@article {957, title = {Perceived quality of life (QOLIE-31-P), depression (NDDI-E), anxiety (GAD-7), and insomnia in patients with epilepsy attended at a refractory epilepsy unit in real-life clinical practice}, journal = {Neurological Sciences}, volume = {43}, year = {2022}, month = {2022}, pages = {1955-1964}, doi = {https://doi.org/10.1007/s10072-021-05595-3}, url = {https://link.springer.com/article/10.1007/s10072-021-05595-3}, author = {Gonzalez-Martinez, Alicia and {\'A}lvaro Planchuelo-G{\'o}mez and Vieira Campos, Alba and Mart{\'\i}nez-Dubarbie, Francisco and Vivancos, Jos{\'e} and De Toledo-Heras, Mar{\'\i}a} } @conference {941, title = {Clinical course of migraine during the COVID-19 Lockdown}, booktitle = {International Headache Congress 2021}, year = {2021}, month = {2021}, publisher = {International Headache Society \& European Headache Federation}, organization = {International Headache Society \& European Headache Federation}, address = {Virtual Congress}, abstract = {

Objective: Previous studies have demonstrated that migraine can worsen due to stress, changes in lifestyle habits or infections. We hypothesize that changes during coronavirus disease 2019 (COVID-19) lockdown might have worsened the clinical course of migraine.
Methods: Retrospective survey study collecting demographic data, clinical variables related to headache (frequency), migraine (subjective worsening, frequency, and intensity), lockdown, and symptoms of post-traumatic stress from migraine patients followed-up at three Headache Units between June-July 2020.
Results: 222 subjects were included. Among them, 201/222 (90.5\%) were women, aged 42.5 +- 12.0 (mean +- SD). Subjective improvement of migraine was reported in 31/222 participants (14.0\%), while worsening in 105/222 (47.3\%) and was associated with changes in migraine triggers such as stress related to going outdoors and intake of specific foods/drinks. Intensity of attacks increased in 67/222 patients (30.2\%), and it was associated with the subjective worsening, female sex, recent insomnia, and use of acute medication during a headache. An increase in monthly days with any headache was observed in 105/222 patients (47.3\%) and was related to symptoms of post-traumatic stress, older age and living with five or more people.

Conclusion: Approximately half the migraine patients reported worsening of their usual pain during the lockdown; worsening was related to changes in triggers and the emotional impact of the lockdown.

}, url = {https://journals.sagepub.com/doi/pdf/10.1177/03331024211034005}, author = {Gonzalez-Martinez, Alicia and {\'A}lvaro Planchuelo-G{\'o}mez and {\'A}ngel L. Guerrero and Garc{\'\i}a-Azor{\'\i}n, David and Santos-Lasaosa, Sonia and P{\'e}rez-Navarro, Mar{\'\i}a P and Odriozola-Gonz{\'a}lez, Paula and Irurtia, Mar{\'\i}a Jes{\'u}s and Quintas, Sonia and Rodrigo de Luis-Garc{\'\i}a and Ana B Gago-Veiga} } @article {952, title = {Effects of the onabotulinumtoxinA follow-up delay in migraine course during the COVID-19 lockdown}, journal = {Neurological Sciences}, volume = {42}, year = {2021}, pages = {5087-5092}, issn = {1590-3478}, doi = {10.1007/s10072-021-05180-8}, url = {https://doi.org/10.1007/s10072-021-05180-8}, author = {Gonzalez-Martinez, Alicia and {\'A}lvaro Planchuelo-G{\'o}mez and {\'A}ngel L. Guerrero and Garc{\'\i}a-Azor{\'\i}n, David and Santos-Lasaosa, Sonia and Navarro-P{\'e}rez, Mar{\'\i}a Pilar and Odriozola-Gonz{\'a}lez, Paula and Irurtia, Mar{\'\i}a Jes{\'u}s and Quintas, Sonia and de Luis-Garc{\'\i}a, Rodrigo and Ana B Gago-Veiga} } @article {944, title = {Evaluation of the Impact of the COVID-19 Lockdown in the Clinical Course of Migraine}, journal = {Pain Medicine}, volume = {22}, year = {2021}, month = {2021}, pages = {2079-2091}, abstract = {

Objective: Previous studies have demonstrated that emotional stress, changes in lifestyle habits and infections can worsen the clinical course of migraine. We hypothesize that changes in habits and medical care during coronavirus disease 2019 (COVID-19) lockdown might have worsened the clinical course of migraine.

Design: Retrospective survey study collecting online responses from migraine patients followed-up by neurologists at three tertiary hospitals between June and July 2020.

Methods: We used a web-based survey that included demographic data, clinical variables related with any headache (frequency) and migraine (subjective worsening, frequency, and intensity), lockdown, and symptoms of post-traumatic stress.

