- 한국인 인구집단에서 교육수준이 긴장형두통의 유병률에 미치는 영향
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Dong-Won Lee, Yang-Ki Minn, Min Kyung Chu, Kyung-Mi Oh, Byung-Kun Kim, Kwang Soo Lee, Soo-Jin Cho
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Korean J Headache. 2011;12(1):57-60. Published online June 30, 2011
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- Objective: Education reflects socioeconomic status and may influence pain modulation or thresholds in primary headache disorders. Tension-type headache(TTH) is the most common type of primary headache and the influence of education on the prevalence of TTH has not been well evaluated. The aims of this study were to evaluate the asso- ciation between education level and the prevalence of TTH and the influence of other contributors. Methods: For this study, a stratified random population sample of Koreans, over the age of 19, was selected and evalua- ted using a 12-item, semi-structured interview designed to identify headache type using ICHD-2 criteria. Education levels were classified into college, high school, and middle school or below. Household income and occupation were evaluated as contributors. Results: Among 1507 participants, 463(30.7%) were diagnosed with TTH; 228 were frequent episodic TTH, 224 were infrequent episodic TTH, and 11 were chronic TTH. College level was associated with a lower prevalence of tension-type headache(25.8% vs 33.8% in high school, 32.9% in middle school or below, p=0.006). Prevalence of frequent episodic TTH was lower in college graduate(p=0.002). After adjusting age, gender, and income, education level is the significant contributor for prevalence of TTH. Conclusions: Among variables of socioeconomic status, education is the important modulator of TTH, especially in women.
- 한국인 인구집단에서 고빈도 삽화성 긴장형두통의 영향
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Soo-Jin Cho, Min Kyung Chu, Byung-Kun Kim, Jae-Myun Chung, Kwang Soo Lee
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Korean J Headache. 2010;11(2):91-94. Published online December 31, 2010
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- Background
Frequent episodic tension-type headache (ETTH) is a subtype of tension-type headache (TTH) based upon ICHD-2 criteria. ETTH is generally considered as mild primary headache disorder but the impact of frequent ETTH has not been evaluated separately from infrequent ETTH. Therefore, this study evaluated the impact of frequent ETTH. Method: For this study, a stratified random population sample of Koreans, over the age of 19, was selected and evaluated using a 12-item, semi-structured interview designed to identify headache type using ICHD-2 criteria. The burden of the headache was evaluated by the headache impact test-6 (HIT-6). Results: Among 1507 participants, 463 (30.7%) were diagnosed with TTH; 228 were diagnosed with frequent ETTH, 224 were infrequent ETTH, and 11 were chronic TTH. Thirty-two patients (6.9%) with TTH had substantial to severe impact in HIT-6 (≥56); 22 had frequent ETTH, 7 had infrequent TTH, and 3 had chronic TTH (p<0.01). Frequent TTH, severity of pain by visual analogue scales, aggravation with physical activity, moderate or severe intensity, and phonophobia influenced on total scores of HIT-6. Conclusion: Frequent ETTH is a common headache disorder and had significant impact, so medical and social attentions are promptly needed.
- 만성 긴장형두통 환자들에서 두통으로 인한 활동 무능에 기여하는 인자들에 관한 연구
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Jeong Wook Park, Kwang Soo Lee
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Korean J Headache. 2006;7(1):31-36. Published online June 30, 2006
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- Objective: To evaluate the impact of headache variables, such as frequency, intensity, duration of attack episode and demographics on functional disability in chronic tension-type headache patients.
Background: Chronic tension-type headache does not reduce life expectancy, but it can have considerable impact on functional disability and socioeconomic status. R eduction of headache related disability is one of the m ain treatm ent goals in the m anagement of headaches. Therefore, it is essential to understand w hich headache characteristics contribute to headache related disability.
Methods
D ata from patients w ith chronic tension-type headache (n = 109) were used to evaluate the relationship between headache variables (frequency, pain intensity, duration of attack), headache related demographics (age, duration of headache illness, analgesics consumption) and headache related functional disability. The patients w ere divided into different groups based on each variable. Headache related functional disability was assessed as scores on the activity interference scale of three aspects of daily living and m issing days due to headache.
Results
In this study, higher average pain intensity w as significantly associated w ith m ore severe headache related disability. A lthough there was a tendency for patients w ith the higher frequency, longer duration attack of headache to show severe disability, these w ere not statistically significant. M ultiple regression analysis revealed that average pain intensity is only significant predictor of headache related disability.
