Verbal scales in the acute treatment of migraine: semantic categories and clinical relevance

Verbal scales are currently used as efficacy parameters in acute migraine trials. In order to determine the correlation between headache intensity, functional disability, and relevant pain reduction, 100 patients completed a questionnaire. Our results showed that a verbal scale of headache intensity alone has different implications from one that includes pain intensity and functional ability. The reduction from a moderate to a mild headache was satisfactory to only 15% of the patients. In contrast, 77% of patients were satisfied when the headache intensity was reduced from severe to mild. These findings imply that, in assessing the efficacy of drugs used for migraine, a redaction in pain intensity from moderate to mild should not be considered as a good outcome.