Results: The response rate of the survey was 239/324 (73.8\%). The final analysis included 222 subjects. Among them, 201/222 (90.5\%) were women, aged 42.5 +- 12.0 (mean+-SD). Subjective improvement of migraine during lockdown was reported in 31/222 participants (14.0\%), while worsening in 105/222 (47.3\%) and was associated with changes in migraine triggers such as stress related to going outdoors and intake of specific foods or drinks. Intensity of attacks increased in 67/222 patients (30.2\%), and it was associated with the subjective worsening, female sex, recent insomnia, and use of acute medication during a headache. An increase in monthly days with any headache was observed in 105/222 patients (47.3\%) and was related to symptoms of post-traumatic stress, older age and living with five or more people.

Conclusions: Approximately half the migraine patients reported worsening of their usual pain during the lockdown. Worse clinical course in migraine patients was related to changes in triggers and the emotional impact of the lockdown.

}, keywords = {COVID-19, Headache, Lockdown, Migraine, SARS-CoV-2}, issn = {1526-4637}, doi = {10.1093/pm/pnaa449}, url = {https://doi.org/10.1093/pm/pnaa449}, author = {Gonzalez-Martinez, Alicia and {\'A}lvaro Planchuelo-G{\'o}mez and {\'A}ngel L. Guerrero and Garc{\'\i}a-Azor{\'\i}n, David and Santos-Lasaosa, Sonia and Navarro-P{\'e}rez, Mar{\'\i}a Pilar and Odriozola-Gonz{\'a}lez, Paula and Irurtia, Mar{\'\i}a Jes{\'u}s and Quintas, Sonia and Rodrigo de Luis-Garc{\'\i}a and Ana B Gago-Veiga} } @conference {940, title = {Evaluation of the burden of migraine on the partners lifestyle: a multicenter study}, booktitle = {International Headache Congress 2021}, year = {2021}, month = {2021}, publisher = {International Headache Society \& European Headache Federation}, organization = {International Headache Society \& European Headache Federation}, address = {Virtual Congress}, abstract = {

Objective: Migraine is a highly disabling disease that affects the patient{\textquoteright}s life, but its consequences on the patient{\textquoteright}s partner have been barely studied. The objective was to analyze these effects on romantic relationship, relationship with their children, friendship and work; as well as to evaluate caregiver burden and the presence of anxiety and/or depression.
Methods: Cross-sectional observational study. An online survey was filled by partners of migraine patients from five Spanish Headache Units. Questions about the four assessed areas and two scales to evaluate anxiety, depression and caregiver burden (Hospital Anxiety and Depression Scale and Zarit scale) were included. The presence of anxiety and depression was compared to the Spanish prevalence (6.7\% in both cases).
Results: Out of 176 registered responses, 155 were accepted. The sample included 86.5\% of women, with mean age 44.2 +- 10.4 years. Effects on partners were found on love relationship and items concerning children and friendships, with a minor impact at work. Partners showed a significant moderate burden according to the Zarit scale (p = 12/155 = 0.077 [0.041-0.131]; p \< 0.001) and a higher anxiety rate than the 6.7\% national prevalence (p = 23/155 = 0.148 [0.096-0.214]; p \< 0.001), but similar depression rate.
Conclusion: We found an impact on the patient{\textquoteright}s partners on the studied areas. Migraine is a disease that implies caregiver burden in the patient{\textquoteright}s environment with possible effect on anxiety levels.

}, url = {https://journals.sagepub.com/doi/pdf/10.1177/03331024211034005}, author = {Fern{\'a}ndez-Bermejo, Eva M and {\'A}lvaro Planchuelo-G{\'o}mez and Quintas, Sonia and Gonzalez-Martinez, Alicia and Garc{\'\i}a-Azor{\'\i}n, David and Sierra, {\'A}lvaro and {\'A}ngel L. Guerrero and Santos-Lasaosa, Sonia and Navarro-P{\'e}rez, Mar{\'\i}a P and Gonz{\'a}lez-Garc{\'\i}a, Nuria and D{\'\i}az-de-Ter{\'a}n, Javier and Ana B Gago-Veiga} } @conference {942, title = {Has onabotulinumtoxinA follow-up delay during COVID-19 lockdown affected the migraine course?}, booktitle = {International Headache Congress 2021}, year = {2021}, month = {2021}, publisher = {International Headache Society \& European Headache Federation}, organization = {International Headache Society \& European Headache Federation}, address = {Virtual Congress}, abstract = {

