gritti, A, Mazzotta, G, Carotenuto, M, Can headacheimpairintellectualabilities in children? An observationalstudy, Neuropsychiatr. Dis. Treat, 2012, 8, 509–513.
27. 28. Eccleston, C,Chronicpainanddistraction: an experimentalinvestigationintothe role of sustainedandshiftingattention in theprocessing of chronicpersistentpain,BehavResTher, 1995, 33:391–405.
28. 29. Moore, D.J, Keogh, E, Eccleston, C, Headacheimpairsattentionalperformance, PAIN®, 2013,154(9), 1840-1845.
29. 30. Surbakti, K.P, Melani, R, DwiPujiastuti, R.A, Associationbetweenpainintensityandcognitivefunction in primaryheadache, Pharmacia, 2023, 70(4).
30. 31. Gil-Gouveia, R, Oliveira, A.G, Martins, I.P, Cognitivedysfunctionduringmigraineattacks: A study on migrainewithout aura, Cephalalgia, 2015, 35, 662–674.
31. 32. Lee, S.H, Kang, Y, Cho, S. J, Subjectivecognitivedecline in patientswithmigraineanditsrelationshipwithdepression, anxiety, andsleepquality, Thejournal of headacheandpain, 2017, 18, 1-8.