Conclusions
For chronic tension-type headache, headache intensity appears to be a major determinant of headache related disability, while headache frequency w as not clearly related to disability. A ccording to our findings, effective symptomatic medication that can stop headache before it reaches high intensity would have great potential to reduce headache related disability and headache attacks w ith severe intensity should not be underestimated even if they are infrequent. Korean Journal of Headache 7(1):31-30, 2006
- 일반연제-Catechol-O-methyltransferase Gene polymorphism of Migraine Without Aura in Korean Population
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Jeong Wook Park , Kwang Soo Lee
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Korean J Headache. 2005;6(1):107-107. Published online June 30, 2005
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- Background
Following the first clinical and pharmacological suggestion of altered dopaminergic neu- rotransmission in migraine, recent genetic association studies have addressed the possible genetic role of the dopaminergic system in migraine. COMT(Catechol-O-methyltransferase) is an enzyme which play a crucial role in the metabolism of dopamine. This genetic polymorphism is associated with 3～4 fold variation of enzymatic activity. So change in their activity could participated in migraine pathogenesis and its clinical phenotype. Objectives: We assessed the role of the COMT enzyme polymorphism in the genetic susceptibility to migraine and their phenotypical expression in Korean population. Methods: The 77 migraine without aura and 94 healthy volunteers were included in the study. The analysis of COMT polymorphism was performed using PCR. After amplifying COMT genes by PCR and assessed genotype and allele by restriction fragment length polymorphism(RFLP). Results: Result of chi-square statistical analysis indicated that the genotype frequency and allele distri- bution was not different between migraine without aura and control group. Compared to individuals with H/H genotype, migraineurs with L allele showed more severe pain intensity(p=0.001) and over represen- ted the associated nausea/vomiting symptom during migraine attack(94% vs 75%: p=0.031) compared those without L allele. Conclusion: Altered dopaminergic activity due to polymorphism of COMT gene may be one of the mechanisms involved in the contribution to the pain intensity of attack and dopamine related symptom although this polymorphism does not appear to be involved in a genetic predisposition to development of migraine without aura.
- Genetically Determined Serotonergic Tone Contribute to Development of Analgesics Overuse in Chronic Tension-Type Headache
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Jeong Wook Park, Joong Seok Kim, Yeong In Kim, Kwang Soo Lee
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Korean J Headache. 2004;5(1):104-104. Published online June 30, 2004
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- Background
Approximately one half of all patients with chronic daily headache report an associated regular use of analgesics, making the issue of an important public health matter. But the analysis of factors related to the development to analgesics overuse in chronic tension-type headache remain poorly unders- tood. We tried to establish the role played by chronic analgesics exposure in the natural course and clinical phenotype of headache in patients of chronic tension-type headache. And we also evaluated genetically determined innate factor that could exert a profound influence in development of analgesics overuse using serotonin transporter protein polymorphism and serotonergically related harm avoidance(HA) personality dimension. Methods: We surveyed headache characteristics via a standardized questionnaire in 38 patients with chronic tension-type headache with analgesics overuse(CTTH-AO) and in 40 patients with chronic tension- type headache with analgesics non-overuse(CTTH-NO), and in 100 healthy controls. We amplified sero- tonin transporter protein gene linked polymorphic region(5-HTTLPR) by means of polymerase chain reaction and performed genotype polymorphism analyses and investigated the serotonin related personality trait by evaluating the HA dimension in tridimensional personality questionare(TPQ). Results: We found significantly higher pain intensity and disability score in patients with CTTH-AO. Most of patients with CTTH-AO used caffeine contained compound analgesics as for instant pain relief drugs. There was excess frequency of the short allele and a different genotype distribution in patients with CTTH-AO. S/S genotype frequency was higher in patients with CTTH-AO(83%) than in those with CTTH-NO(74%) and controls(59%; P = 0.02). TPQ questionnaires showed significantly higher HA scores in both CTTH-AO(22.35.4) and CTTH-NO(19.96.7) compared with controls(16.36.1). In those of chronic tension-type headache, individuals with S/S allele have significantly higher frequency of analgesics usage (13.3/month) than with S/L, L/L allele(7.0/month). Conclusions: This suggests a serotonergic activity might be involved in development of analgesics over- use in chronic tension-type headache, and 5-HTTLPR might be one of the genetically contributing factors. Korean Journal of Headache 5(1):104-104, 2004
- 편두통과 성호르몬
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Jeong Wook Park, Kwang Soo Lee
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Korean J Headache. 2004;5(1):65-74. Published online June 30, 2004
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- The usual woman life cycle is associated with carefully orchestrated hormonal milestones: Menarche, pregnancy, oral contraceptive use, menopause, and the use of replacement sex hormone. All these events alter the sex hormones and may cause a change in the migraine. There is a variety of evidence on the relationship between migraine and sex hormones. Before menarche, there seems to be no differences in the prevalence of migraine between girls and boys. But after puberty, women with migraine begin to outnumber men by at least 3～5 times and definite changes of patterns of attacks are noted at menstrual period, related pregnancy, at menopause. The hormone treatment can change the migraine attack. This paper also suggests the approaches to the management of hormone related migraine associated with oral contraceptives and hormone replacement therapy. Korean Journal of Headache 5(1):65-74, 2004
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