“Border Zone” Between Episodic and Chronic Migraine Explored in Research by Montefiore Headache Center 

There is a great deal of similarity between those with high frequency episodic migraines with those who have chronic migraines such as similar “sociodemographic characteristics, headache-related disability and a host of problems like chronic pain, psychiatric comorbidities and medical comorbidities”according to a study done by the American Migraine Prevalence and Prevention (AMPP) Study by researchers at the Montefiore Headache Center in the Bronx, N.Y and Vedanta Research in Chapel Hill, NC. Those who ride the border-line, with high-frequency episodic migraines (HFEM) have about 10-14 migraine days per month whereas chronic migraineurs (CM) have more than 15 migraine days per month. Episodic migraineurs with less than day migraine days per month are considered low-frequency episodic migraine (LFEM). The study analyzed data from 18,500 respondents to the AMPP of them 10,609 had LFEM, 640 with HFEM and 655 with CM.

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“Researchers found respondents with HFEM and CM reported significantly lower household income levels, were less likely to be employed full time and were more likely to be occupationally disabled compared to those with LFEM. Data also showed as headache frequency increased, so did diagnoses of anxiety, depression and bipolar disorder. Rates of chronic pain also increased and were significantly higher in those with HFEM and CM. Additionally, patients with HFEM and CM reported higher rates of cardiovascular and pulmonary diseases, such as asthma, bronchitis, heart disease and stroke, compared to those with LFEM. Significant differences were not seen between those with CM and HFEM on most variables.”

““These data suggest a substantial biological overlap between HFEM and CM,” said Richard B. Lipton, M.D., director, Montefiore Headache Center, and professor and vice-chair of Neurology, Albert Einstein College of Medicine of Yeshiva University. “It is apparent, based on these findings, that people living in this “border zone” of high-frequency episodic migraine face a similar burden as those with chronic migraine. There is a need for additional treatment options for people with HFEM who in many ways experience similar challenges to those with chronic migraine.””

I can see why the Impact would be similar at high episodic levels. It is a lot of migraines to deal with there. And at that level, you certainly start to live with a severe impact.

I lived in the border zone for a time so I can honestly agree the impact is very similar. So similar I cannot tell you the difference to tell you the truth. Because for a time I didn’t know my menstrual migraines were migraines so when I went into chronic migraines is really hard to say… so obviously there was no change in impact. All I can say is when my migraines with aura went into chronic migraines and then, in fact, I would have been well into chronic migraines… and way over the borderline. The only difference in regards to impact was when I began to work full time and my sleep issues began to seriously impact my migraines and they went from well about I guess 20 to daily, then back to 20 with the best treatment I ever had, then back to daily again. So daily, working full time, with little pain management… that makes a difference. But the impact from HFEM and CM I think we are really in the same boat, to be honest… and one that can easily rock the wrong way.

See more on migraine:

Research shows fibromyalgia and migraine can worsen depression

Chronic migraine: Topamax to blame for brain drain?

Migraine botox study

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