Supplementary Material for: A Propensity Score Matching Study on the Effect of OnabotulinumtoxinA Alone versus Short-Term Psychodynamic Psychotherapy Plus Drug-of-Choice as Preventive Therapy in Chronic Migraine: Effects and Predictive Factors

<b><i>Objective:</i></b> The objective of this study was to test the superiority of multidisciplinary approach, that is, Short-Term Psychodynamic Psychotherapy (STPP) plus drug of choice, versus monotherapy, that is, OnabotulinumtoxinA (OnaBoNT-A). <b><i>Method:</i></b> We consecutively recorded data from chronic migraine (CM) patients, with or without medication overuse headache (MOH), who underwent STPP or OnaBoNT-A, with a 3-month follow-up schedule. Headache days and analgesics intake were monitored as primary outcome measures. Propensity score matching (PSM) was used to eliminate discrepancies between groups. Discriminant function analysis (DFA) was used to pinpoint predictive factors associated with the clinical response. <b><i>Results:</i></b> 96 patients with CM (64% with MOH) were treated with STPP and 54 (59% with MOH) with OnaBoNT-A. At baseline, OnaBoNT-A patients had more failed preventive therapies, more years of illness and chronicity, and were older; STPP patients were more depressed and had a higher HIT-6. Both STPP and OnaBoNT-A patients showed a significant reduction of headache days (STPP: −14 vs. OnaBoNT-A:−14.3) and analgesics intake (STPP: −12,3 vs. OnaBoNT-A −13.5 pills/month), respectively. MOH diminished more in STPP, adherence was higher in OnaBoNT-A. Results were confirmed after PSM balancing of the groups for those variables that resulted as different (but age). <b><i>Conclusion:</i></b> OnaBoNT-A monotherapy produced similar results to psychotherapy plus medication, after correcting for baseline differences.

<b><i>研究目的：</i></b> 本研究旨在验证多学科联合疗法（即短期精神动力学心理治疗（Short-Term Psychodynamic Psychotherapy，STPP）联合首选药物）相较于单一疗法（即注射用A型肉毒毒素（OnabotulinumtoxinA，OnaBoNT-A））的优越性。<b><i>研究方法：</i></b> 本研究连续纳入伴或不伴药物过量使用性头痛（medication overuse headache，MOH）的慢性偏头痛（chronic migraine，CM）患者，将其分配至STPP组或OnaBoNT-A组，并开展为期3个月的随访。以头痛日数与镇痛药物服用量作为主要结局指标。采用倾向得分匹配（propensity score matching，PSM）消除组间基线差异，采用判别函数分析（discriminant function analysis，DFA）明确与临床应答相关的预测因素。<b><i>研究结果：</i></b> 共计96例CM患者（其中64%伴MOH）接受STPP治疗，54例CM患者（其中59%伴MOH）接受OnaBoNT-A治疗。基线时，OnaBoNT-A组患者的预防性治疗失败次数更多、病程更长、慢性化程度更高，且年龄更大；STPP组患者抑郁症状更显著，头痛影响测定量表6版（HIT-6）得分更高。两组患者的头痛日数与镇痛药物服用量均出现显著降低：其中STPP组头痛日数较基线减少14天，OnaBoNT-A组减少14.3天；STPP组每月镇痛药物服用量较基线减少12.3片，OnaBoNT-A组减少13.5片。药物过量使用性头痛在STPP组中改善更为显著，而OnaBoNT-A组的治疗依从性更高。在针对基线存在差异的变量（年龄除外）进行PSM组间平衡后，上述结果仍保持一致。<b><i>研究结论：</i></b> 在校正基线差异后，OnaBoNT-A单一疗法的治疗效果与心理治疗联合药物疗法相当。