Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20220028-en
Brazilian Journal of Pain
Review Article

Comorbidity between chronic headache and depression treated with botulinum toxin: literature review

A comorbidade entre cefaleia crônica e depressão tratada com toxina botulínica: revisão da literatura

Denis Eduardo Bertini Bo; Eduardo de Melo Carvalho Rocha

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Abstract

BACKGROUND AND OBJECTIVES: It is estimated that up to 40% of patients with migraine have at least one episode of major depression during their lifetime. On the other hand, patients with depression are twice as likely to suffer from migraine when compared to the population without the mood disorder. The comorbidity of both conditions increases the frequency of pain crises and the individual’s disability. A therapy that could act on the disorders, when simultaneous, would offer advantages through a broader and more effective action, such as botulinum toxin (BTX). Due to the lack of a clear definition on the subject, the objective of this study was to review how the concomitant treatment with BTX of the two morbidities behaves.

CONTENTS: A review of articles in English, Portuguese, and Spanish indexed in Pubmed/Medline, LILACS and Scielo databases was carried out. Of the eight articles selected, most individuals were women aged 40 to 50 years. The sample size ranged from 30 to 715 subjects. The predominance was of prospective studies. All studies found a significant reduction in pain. Six studies found a significant decrease in depression. The frequency of adverse effects ranged from 4.1% to 30%, with eyelid ptosis and headache being the most frequent.

CONCLUSION: BTX seems to be useful for the treatment of chronic headache and depression. There was a tendency to relate the improvement in depression with the decrease in pain. The specific action of the toxin in the treatment of depression was inconclusive. New studies, with high methodological rigor, as well as systematic reviews, should be carried out to reach a greater depth of comprehension of the subject and to determine the real efficacy of BTX in relieving concomitant headache and depression.

Keywords

Depression, Botulinum toxins type A, Disorder headache

Resumo

JUSTIFICATIVA E OBJETIVOS: Estima-se que até 40% dos pacientes com migrânea apresentam, pelo menos, um episódio de depressão maior ao longo da vida. Por outro lado, pacientes com depressão apresentam duas vezes mais chance de ter migrânea quando comparados à população sem transtorno de humor. A comorbidade dos dois quadros aumenta a frequência das crises de dor e a incapacidade do indivíduo. Uma terapêutica que pudesse agir nos transtornos, quando simultâneos, ofereceria vantagens, por uma ação mais ampla e eficaz, a exemplo da toxina botulínica (TXB). Por faltar ainda uma clara definição sobre o tema, o objetivo deste estudo foi revisar como se comporta o tratamento concomitante das duas morbidades com a TXB.

CONTEÚDO: Foi realizada revisão de artigos indexados nas bases de dados Pubmed/Medline, LILACS, Scielo nos idiomas inglês, português e espanhol. Dos oito artigos selecionados, a maioria dos indivíduos foram mulheres de 40 a 50 anos. O tamanho das amostras variou de 30 a 715 pacientes. A predominância foi de estudos prospectivos. Todos os estudos encontraram redução significativa da dor. Seis trabalhos encontraram diminuição significativa da depressão. A frequência dos efeitos adversos variou de 4,1% a 30%, sendo ptose palpebral e dor de cabeça os mais frequentes.

CONCLUSÃO: A TXB parece ser útil para tratamento da cefaleia crônica e depressão. Houve uma tendência a relacionar a melhora da depressão com a diminuição da dor. A ação específica da toxina no tratamento da depressão foi inconclusiva. Novos estudos, com alto rigor metodológico, assim como revisões sistemáticas, deve ser realizados para alcançar maior aprofundamento do assunto, a fim de determinar a real eficácia da TXB no alívio da cefaleia e depressão concomitantes.

Palavras-chave

Depressão, Toxina botulínica tipo A, Transtornos de enxaqueca

References

Teixeira AL, Gomez RS. Cefaleias na prática clínica. 2017.

Zukerman E. Cefaleia e qualidade de vida. Einstein. 2004;2(Suppl 1):S73-5.

Relatório sobre a saúde no mundo. Saúde mental: nova concepção, nova esperança. 2001.

Krymchantowski AV. Condutas em cefaleias. 2008.

Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335-43.

Krishnan RRK, France RD, Pelton S, McCann UD, Davidson J, Urban BJ. Chronic pain and depression. II. Symptoms of anxiety in chronic low back pain patients and their relationship to subtypes of depression. Pain. 1985;22(3):289-94.

Bair MJ, Robinson RL, Katon W, Kroenke K. Depression and pain comorbidity: a literature review. Arch Intern Med. 2003;163(20):2433-45.

Gallagher RM, Verma S. Managing pain and comorbid depression: a public health challenge. Semin Clin Neuropsychiatry. 1999;4(3):203-20.

Fields HL. Pain modulation: expectation, opioid analgesia and virtual pain. Prog Brain Res. 2000;122:245-53.

