Anxiety and depression levels in cervicogenic headache patients before and after botulinum toxin A treatment

Background: The etiology of cervicogenic headaches includes cervical joint pathologies, upper cervical nerve radiculopathies, occipital neuralgias, and myofacial pain. There are contradictory results regarding the effect of Botulinum neurotoxin type A (BoNT-A) treatment on pain levels and frequencies. The prevalence of depression in patients with chronic headache is reported to be between 10-100% and generally is accepted to be more than 50%. Although there are several studies investigating the effect of BoNT-A on pain levels and frequencies in cervicogenic headaches, we were not able to find any articles in the literature that studied the effect of BoNT-A treatment on anxiety and depression in these patients. Purpose: To determine the effect of BoNT-A treatment on anxiety and depression levels in cervicogenic headache patients. Material and method: Eighteen patients with cervicogenic headache were included in this study. In each patient, a total of 150 units Dysport® was injected (10 units to frontal muscles, 20 units to temporal muscles and 15 units each to semispinalis capitis, splenius capitis and trapezius muscles bilaterally). All of the patients were asked to complete the Visual Analog Scale (VAS), Beck Anxiety Inventory, and Beck Depression Inventory prior to treatment. Headache frequencies were also recorded. All patients were followed for a 6-week period and they completed the same scales in the end of the study. Results: The mean values of monthly pain frequency pre- and post-treatment were 19.72±5.71 and 7.60±4.19, respectively. And the mean pain scores at pre- and posttreatment were 79.70±10.20 and 45.60±17.25, respectively. Monthly pain frequency and pain score improved significantly (all p