Migren Hastalarında Empati ve Mükemmelliyetçilik

Öz

Amaç: Migren, merkezi sinir sistemini etkileyen yansımaları nedeniyle kişilik değişkenleriyle birlikte görülebilen yaygın bir baş ağrısı bozukluğudur. Araştırmanın amacı hastaların özellikleri ve migren kliniği, empati puanları ayrıca mükemmeliyetçilik puanları arasındaki ilişkiyi araştırmaktır. Yöntemler: Çalışma, kontrol grubu için (>18 yaş) 104 migrenli ve 104 sağlıklı birey ile gerçekleştirildi. Ağrıya yönelik empati “Empathy for Pain Scale” ile, mükemmeliyetçilik ise “Short Form of Perfectionism Scale” ile belirlendi. Migrenlilerin son 6 aydaki atak sıklığı, atak süresi, ailede migren öyküsü, herhangi bir kronik hastalık varlığı, profilaktik tedavi, çoklu analjezik kullanımı ve sosyodemografik özellikleri araştırıldı. Bulgular: Migrenlilerin empati yeteneği kontrol grubuna göre yüksekti (p<0,05). Çocuğu olmayan migrenlilerin empati puanı, çocuğu/çocukları olan migrenlilere göre daha yüksekti (p<0,05). Migrenlilerde mükemmeliyetçilik puanının kontrol grubuna göre biraz daha yüksek olduğu saptandı ancak kontrol grubundan farklı değildi (p>0,05). Sonuç: Migrenlilerin başkalarının acısı için hissettikleri tiksinme, kaçınma özelliklerinin yüksek (p<0,05) olması, muhtemelen bu hastaların dolaylı duyumlarının (p<0,05) ve dolaylı ağrılarının (p<0,005) artması sonucu olabilir. Aile öyküsü olmayan hastalarda atak sıklığının yüksek olması (p<0,05), migren atak sıklığında çevresel faktörlerin önemine dikkat çekmektedir. Bununla birlikte, sigara kullanan migrenlilerde, muhtemelen oksidatif stresin yüksek olması sebebiyle empati azalmış (p<0,05) ve 6 ayda atak sıklığı artmış (p<0,05) olarak tespit edilmiştir.

Anahtar Kelimeler

• migren
• empati
• mükemmelliyetçilik

Empathy and Perfectionism in Migraine

Öz

Abstract Objective: Migraine is a common headache disorder which can be seen with personality variables because of the projections effecting the central nervous system. The aim of the study is to investigate the relationship between patients’ characteristics and the migraine clinic, the empathy scores, also the perfectionism scores. Methods: The study performed with (>18 age) 104 migraineurs, and 104 healtly individuals for control group. Empathy for pain was determined via "Empathy for Pain Scale" and the perfectionism via "Short Form of Perfectionism Scale". The attack frequency in last 6 months, the duration of attacks, family history of migraine, presence of any chronic disease, prophylactic treatment, use of multiple analgesics of migraineurs and their sociodemographic characteristics were also investigated. Results: Empathy of migraineurs was high according to control group (p<0,05). The childless migraineurs had higher scores of empathy compared to migraineurs with a child/children (p<0,05). Perfectionism score in migraineurs was slightly more than the neutral option, but it was not different from the control group (p>0,05). Conclusions: Disgust, avoidance properties of migraineurs was high (p<0,05), probably because of increased vicarious sensations (p<0,05), and vicarious pain (p<0,005) of these patients. The high frequency of attacks without a family history (p<0,05) draws attention to the importance of environmental factors in the frequency of migraine attacks. Besides, probably higher oxidative stress in cigarette user migraineurs is related to decreased empathy (p<0,05), and also higher frequency of attacks in 6 months (p<0,05).