Objective: During the COVID-19 pandemic face-to-face procedures have been postponed. We aim to evaluate the impact of onabotulinumtoxinA follow-up delay in migraine during COVID-19 pandemic.
Methods: Subjective worsening, intensity of migraine attacks and frequency of headache and migraine were retrospectively compared between patients with unmodified and interrupted onabotulinumtoxinA follow-up in Headache Units.
Results: We included 67 patients with chronic migraine or high-frequency episodic migraine under onabotulinumtoxinA treatment, 65 (97.0\%) female,
44.5 +- 12.1 years old. Treatment administration was voluntarily delayed in 14 (20.9\%) patients and nine (13.4\%) were unable to continue follow-up. Patients with uninterrupted follow-up during lockdown presented 8.4 and 8.1 less monthly days with headache (adjusted p = 0.011) and migraine attacks (adjusted p = 0.009) compared to patients whose follow-up was interrupted, respectively.
Conclusion: Involuntary delay of onabotulinumtoxinA follow-up in patients with migraine due to COVID-19 pandemic was associated with a higher frequency of headache and migraine attacks. Safe administration of onabotulinumtoxinA during lockdown should be promoted.

}, url = {https://journals.sagepub.com/doi/pdf/10.1177/03331024211034005}, author = {Gonzalez-Martinez, Alicia and {\'A}lvaro Planchuelo-G{\'o}mez and {\'A}ngel L. Guerrero and Garc{\'\i}a-Azor{\'\i}n, David and Santos-Lasaosa, Sonia and Navarro-P{\'e}rez, Mar{\'\i}a P and Odriozola-Gonz{\'a}lez, Paula and Irurtia, Mar{\'\i}a Jes{\'u}s and Quintas, Sonia and Rodrigo de Luis-Garc{\'\i}a and Ana B Gago-Veiga} } @conference {945, title = {Longitudinal reduction of quality of life in patients with epilepsy and no seizure increase during the COVID-19 pandemic}, booktitle = {7th Congress of the European Academy of Neurology}, year = {2021}, month = {2021}, publisher = {Wiley}, organization = {Wiley}, address = {Virtual Congress}, abstract = {

Background and aims: In early 2020, the novel coronavirus disease (COVID-19) pandemic has impaired medical care of chronic neurological diseases, including epilepsy. The objective of this study is to evaluate the impact of the COVID-19 pandemic in the levels of anxiety, depression, somnolence and quality of life using validated scales in patients with epilepsy in real-life clinical practice.
Methods: Self-administered scales of anxiety disorders (GAD-7), depression (NDDI-E), somnolence (Epworth Sleepiness Scale; ESS) and quality of life (QOLIE-31-P) in patients with epilepsy treated in the Refractory Epilepsy Unit of a tertiary hospital were longitudinally analyzed with Generalized Linear Mixed Models. Data were collected before the beginning (December 2019-March 2020) and during the COVID-19 pandemic (September 2020-January 2021).
Results: 37 patients, 45.0+-17.3 years of age, 43.2\% women, epilepsy duration 23.0+-14.9 years, number of anti-epileptic drugs 2.1+-1.4, answered in the two periods. Significant longitudinal reduction of QOLIE-31-P scores (from 58.9+-19.7 to 56.2+-16.2, p=0.035) was identified. No statistically significant longitudinal changes in NDDI-E (from 12.3+-4.3 to 13.4+-4.4, p=0.293) or the number of seizures (from 0.9+-1.9 to 2.5+-6.2, p=0.125) were found. Significant higher ESS (from 4.9+-3.7 to 7.4+-4.9, p=0.001) and lower GAD-7 scores (from 8.8+-6.2 to 8.3+-5.9, corrected p=0.024 adjusted by refractory epilepsy and sleep disturbance) were found during the COVID-19 pandemic.
Conclusion: During the COVID-19 pandemic, quality of life was lower in patients with epilepsy, levels of anxiety were reduced and sleepiness levels were raised, without seizure change. Additional studies would be useful to adequately manage these comorbidities.
Disclosure: There is no disclosure.

}, url = {https://www.ean.org/fileadmin/user_upload/ean/congress-2021/EAN2021AbstractBook.pdf}, author = {Gonzalez-Martinez, Alicia and {\'A}lvaro Planchuelo-G{\'o}mez and Vieira, Alba and Mart{\'\i}nez-Dubarbie, Francisco and Vivancos, Jos{\'e} and De Toledo, Mar{\'\i}a} } @article {943, title = {Medium-term changes in patients with epilepsy during the COVID-19 pandemic}, journal = {Acta Neurologica Scandinavica}, volume = {144}, year = {2021}, pages = {450-459}, abstract = {

Objectives: The novel coronavirus disease (COVID-19) pandemic has led to social distancing measures and impaired medical care of chronic neurological diseases, including epilepsy, which may have adversely affected well-being and quality of life of patients with epilepsy (PWE). The objective of this study is to evaluate the impact of the COVID-19 pandemic in the levels of anxiety, depression, somnolence, and quality of life using validated scales in PWE in real-life clinical practice.

