Comparison and predictors of chronic migraine vs. new daily persistent headache presenting with a chronic migraine phenotype

Objective To compare the clinical phenotype of patients with chronic migraine (CM) to patients with new daily persistent headache of the chronic migraine subtype (NDPH-CM). Methods A study was conducted of CM (n = 257) and NDPH-CM (n = 76) from a tertiary headache center in the UK, and in the US of patients with daily CM (n = 60) and NDPH-CM (n = 22). Results From the UK cohort, the age of first headache onset was lower in CM (mean +/- SD: 16 +/- 12 years) than in NDPH-CM (mean +/- SD: 23 +/- 14 years; p < 0.001). There was a greater number of associated migrainous symptoms in CM compared to NDPH-CM (median and interquartile range: 6, 5-8 vs. 5, 4-7; p < 0.001). A family history of headache was more common in CM compared to NDPH-CM (82%, 202/248, vs. 53%, 31/59; p < 0.001). In the US cohort there were no differences. Osmophobia (B = -1.08; p = 0.002) and older age at presentation to the clinic (B = -0.06; p = 0.001) were negative predictors of NDPH-CM. Conclusion NDPH-CM is relatively less migrainous than CM in the UK cohort. Family history of headache is less common in NDPH-CM, with negative predictors for NDPH-CM including osmophobia and older age of presentation to the clinic. More work is required to understand the chronic migraine phenotype of new daily persistent headache.

Automated summary

This study compared the clinical phenotype of chronic migraine (CM) patients to patients with the chronic migraine subtype of new daily persistent headache (NDPH-CM). The UK cohort showed that CM patients had an earlier age of first headache onset, more associated migrainous symptoms, and a higher prevalence of a family history of headache compared to NDPH-CM patients. No differences were found in the US cohort. Osmophobia and older age at presentation were negative predictors of NDPH-CM.