Scientific Concept of the National Cohort (status ... - Nationale Kohorte

A.2 Scientific background and rationale for study elements
onset of migraine and tension-type headache. These studies, however, report inconsistent
findings. Certain triggering factors for migraine and for tension-type headache have been
identified 108, 109 and include alcohol consumption and physical activity 110, 111 . Modifications of
lifestyle habits might provide a sufficient, feasible, and cost-effective preventive strategy.
Migraine is a common, primary headache disorder characterized by episodic, severe headache
and, in about 25% of cases, transient neurologic symptoms known as migraine aura.
It is a disorder of young and mid-age adulthood, and women are affected three to four times
as often as men. Migraine, particularly migraine with aura, is associated with an unfavorable
cardiovascular risk profile and with an increased risk of major CVD. This risk is different according
to aura status. Active migraine with aura is associated with a significantly increased
risk of subsequent major cardiovascular events, ischemic stroke, MI, coronary revascularization,
angina, and death due to ischemic CVD. In Germany, only few studies have investigated
the frequency and impact of different headache types on an affected individual 110-113 . Tensiontype
headache is even more common, affecting about one in four to one in three adults in
12 months without any difference by gender. For both headache disorders, migraine and
tension-type headache, prospective population-based studies are very rare and analytic risk
factor analyses based on incident cases are lacking.
Assessment of headache:
Examinations and questionnaires (at baseline and during reassessment)
Level 1: Questionnaire
Active follow-up:
Self-report of physician-diagnosed migraine and tension-type headache
Restless legs syndrome: Standard criteria for the definition and diagnosis of restless legs
syndrome (RLS) were published by the International Restless Legs Syndrome Study Group
in 1995 114 . These criteria include the desire to move the limbs usually associated with paresthesia
or dysesthesia of the legs, a motor restlessness, a worsening or exclusive presence
of symptoms at rest (lying or sitting) with at least partial and temporary relief by activity and a
worsening of the symptoms in the evening or during the night. RLS is a common disease with
a prevalence of 8–15% in the general population 115 , affecting women twice as often as men.
RLS is one of the few neurologic disorders that can be assessed by posing specific questions
to participants in population-based studies. The etiology of RLS is still not known. Parity is a
major factor in explaining the difference between the two genders. Few data on risk factors
for RLS in the general population are known and all currently existing data come from crosssectional
or case-control studies. RLS prevalence is related to age and cases have a higher
prevalence of self-reported diabetes, a higher body mass index (BMI), perform less exercise,
and consume less alcohol than non-cases. Cases with RLS report considerably reduced
mental health and more depressed mood, either self-reported or professionally assessed, as
well as more social isolation. Further research, especially about the impact of health-related
behaviors, e.g., physical activity, alcohol consumption, smoking, and diet and psychosocial
factors, on the occurrence of RLS is needed since any potential association would be subject
to preventive strategies.
Assessment of RLS:
Examinations and questionnaires (at baseline and during reassessment)
Level 1: Questionnaire
Active follow-up (and medical verification of self-reports):
Self-report of physician-diagnosed RLS
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A.2