Anahtar Kelimeler

• migraine
• empathy
• perfectionism

Kaynakça

1. Anarte-Lazo E., Carvalho G.F., Schwarz A., Luedtke K., Falla D. Differentiating migraine, cervicogenic headache and asymptomatic individuals based on physical examination findings: a systematic review and meta-analysis. BMC Musculoskelet Disord., 22(1): 755, 2021. doi: 10.1186/s12891-021-04595-w.
2. Bernhardt B.C., Singer T. The neural basis of empathy. Annu Rev Neurosci, 35: 1–2, 2012. Blair R.J.R. Responding to the emotions of others: Dissociating forms of empathy through the study of typical and psychiatric populations. Conscious Cogn, 14: 698–718, 2005.
3. Brewerton T.D., George M.S. Is migraine related to the eating disorders? Int J Eat Disord., 14(1): 75-9, 1993. doi: 10.1002/1098-108x(199307)14:1<75::aid-eat2260140110>3.0.co;2-d.
4. Buse D.C., Manack A.N., Fanning K.M., Serrano D., Reed M.L., Turkel C.C., Lipton R.B. Chronic migraine prevalence, disability, and sociodemographic factors: results from the American Migraine Prevalence and Prevention Study. Headache, 52(10): 1456-70, 2012. doi: 10.1111/j.1526-4610.2012.02223.x.
5. Buyukhatipoglu H., Kirhan I., Vural M., Taskin A., Sezen Y., Dag O.F., Turan M.N., Aksoy N. Oxidative stress increased in healthcare workers working 24-hour on-call shifts. Am J Med Sci., 340(6): 462-7, 2010. doi: 10.1097/MAJ.0b013e3181ef3c09.
6. Cankaya S., Oktem E. O., Saatci O., Velioglu H.A., Uygur A.B., Ozsimsek A., Hanoglu L., Yulug, B. Paracetamol alters empathy scores in healthy and headache subjects: Functional MRI correlates. Journal of Clinical Neuroscience, 78: 215–221, 2020.
7. Cerami C., Crespi C., Bottiroli S., Santi G.C., Sances G., Allena M., Vecchi T, Tassorelli C. High perceived isolation and reduced social support affect headache impact levels in migraine after the Covid-19 outbreak: A cross sectional survey on chronic and episodic patients. Cephalalgia, 41(14): 1437-1446, 2021. doi: 10.1177/03331024211027568.
8. Cheng H., Treglown L., Green A., Chapman B.P., Κornilaki E.N., Furnham A. Childhood onset of migraine, gender, parental social class, and trait neuroticism as predictors of the prevalence of migraine in adulthood. Journal of Psychosomatic Research, 88: 54-58, 2016.

