PO-14 | Pain catastrophizing in chronic migraine patients receiving eptinezumab treatment

Alessandra Parisi,¹ Licia Grazzi,¹ Alberto Raggi,² Giulia Regonesi,¹ Montisano Danilo Antonio¹ | ¹Headache Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano; ²Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy

Background: The Pain Catastrophizing Scale (PCS) is a questionnaire used to assess the extent to which individuals experience negative and exaggerated thoughts and feelings about their pain. This study aimed to evaluate changes in pain catastrophizing over time, from baseline to 9 months, in migraine patients undergoing Eptinezumab treatment.

Methods: The PCS was used to assess 34 patients undergoing treatment with Eptinezumab at the Headache Center of the Carlo Besta Neurological Institute in Milan. This instrument was administered and explained during a regularly scheduled visit.

Results: Participants had a mean age of 46.97 years (median: 49.5, SD: 12.3), and included 33 females and 1 male. Eight patients dropped out due to adverse events. Although baseline scores did not always reach the clinical significance cut-off (>30), a high level of Pain Catastrophizing was observed (median PCS tot = 22, SD = 8.24), mainly driven by high scores in Helplessness (12 ± 3.77) and Rumination (10 ± 4.07). Magnification is lower at baseline (median: 1.5, SD: 1.42). The comparison at T9 was conducted only for a subset of 16 patients who have completed the follow-up thus far. A significant reduction in the total PCS score was observed (T0 = 19.5 ± 7.93 vs T9 = 12 ± 10.17), with marked decreases in Helplessness (T0 = 11 ± 4.10 vs T9 = 6 ± 4.30) and Rumination (T0 = 8.5 ± 3.84 vs T9 = 6.5 ± 5.13). While PCS scores showed a downward trend by T9, it is also important to consider the high standard deviations across scores, which highlight considerable inter-individual variability. 

Conclusion: Baseline Pain Catastrophizing levels in our sample of chronic migraine patients were close to the upper limit of the normal range. This supports the tendency of these patients to experience intrusive thoughts, persistent worry, and feelings of Helplessness, which amplify the subjective experience of pain. By 9 months, significant improvements were observed in overall catastrophizing, particularly in Helplessness & Rumination subscales. These findings emphasize the need to study psychological factors, given their potential impact on the progression and outcomes of migraine treatment.