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Ability To Cope With Chronic Pain Puts Migraine Surgery Patients In Perspective
Lisa Gfrerer, MD PhD, Heather R. Faulkner, MD MPH, William G. Austen, Jr., MD.
Massachusetts General Hospital, Boston, MA, USA.

PURPOSE: Migraine surgery candidates are chronic pain patients. However, chronic pain analysis tools are not typically applied to migraine surgery patients. This is the first migraine study to include the Pain Self Efficacy Questionnaire (PSEQ), which is used to determine patients’ pain coping abilities. It is an important predictor of pain intensity/disability in patients with musculoskeletal pain. METHODS: Forty patients prospectively completed Migraine Headache Index, Migraine Disability Assessment Score (MIDAS) and PSEQ preoperatively, and 12 months postoperatively. Scores were evaluated using paired t-tests and Pearson correlation. PSEQ scores were compared to other chronic pain conditions. RESULTS: All scores improved significantly from baseline (Table1). Mean preoperative migraine PSEQ score was 19±11, the poorest pain coping score reported in the literature. Mean postoperative migraine PSEQ improvement was 105%(39±22), which was the highest of those compared (Figure1). CONCLUSIONS:MIDAS is suboptimal to describe disability in our patients due to a mean preoperative score of 102, as severe disability is defined as 21+. PSEQ successfully demonstrates extent of disability in this patient population and puts migraine surgery in perspective to other known pain treatments. It further evaluates functional outcome, rather than just improvement in symptoms. This significantly adds to our understanding of this patient population.

Mean MHI/ MIDAS/ PSEQ scores preoperatively and at 12 months postoperatively. Abbreviations: MH= mig
Preop Mean±SDPostop (12m) Mean±SDp value Preop vs. Postop
MH frequency (days per month)20.6±8.75.3±6.9<0.0001
MH duration (hours)15.7±8.97.23±8.5<0.0001
MH pain (scale of 0-10)8.3±1.64.7±3.2<0.0001
MHI (fre x dur x pain)118±10019±33 (-84%)<0.0001
MIDAS score102±9344±68<0.0025
PSEQ score19±1139±22 (+105%)<0.0001

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