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CC BY 4.0 · Arq Neuropsiquiatr 2023; 81(09): 795-802
DOI: 10.1055/s-0043-1772603
Original Article

Clinical characteristics of headaches in an urban Mennonite group in South Brazil

Características clínicas das cefaleias em um grupo menonita urbano do sul do Brasil
David Lemke Dück 
1   Universidade Federal do Paraná, Setor de Ciências da Saúde, Curitiba PR, Brazil.
,
Marco Antonio Takashi Utiumi 
2   Clínica de Neurologia São José, Centro de Cefaleia, São José dos Pinhais PR, Brazil.
,
Angelica Beate Winter Boldt 
3   Universidade Federal do Paraná, Departamento de Genética, Curitiba PR, Brazil.
,
Elcio Juliato Piovesan 
2   Clínica de Neurologia São José, Centro de Cefaleia, São José dos Pinhais PR, Brazil.
4   Universidade Federal do Paraná, Departamento de Clínica Médica, Curitiba PR, Brazil.
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Abstract

Background Genetic variants play a pathophysiological role in headaches, especially in migraine. The Mennonite group (MG) has been geographically and genetically isolated throughout its history, harboring a distinctive distribution of diseases.

Objective To determine the characteristics of headaches in a group with direct Mennonite ancestry contrasting with other urban community members (control group [CG]).

Methods Subjects with headaches were asked to complete a questionnaire covering: the type of headache, presence of aura, frequency and duration of attacks, pain location and severity, analgesic consumption, premonitory and postdromic manifestations, Depressive Thoughts Scale, Epworth Sleepiness Scale (ESS), General Anxiety Disorder-7, Patient Health Questionnaire-9 (PHQ-9), Migraine Disability Assessment, and Composite Autonomic System Score.

Results We included 103 participants (CG: 45, Mennonite group [MG]: 58). Migraine was the most common headache (CG: 91.1%; MG: 81.0%; p = 0.172), followed by tension-type headache (CG: 8.9%; MG: 15.5%; p = 0.381). Aura was identified by 44.4% and 39.7% in the CG and MG, respectively (p = 0.689). The groups differed only concerning the frequency of retro-orbital pain (CG: 55.6%; MG: 32.8%; p = 0.027), PHQ-9 (CG: median 7, range 0 to 22; MG: median 5, range 0 to 19; p = 0.031) and ESS (CG: median 0, range 0 to 270; MG: median 0, range 0 to 108; p = 0.048) scores.

Conclusion There were no major differences in the prevalence and clinical characterization of headaches between the MG and the CG. However, the latter showed more diffuse pain, sleepiness, and depressive symptoms. Specific genetic or epigenetic variants in Mennonite descendants might account for these differences.

Resumo

Antecedentes Variantes genéticas desempenham um papel fisiopatológico nas cefaleias, especialmente na migrânea. O grupo menonita (GM) tem estado geográfica e geneticamente isolado ao longo de sua história, abrigando uma distribuição distinta de doenças.

Objetivo Determinar as características das cefaleias em um grupo com ascendência menonita direta, comparando-as com as de outros membros da comunidade urbana (grupo controle [GC]).

Métodos Participantes com cefaleia foram convidados a preencher um questionário abrangendo: tipo de cefaleia; presença de aura; frequência e duração dos ataques; localização e gravidade da dor; consumo de analgésicos; manifestações premonitórias e posdrômicas; Escala de Pensamentos Depressivos; Escala de Sonolência de Epworth (ESS); Transtorno de Ansiedade Geral-7 (GAD-7); Questionário de Saúde do Paciente-9 (PHQ-9); Avaliação de Incapacidade da Migrânea (MIDAS) e Escore do Sistema Autônomo Composto (COMPASS-31).

Resultados Incluímos 103 participantes (GC: 45, GM: 58). A migrânea foi a cefaleia mais frequente (GC: 91,1%; GM: 81,0%; p = 0,172), seguida pela cefaleia tensional (GC: 8,9%; GM: 15,5%; p = 0,381). Aura foi identificada por 44,4% e 39,7% nos GC e GM, respectivamente (p = 0,689). Os grupos diferiram apenas com relação à frequência de dor retro-orbitária (GC: 55,6%; GM: 32,8%; p = 0,027), PHQ-9 (GC: mediana 7, amplitude 0 a 22; GM: mediana 5, amplitude 0 a 19; p = 0,031) e ESS (GC: mediana 0, amplitude 0 a 270; GM: mediana 0, amplitude 0 a 108; p = 0,048).

Conclusão Não houve diferenças significativas na prevalência e caracterização clínica das cefaleias nos GM e GC. Entretanto, o último grupo mostrou mais dor difusa, sonolência e sintomas depressivos. Variantes genéticas ou epigenéticas específicas em descendentes de menonitas podem justificar tais diferenças.

Keywords

Reproductive Isolation - Migraine Disorders - Urban Population - Headache

Palavras-chave

Isolamento Reprodutivo - Transtornos de Enxaqueca - População Urbana - Cefaleia

Authors' Contributions

DLD: Conceptualization, data curation, formal analysis, investigation, methodology, writing – original draft, writing – review and editing; MATU: Conceptualization, formal analysis, writing – original draft, writing – review and editing; ABWB: Conceptualization, funding acquisition, investigation, methodology, supervision, writing – original draft, writing – review and editing; EJP: Conceptualization, investigation, methodology, project administration, supervision, writing – original draft, writing – review and editing.


Support

ABWB received a research productivity scholarship from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, in the Portuguese acronym) (protocol number: 314288/2018-0).




Publication History

Received: 13 March 2023

Accepted: 26 May 2023

Article published online:
04 October 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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