Levenson JL, Hamer R, Silverman JJ, Rossiter L F. Psychopathology in medical inpatients and its relationship to length of hospital stay: a pilot study. Int J Psychiatry Med. 1986;16(3):231-6.

Merikangas KR, Stevens DE, Angst J. Psychopathology and headache syndromes in the community. Headache. 1994;34(8):S17-22.

Mercante J P, Peres M F, Guendler V, Zukerman E, Bernik MA. Depression in chronic migraine: severity and clinical features. Arq Neuropsiquiatr. 2005;63(2A):217-20.

McLean G, Mercer S W. Chronic migraine, comorbidity, and socioeconomic deprivation: cross-sectional analysis of a large nationally representative primary care database. J Comorb. 2017;7(1):89-95.

Moschiano F, D’Amico D, Canavero I, Pan I, Micieli G, Bussone G. Migraine and depression: common pathogenetic and therapeutic ground?. Neurol Sci. 2011;32(^sSuppl 1):S85-8.

Breslau N, Davis GC, Schultz LR, Peterson EL. Joint 1994 Wolff Award Presentation. Migraine and major depression: a longitudinal study. Headache. 1994;34(7):387-93.

Sadock B, Sadock VA, Ruiz P. Compêndio de psiquiatria: ciência do comportamento e psiquiatria clínica. 2017.

Manual diagnóstico e estatístico de transtornos mentais. 2014.

Martins NM, Oliveira OWB, Dutra LQ, Rezende AQM, Dantas EF, Pereira ABC. Migrânea com aura, qualidade de vida e tratamento: um relato de caso. Rev Saúde. 2010;1(1):15-24.

Natoli JL, Manack A, Dean B, Butler Q, Turkel CC, Stovner L, Lipton RB. Global prevalence of chronic migraine: a systematic review. Cephalalgia. 2010;30(5):599-609.

Buse DC, Silberstein SD, Manack AN, Papapetropoulos S, Lipton RB. Psychiatric comorbidities of episodic and chronic migraine. J Neurol. 2013;260(8):1960-9.

Antilla V, Bulik-Sullivan B, Finucane HK, Walters RK, Bras J, Duncan L, Escott-Price V. Analysis of shared heritability in common disorders of the brain. Science. 2018;360(6395).

Ligthart L, Nyholt DR, Penninx BW, Boomsma DI. The shared genetics of migraine and anxious depression. Headache. 2010;50(10):1549-60.

Schur EA, Noonan C, Buchwald D, Goldberg J, Afari N. A twin study of depression and migraine: evidence for a shared genetic vulnerability. Headache. 2009;49(10):1493-502.

Marino E, Fanny B, Lorenzi C, Pirovano A, Franchini L, Colombo C. Genetic bases of comorbidity between mood disorders and migraine: possible role of serotonin transporter gene. Neurol Sci. 2010;31(3):387-91.

Duailibi K. Depressão e seus impactos. 2018.

Tsuji SR, Carvalho SD. Aspectos psíquicos das cefaleias primárias. Rev Neuroci. 2002;10(3):129-36.

Haque B, Rahman KM, Hoque A, Hasan AT, Chowdhury RN, Khan SU. Precipitating and relieving factors of migraine versus tension type headache. BMC Neurol. 2012;12:82.

Lipp M, Malagris L. O stress emocional e seu tratamento. Terapias cogntivo-comportamentais: um diálogo com a psiquiatra. 2001:475-89.

Ebrecht M, Hextall J, Kirtley LG, Taylor A, Dyson M, Weinman J. Perceived stress and cortisol levels predict speed of wound healing in healthy male adults. Psychoneuroendocrinology. 2004;29(6):798-809.

McEwen BS. Protective and damaging effects of stress mediators. N Engl J Med. 1998;338(3):171-9.

Doan L, Manders T, Wang J. Neuroplasticity underlying the comorbidity of pain and depression. Neural Plast. 2015;2015:504691.

Maizels M, Aurora S, Heinricher M. Beyond neurovascular: migraine as a dysfunctional neurolimbic pain network. Headache. 2012;52(10):1553-65.

Lynch ME. Antidepressants as analgesics: a review of randomized controlled trials. J Psychiatry Neurosci. 2001;26(1):30-6.

Von Korff M, Dworkin S F, Le Resche L, Kruger A. An epidemiologic comparison of pain complaints. Pain. 1988;32(2):173-83.

Wise TN, Fishbain DA, Holder-Perkins V. Sintomas físicos dolorosos na depressão: um desafio clínico. Pain Med. 2007;8(S2):S75-6.

Walter AK, Kavelaars A, Heijnen CJ, Dantzer R. Neuroinflammation and comorbidity of pain and depression. Pharmacol Rev. 2013;66(1):80-101.

Wolff HG. Personality features and reactions of subjects with migraine. Arch Neurol Psychiatry. 1937;37(4):895-921.

Wenzel RG. Pharmacology of botulinum neurotoxin serotype A. Am J Health Syst Pharm. 2004;61(22 Suppl 6):S5-S10.

