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Smell Sensitivity in Chronic Migraine: A Case-Control Study

This study has been completed.
Sponsor:
Collaborator:
Merck Sharp & Dohme Corp.
Information provided by (Responsible Party):
Thomas Jefferson University
ClinicalTrials.gov Identifier:
NCT01687088
First received: September 13, 2012
Last updated: October 21, 2014
Last verified: October 2014

September 13, 2012
October 21, 2014
July 2011
March 2012   (final data collection date for primary outcome measure)
Comparison of UPSIT Scores Between Subjects and Controls at Two Time Points [ Time Frame: Chronic migraineurs up to 12 months. Controls up to 2 weeks. ] [ Designated as safety issue: No ]

Migraineurs and controls will take the University of Pennsylvania Smell Identification Test (UPSIT) in the office. The UPSIT test is a series of 40 questions and the score is the number of questions answered correctly. Each question is multiple choice and must be answered. The number of correct answers regarding the smells being experienced is the subjects score. The higher the score the better the sense of smell. This allows groups to be compared. In this study after the first visit, migraineurs will be given the UPSIT test without a headache and then they will self-administer the UPSIT during a migraine attack day at home.

Age and sex matched controls will also take the first UPSIT in the office. They will take second UPSIT 2 weeks later at home.

difference in UPSIT scores between subjects and controls [ Time Frame: Chronic migraineurs up to 12 months. Controls up to 2 weeks. ] [ Designated as safety issue: No ]

Migraineurs and controls will take the University of Pennsylvania Smell Identification Test (UPSIT) in the office. After the first visit, migraineurs will self-administer the UPSIT during a migraine attack day at home.

Age and sex matched controls will also take the first UPSIT in the office. They will take second UPSIT 2 weeks later at home.

Complete list of historical versions of study NCT01687088 on ClinicalTrials.gov Archive Site
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Smell Sensitivity in Chronic Migraine: A Case-Control Study
Olfactory Acuity in Chronic Migraine: A Case-Control Study

Olfactory impairment is a common symptom of neurologic disorders and may be related to dopaminergic dysfunction. Studies show that patients with migraine show increased sensitivity to light and sound. In our previous study in episodic migraineurs, olfaction was similar to age and sex-matched controls outside of attacks, but lower during acute attacks.

The hypothesis is that olfactory function in chronic migraine (CM) will have mild impairment of olfaction at baseline but a more significant impairment during migraine or headache exacerbations.

The investigators have two objectives:

  • To determine baseline olfactory acuity in subjects with CM and compare them to age and sex-matched controls
  • To determine how olfaction changes during acute exacerbations of migraine in those with CM

To execute this study, the investigators will interview subjects and controls to ensure that they meet inclusion and exclusion criteria. After obtaining informed consent, subjects and controls will complete a questionnaire survey regarding their history or lack of history of headaches, smell sensitivity, osmophobia and current medication use and answer questions about attack frequency, location of headache, duration of disease, use of medication for pain, and disability. Both migraineurs and controls will take the University of Pennsylvania Smell Identification Test (UPSIT) in the office.

After the first visit, migraineurs and controls will self-administer the UPSIT at home. They will be required to return the second test to the Jefferson Headache Center.

The investigators will use analysis of variance (ANOVA) to determine variance in UPSIT scores between subjects and controls. To achieve a 90% power that the study will detect a statistically significant difference between the mean UPSIT scores at a two-sided 5 percent significance level, our sample size for both subjects and controls is 50.

The investigators will interview subjects and controls to ensure that they meet inclusion criteria and do not meet exclusion criteria. After obtaining informed consent, subjects and controls will complete a questionnaire survey with the interviewer regarding their history of headaches, smell sensitivity, osmophobia and current medication use. Subjects will also answer questions about attack frequency, location of headache, duration of disease, use of medication for pain, and disability.

After completing the questionnaire survey, migraineurs and controls will take the University of Pennsylvania Smell Identification Test (UPSIT) in the office. During this visit we will demonstrate and give instructions on how to perform UPSIT at home.

After the first visit, migraineurs will self-administer the UPSIT during a migraine attack day at home. They will be required to mail or drop off the second test at the Jefferson Headache Center.

Age and sex matched controls will take the first UPSIT in the office. They will take second UPSIT 2 weeks later at home and call the Headache Center to notify the staff that they have completed the second UPSIT. They will be asked to mail or drop off the test at the Jefferson Headache Center.

The UPSIT is a standardized, validated test for olfaction. There are a total of 40 odorants, with four booklets each containing ten odorants. The stimuli are embedded in "scratch and sniff" microcapsules at the bottom of each page. Subjects must choose one answer among four possible answers for each odorant - a forced choice test. The validity and reliability of the UPSIT, as well as the basis for using these particular odorants, has been demonstrated in multiple studies. The tests kits will be supplied by Dr. Richard Doty at University of Pennsylvania.

The investigators will use analysis of variance (ANOVA) to determine variance in UPSIT scores between subjects and controls. We will also use ANOVA to examine differences based on subject characteristics, including attack frequency, duration of illness, osmophobia during attacks, and if odors trigger headaches. The investigators will also use Chi-square and the Wilcoxon rank sum test to determine categorical outcomes such as gender and statistical significance between groups.

To achieve a 90% power that the study will detect a statistically significant difference between the mean UPSIT scores at a two-sided 5 percent significance level, our sample size for both subjects and controls is 50. This is based on the assumption that the standard deviation of the response variable is 3 units. The investigator's assumptions about effect size are based on previous studies using the UPSIT to detect differences in subjects and controls in other neurologic disorders, such as schizophrenia.

Observational
Observational Model: Case Control
Time Perspective: Prospective
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Non-Probability Sample

Male and female subjects, over age 18 years who meet criteria for diagnosis of chronic migraine Controls will be age and sex-matched and will have no history of migraine

  • Chronic Migraine
  • Olfactory Acuity
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  • chronic migraineurs
    At least 8 migraine days per week and headache at least 15 days per month.
  • controls
    No significant headache or disability as defined by migraine disability scale.
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*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
100
March 2012
March 2012   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Male or female subjects over the age of 18 with Chronic Migraine (>15 headache days/month, at least 8 days meet criteria for migraine)

Exclusion Criteria:

  • Subjects with sinus/nasal disease
  • Subjects with a history of head trauma or degenerative disease
  • Subjects who are decisionally impaired.
  • Controls will be age and sex-matched with no history of migraine. They cannot have any disability from headache as determined by the MIDAS (Migraine Disability Assessment) questionnaire. Only controls with a MIDAS score of "0" (no disability) will be allowed in the study.
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
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NCT01687088
MJM/Olfactory/002
No
Thomas Jefferson University
Thomas Jefferson University
Merck Sharp & Dohme Corp.
Principal Investigator: Michael McNamara, MD Thomas Jefferson University
Thomas Jefferson University
October 2014

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP