Can Headache Profile Predict Future Disability A Cohort Study

Objective: The aim of this study was to determine if headache profile can predict future disability in patients with tension-type headache (TTH). Materials and Methods: Eighty-three individuals with TTH were recruited. To be included in the study participants needed to fulfill the International Headache Society classification's criteria for episodic or chronic TTH form and to be at least 18 years old. Baseline clinical outcomes (headache and neck-related disability, kinesiophobia, self-efficacy, and anxiety) and physical outcomes (neck extensors muscles maximum voluntary contraction) were collected for all participants. A prospective data collection of headache characteristics (intensity and frequency) was conducted using daily SMS or e-mail over a 1-month period. Headache-related disability was assessed at the 3-month follow-up and was used as the disability criterion for TTH. Results: Correlations showed that the number of years with headache (r=0.53,P<0.001), self-reported neck pain intensity (r=0.29,P=0.025), headache frequency (r=0.60,P<0.001) and intensity (r=0.54,P<0.001), anxiety (r=0.28;P=0.031), as well as neck-related disability (r=0.64,P<0.001) were correlated to headache-related disability assessed at 3 months. Multiple regression showed that these determinants can be used to predict headache disability (R-2=0.583). Headache frequency (beta=0.284) was the best individual predictor. Discussion: Results showed that TTH frequency and intensity and the presence of concomitant infrequent migraine are predictors of future disability over a 3-month period. Further studies are needed to evaluate the contribution of other potential physical outcomes on headache-related disability.