Setler PE. Therapeutic use of botulinum toxins: background and history. Clin J Pain. 2002;18(6):S119-24.

Dressler D, Saberi FA. Botulinum toxin: mechanisms of action. Eur Neurol. 2005;53(1):3-9.

Cardoso F. Toxina botulínica tipo B no manejo de distonia não-responsiva a toxina botulínica tipo A. Arq Neuropsiquiatr. 2003;61(3A):607-10.

Smuts JA, Schultz DB, Barnard A. Mechanism of action of botulinum toxin type A in migraine prevention: a pilot study. Headache. 2004;44(8):801-5.

de Mello Sposito MM. Toxina botulínica do tipo A: mecanismo de ação. Acta Fisiátrica. 2009;16(1):25-37.

Finzi E, Wasserman E. Treatment of depression with botulinum toxin A: a case series. Dermatol Surg. 2006;32(5):645-50.

Wollmer MA, de Boer C, Kalak N, Beck J, Götz T, Schmidt T. Facing depression with botulinum toxin: a randomized controlled trial. J Psychiatr Res. 2012;46(5):574-81.

Niedenthal P M. Embodying emotion. Science. 2007;316(5827):1002-5.

Larsen RJ, Kasimatis M, Frey K. Facilitating the furrowed brow: an unobtrusive test of the facial feedback hypothesis applied to unpleasant affect. Cogn Emot. 1992;6(5):321-38.

Ekman P, Levenson RW, Friesen WV. Autonomic nervous system activity distinguishes among emotions. Science. 1983;221(4616):1208-10.

Strack F, Martin LL, Stepper S. Inhibiting and facilitating conditions of the human smile: a nonobtrusive test of the facial feedback hypothesis. J Pers Soc Psychol. 1988;54(5):768-77.

Finzi E, Rosenthal NE. Emotional proprioception: treatment of depression with afferent facial feedback. J Psychiatr Res. 2016;80:93-6.

Matsuo K, Ban R, Hama Y, Yuziriha S. Eyelid opening with trigeminal proprioceptive activation regulates a brainstem arousal mechanism. PLoS One. 2015;10(8).

Classificação internacional de cefaleias. 3rd ed. (ICHD). Sinapse. 2018;18(2):1-170.

Boudreau G P, Grosberg BM, McAllister PJ, Lipton RB, Buse DC. Prophylactic on a botulinumtoxin A in patients with chronic migraine and comorbid depression: an open-label, multicenter, pilot study of efficacy, safety and effect on headache-related disability, depression, and anxiety. Int J Gen Med. 2015;8:79-86.

Zhang H, Zhang H, Wei Y, Lian Y, Chen Y, Zheng Y. Treatment of chronic daily headache with comorbid anxiety and depression using botulinum toxin A: a prospective pilot study. Int J Neurosci. 2017;127(4):285-90.

Aydinlar EI. Dikmen PY, Kosak S, Kocaman AS. On a botulinumtoxin A effectiveness on chronic migraine, negative emotional states and sleep quality: a single-center prospective cohort study. J Headache Pain. 2017;18(1):1-10.

Guerzoni S, Pellesi L, Baraldi C, Cainazzo MM, Negro A, Martelletti P. Long-term treatment benefits and prolonged efficacy of on a botulinum toxin A in patients affected by chronic migraine and medication overuse headache over 3 years of therapy. Front Neurol. 2017;8:586.

Kollewe K, Escher CM, Wulff DU, Fathi D, Paracka L, Mohammadi B. Long-term treatment of chronic migraine with on a botulinum toxin A: efficacy, quality of life and tolerability in a real-life setting. J Neural Transm. 2016;123(5):533-40.

Blumenfeld AM, Tepper SJ, Robbins LD, Manack Adams A, Buse DC, Orejudos A. Effects of on a botulinum toxin A treatment for chronic migraine on common comorbidities including depression and anxiety. J Neurol Neurosurg Psychiatry. 2019;90(3):353-60.

Maasumi K, Thompson NR, Kriegler JS, Tepper SJ. Effect of on a botulinum toxin A injection on depression in chronic migraine. Headache. 2015;59(9):1218-24.

Demiryurek BE, Erten DH, Tekin A, Ceylan M, Aras YG, Gungen BD. Effects of onabotulinumtoxinA treatment on efficacy, depression, anxiety, and disability in Turkish patients with chronic migraine. Neurol Sci. 2016;37(11):1779-84.

Dodick D W, Turkel CC, DeGryse RE, Aurora SK, Silverstein SD, Lipton RB. OnabotulinumtoxinA for treatment of chronic migraine: pooled results from the double-blind, randomized, placebo‐controlled phases of the PREEMPT clinical program. Headache. 2010;50(6):921-36.

Charles E. Infiltrations of on a botulinum toxin in resistant depression: comparison of two facial injection sites. .

Helse Stavanger H F. Glabellar botulinum toxin injections for the treatment of geriatric depression. .


Submitted date:
11/27/2021

Accepted date:
05/09/2022

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