9. Chi D.S., Lin T.C., Hall K., Ha T., Li C., Wu Z.D., Soike T., Krishnaswamy G. Enhanced effects of cigarette smoke extract on inflammatory cytokine expression in IL-1β-activated human mast cells were inhibited by Baicalein via regulation of the NF-κB pathway. Clin Mol Allergy, 6(10): 3, 2012. doi: 10.1186/1476-7961-10-3.
10. Curone M., Tullo V., Lovati C. et al. Prevalence and profile of obsessive–compulsive trait in patients with chronic migraine and medication overuse. Neurol Sci, 35: 185–187, 2014. https://doi.org/10.1007/s10072-014-1767-8
11. Dallavalle G., Pezzotti E., Provenzi L., Toni F., Carpani A., Borgatti R. Migraine Symptoms Improvement During the COVID-19 Lockdown in a Cohort of Children and Adolescents. Frontiers in Neurology, 8(11): 579047, 2020. doi:10.3389/fneur.2020.579047
12. Depow G.J., Francis Z., Inzlicht M. The Experience of Empathy in Everyday Life. Psychol Sci., 32(8): 1198-1213, 2021. doi: 10.1177/0956797621995202.
13. Giffin N.J., Ruggiero L., Lipton R.B., et al. Premonitory symptoms in migraine: an electronic diary study. Neurology, 60: 935–40, 2003.
14. Goadsby P.J., Holland P. R. Pathophysiology of Migraine: An Update. Neurol Clin, 37: 651–671, 2019.
15. Gogolla N. The insular cortex. Current Biology, 27(12): 580-586, 2017.
16. Grignoli N., Petrocchi S., Bernardi S., Massari I., Traber R., Malacrida R., Gabutti L. Influence of Empathy Disposition and Risk Perception on the Psychological Impact of Lockdown During the Coronavirus Disease Pandemic Outbreak. Front Public Health, 20(8): 567337, 2021. doi: 10.3389/fpubh.2020.567337.
17. Giummarra M., Fitzgibbon B., Georgiou-Karistianis N., Beukelman M., Verdejo-Garcia A., Blumberg Z., Chou M., Gibson, S. The Empathy for Pain Scale. EJP, 19: 807-816, 2015. https://doi.org/10.1002/ejp.607
18. Gu X., Liu X., Van Dam N.T., Hof P.R., Fan J. Cognition–emotion integration in the anterior insular cortex. Cereb Cortex, 23: 20– 27, 2013a.
19. Gu X., Hof P.R., Friston K.J., Fan J. Anterior insular cortex and emotional awareness. J. Comp. Neurol., 521: 3371-3388, 2013b. https://doi.org/10.1002/cne.23368
20. Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition. Cephalalgia, 38: 1–211, 2018.
21. King-Casas B., Sharp C., Lomax-Bream L., Lohrenz T., Fonagy P., Montague P.R. The rupture and repair of cooperation in borderline personality disorder. Science, 321: 806– 810, 2008.
22. LaBerge D. Attention, awareness, and the triangular circuit. Conscious. Cogn, 6(2-3): 149–181, 1997.
23. Langdon R., DiSabella M., Strelzik J., Fletcher A. Pediatric Migraine and Academics. Pshyschological and Behavioral Aspects of Headache and Pain, 24: 40, 2020. https://doi.org/10.1007/s11916-020-00869-5 Mackes N.K., Golm D., O’Daly O.G., et al. Tracking emotions in the brain–Revisiting the Empathic Accuracy Task. NeuroImage, 178: 677–86, 2018.
24. Morrison I., Tipper S.P., Fenton-Adams W.L., Bach P. ‘Feeling’ others’ painful actions: The sensorimotor integration of pain and action information. Hum Brain Mapp, 34: 1982–1998, 2012.
25. Mungoven T.J., Henderson L.A., Meylakh N. Chronic Migraine Pathophysiology and Treatment: A Review of Current Perspectives. Front Pain Res (Lausanne), 25(2): 705276, 2021. doi: 10.3389/fpain.2021.705276.
26. Oguz-Akarsu E., Baykan B., Ertaş M., Zarifoğlu M., Kocasoy O.E., Saip S., Siva A., Önal A. E., Karlı N. Sex Differences of Migraine: Results of a Nationwide Home-based Study in Turkey. Arch. Neuropsychiatry, 57: 126−130, 2020. Preis M.A., Kroener-Herwig B. Empathy for pain: The effects of prior experience and sex. Eur J Pain, 16: 1311–1319, 2012.
27. Pelzer N., Louter M.A., van Zwet E.W., Nyholt D.R., Ferrari M.D., van den Maagdenberg A.M., et al. Linking migraine frequency with family history of migraine. Cephalalgia, 39(2): 229–36, 2019.