Materials \& Methods: Self-administered scales of anxiety disorders (GAD-7), depression (NDDI-E), somnolence (Epworth Sleepiness Scale; ESS), and quality of life (QOLIE-31-P) in PWE treated in a Refractory Epilepsy Unit were longitudinally analyzed. Data were collected before the beginning (December 2019-March 2020) and during the COVID-19 pandemic (September 2020-January 2021).

Results: 158 patients (85 from the first round and 73 from the second round) 45.0 +- 17.3 years of age, 43.2\% women, epilepsy duration 23.0 +- 14.9 years, number of antiepileptic drugs 2.1 +- 1.4, completed the survey. Significant longitudinal reduction of QOLIE-31-P (from 58.9 +- 19.7 to 56.2 +- 16.2, p = 0.035) and GAD-7 scores (from 8.8 +- 6.2 to 8.3 +- 5.9, corrected p = .024) was identified. No statistically significant longitudinal changes in the number of seizures (from 0.9 +- 1.9 to 2.5 +- 6.2, p = .125) or NDDI-E scores (from 12.3 +- 4.3 to 13.4 +- 4.4, p = .065) were found. Significant longitudinal increase of ESS (from 4.9 +- 3.7 to 7.4 +- 4.9, p = .001) was found.

Conclusions: During the COVID-19 pandemic, quality of life and anxiety levels were lower in PWE, and sleepiness levels were raised, without seizure change.

}, keywords = {Anxiety, COVID-19, Sleep, epilepsy, pandemic, quality of life}, doi = {https://doi.org/10.1111/ane.13481}, url = {https://onlinelibrary.wiley.com/doi/abs/10.1111/ane.13481}, author = {Gonzalez-Martinez, Alicia and {\'A}lvaro Planchuelo-G{\'o}mez and Vieira Campos, Alba and Mart{\'\i}nez-Dubarbie, Francisco and Vivancos, Jos{\'e} and De Toledo-Heras, Mar{\'\i}a} } @conference {917, title = {The utility of the GAD-7 anxiety, NDDI-E depression, Epworth sleepiness and QOLIE-31-P quality of life scales in patients with epilepsy in real clinical practice (2379)}, booktitle = {Proceedings of the American Academy of Neurology 2021 Virtual Annual Meeting}, year = {2021}, publisher = {Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology}, organization = {Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology}, abstract = {

Objective: The objective of this project is to study the presence of psychiatric comorbidity (anxiety and depression), somnolence and quality of life using validated scales in patients with epilepsy in real clinical practice, and its relationship with other clinical and demographic variables.

Background: Previous studies have shown that psychiatric comorbidity, specially anxiety and depression, as well as sleep disorders are more prevalent in patients with epilepsy than in the general population.

Design/Methods: Cross-sectional descriptive observational study using validated scales of anxiety disorders(GAD-7), depression(NDDI-E), sleep disorders(Epworth) and quality of life(QOLIE-31-P) in patients with epilepsy treated in the Refractory Epilepsy Unit of a tertiary hospital.

Results: We recruited 84 patients, age 44.3 {\textpm} 17.4 years, 48.2\% women, duration of epilepsy 21.5 {\textpm} 15.9 years, number of antiepileptic drugs 1.9 {\textpm} 1.2. We found severe anxiety(GAD-7\> 14) in 14.3\%, depression(NDDI-E\> 15) in 20.2\%; abnormal sleepiness(Epworth\> 10) in 14.3\% of patients, and QOLIE-31-P 62.0 {\textpm} 19.2. Each more point in GAD-7 is 21\% more likely to suffer from anxiety(OR 1.21; 95\% CI 1.09{\textendash}1.36; p = 0.0008), NDDI-E scores\<=15 represent 85 \% less chance of having depression(OR 0.15; 95\% CI 0.04{\textendash}0.51]; p = 0.002). We found a positive association between depression according to NDDI-E with seizure frequency(p = 0.017) and number of drugs(p = 0.019); and severe anxiety according to GAD-7 and number of drugs(p = 0.019). We found a negative correlation between QOLIE-31-P with NDDI-E(r = -0.68; p \<0.0001) and GAD-7(r = -0.76; p \<0.0001).

Conclusions: Validated scales in epilepsy for the detection of anxiety(GAD-7) and depression(NDDI-E) are useful in the detection of these disorders in real clinical practice. The assessment of the presence of anxiety-depressive psychiatric comorbidity is especially relevant in patients with a higher frequency of seizures, a greater number of drugs and a poorer quality of life.

}, url = {https://n.neurology.org/content/96/15_Supplement/2379}, author = {Gonzalez-Martinez, Alicia and {\'A}lvaro Planchuelo-G{\'o}mez and Mart{\'\i}nez-Dubarbie, Francisco and Vieira Campos, Alba and Vivancos, Jos{\'e} and De Toledo, Mar{\'\i}a} }