Health Sciences Program Student Theses, Dissertations and Capstones

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Philosophy (PhD) in Health Science

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

Department

College of Health Care Sciences – Health Science Department

First Advisor

Randy Danielsen

Date of original Performance / Presentation

January 2022

Publication Date / Copyright Date

1-1-2022

Abstract

Background: Migraine headache simultaneously presents with early symptoms among most patients with multiple sclerosis (MS). Previous studies associated MS prevalence and incidence of migraine. However, the pathological significance of migraine remains unclear. Thus, a retrospective, cross-sectional dataset from MSCCTM, a self-reporting mHealth digital application (InterPRO Bioscience) for MS patients, was used to assess the relationship between migraine and MS disability or severity. Design/Methods: Patients’ survey responses were used to identify likely migraineurs (chronic vs. episodic migraine). After controlling for demographic variables in mixed effects models, the association between migraineur status and MS disability or severity was tested, along with two measures of MS disability—Patient-Determined Disease Steps (PDDS) and MS-Related Work Disruption (MS-RWD)—and one measure of MS severity, Patient-Derived MS Severity Score (P-MSSS). Results: Logistic generalized linear mixed effects modeling showed that age, MS phenotype, sex, disease-modifying therapies, and self-reported headache treatment were independent and significant predictors, with varying effect sizes. In addition, a significant interaction between sex and headache treatment was identified. Conclusions: Based on an mHealth dataset, the Investigator found that disabled, younger, heavier, or female patients were more likely to experience episodic and chronic migraine. In addition, the study revealed that only a small proportion of MS patients received treatment for headache. Lastly, it demonstrated the usefulness of an mHealth application in screening MS patients for migraine.

Disciplines

Medicine and Health Sciences

Keywords

Headache; mHealth; Migraine; Multiple Sclerosis; Multiple Sclerosis Care Connect (InterPRO Bioscience); Social Ecology Theory (SET)

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