28. Reniers R., Corcoran R., Drake R., Shryane N.M., Vollm B.A. The QCAE: A questionnaire of cognitive and affective empathy. J Pers Assess, 93: 84–95, 2011.
29. Rice K.G., Richardson C.M.E., Tueller S. The short form of the revised almost perfect scale. Journal of personality assesment, 96(3): 368-379, 2014.
30. Robert C., Bourgeais L., Arreto C.D., et al. Paraventricular hypothalamic regulation of trigeminovascular mechanisms involved in headaches. J Neurosci, 33(20): 8827–40, 2013.
31. Seth A. K., Suzuki K., Critchley H. D. An interoceptive predictive coding model of conscious presence. Frontiers in psychology, 2: 395, 2012. https://doi.org/10.3389/fpsyg.2011.00395
32. Sarwar H., Rafiqi S.I., Ahmad S., Jinna S., Khan S.A., Karim T., Qureshi O., Zahid Z.A., Elhai J.D., Levine J.C., Naqvi S.J., Jaume J.C., Imam S. Hyperinsulinemia Associated Depression. Clinical medicine insights Endocrinology and diabetes, 15: 11795514221090244, 2022. https://doi.org/10.1177/11795514221090244
33. Schulte L.H., May A. The migraine generator revisited: continuous scanning of the migraine cycle over 30 days and three spontaneous attacks. Brain, 139: 1987–93, 2016.
34. Schulte L.H., Allers A., May A. Visual stimulation leads to activation of the nociceptive trigeminal nucleus in chronic migraine. Neurology, 29: 90(22), e1973-e1978, 2018. doi: 10.1212/WNL.0000000000005622.
35. Stovner L.J., Hagen K., Jensen R., Katsarava Z., Lipton R.B., Scher A.I., Steiner T.J., Zwart J-A. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia, 27: 193-210, 2007. doi: 10.1111/j.1468-2982.2007.01288.x
36. Stankewitz A., Schulz E. Intrinsic network connectivity reflects the cyclic trajectory of migraine attacks. Neurobiology of pain (Cambridge, Mass.), 11: 100085, 2022. https://doi.org/10.1016/j.ynpai.2022.100085
37. Strumila R., Nobile B., Korsakova L., et al. Psilocybin, a Naturally Occurring Indoleamine Compound, Could Be Useful to Prevent Suicidal Behaviors. Pharmaceuticals (Basel), 14(12): 1213, 2021. doi:10.3390/ph14121213
38. Tuncel D., Inanc Tolun F., Gokce M., Imrek S., Ekerbiçer H. Oxidative stress in migraine with and without aura. Biol Trace Elem Res, 126(1-3): 92-7, 2008. doi: 10.1007/s12011-008-8193-9
39. Viana M., Sances G., Linde M., et al. Clinical features of migraine aura: Results from a prospective diary-aided study. Cephalalgia, 37: 979–89, 2017.
40. Wager T.D., Rilling J.K., Smith E.E., Sokolik A., Casey K.L., Davidson R.J., Kosslyn S.M., Rose R.M., Cohen J.D. Placebo-induced changes in FMRI in the anticipation and experience of pain. Science, 303: 1162– 1167, 2004. Wendt, J.S. Stress and migraine – hyperempathy. Headache, 50(4): 675, 2010. doi:10.1111/j.1526-4610.2010.01641.x.
41. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Retrieved March 15, 2017, from http://www.sls.se/PageFiles/229/helsingfors.pdf, 2008.
42. Wright A., Fisher P.L., Baker N., O'Rourke L., Cherry M.G. Perfectionism, depression and anxiety in chronic fatigue syndrome: A systematic review. Journal of Psychosomatic Research, 140: 110322, 2020. doi: 10.1016/j.jpsychores.2020.110322.
43. Xu S., Yu L., Luo X., Wang M., Chen G., Zhang Q., Liu W., Zhou Z., Song J., Jing H., Huang G., Liang F., Wang H., Wang W. Manual acupuncture versus sham acupuncture and usual care for prophylaxis of episodic migraine without aura: multicentre, randomised clinical trial. BMJ, 368:m697, 2020. doi: 10.1136/bmj.m697.
44. Yıldız D., Uzunsakal E. Alan Araştırmalarında Güvenilirlik Testlerinin Karşılaştırılması ve Tarımsal Veriler Üzerinden Bir Uygulama. Uygulamalı Sosyal Bilimler Dergisi, 1, 2018.
45. Younis S., Hougaard A., Noseda R., Ashina M. Current understanding of thalamic structure and function in migraine. Cephalalgia, 39(13): 1675–1682, 2019.
46. Zaki J., Davis J.I., Ochsner K.N. Overlapping activity in anterior insula during interoception and emotional experience. Neuroimage, 62: 493– 499, 2012.