Clinical significance of osmophobia and effect on quality of life in migraine patients

Introduction: Migraine is a primary headache disease that negatively affects quality of life. Although osmophobia is one of the specific symptom that differentiate migraine from other headache disorders, its clinical consequences are under-researched. In this study, we aimed to evaluate the clinical significance of osmophobia and its effect on quality of life in episodic migraine patients. Materials and Methods: In this cross-sectional study, episodic migraine diagnosed 145 patients were included. The diagnosis and classification of migraine was made according to the 2018 3rd edition of the International Classification of Headache. To evaluate the presence of osmophobia, a semi-structured interview was held with the patients by a neurologist retrospectively. Patients were evaluated with the migraine data form, the Migraine 24-Hour Quality of Life Questionnaire (24-Hr-MQoLQ), the Migraine Disability Assessment Scale (MIDAS), the Patient Health Questionnaire-9 (PHQ-9), the Insomnia Severity Index (ISI), the Generalized Anxiety Disorder-7 (GAD-7), the Allodynia Symptom Checklist (ASC), and the Fatigue Severity Scale (FSS). Results: There was no significant difference between migraine patients with and without osmophobia in terms of age, gender, education level, income status, body mass index, attack severity, attack duration, number of attacks per month, and disease duration (p>0.05). While the mean 24-Hr-MQoLQ of migraine patients with osmophobia was significantly lower (p=0.021) than those without osmophobia. The mean of the MIDAS scale was higher significantly in migraine patients with osmophobia than those without osmophobia (p <0.001). Lower scores in the 24-Hr-MQoLQ were identified in the areas of feeling-concerns (p = 0.048), and social functionality (p = 0.023). On the other hand, the mean ISI, PHQ-9, FSS and ASC scores of migraine patients with osmophobia were statistically significantly higher than those without osmophobia (p <0.001, p = 0.027, p = 0.002, p <0.001). Conclusion: Both 24-hour and 3-month quality of life of migraine patients with osmophobia were more affected than those without osmophobia. At the same manner, insomnia, depression, fatigue and allodynia were observed at higher rates in migraine patients with osmophobia than in patients without osmophobia. In future studies; multidimensional investigation of osmophobia, which is a valuable symptom in daily clinical routine, should be aimed. Keywords: Migraine, Osmophobia, Quality of Life