Abstract
Migraine is a leading cause of disability, yet the relative contribution of individual attack characteristics — pain intensity, frequency, and duration - to migraine-specific quality of life remains incompletely defined, and data from Central Asian populations are scarce. This study examined the clinical and psychometric factors associated with migraine-specific quality of life in a Kazakhstan cohort. In a cross-sectional study, 195 participants (100 patients with migraine [ICHD-3] and 95 controls without migraine) were enrolled; analytic modeling was restricted to 88 women with migraine. Quality of life (MSQ v2.1: RFR, RFP, EF) was modeled against usual-attack pain intensity (VAS), attack frequency and duration, age, and anxiety and depression (HADS) using multivariable linear regression with HC3 confidence intervals and Benjamini–Hochberg correction; HURT burden was reserved for sensitivity analyses to avoid overadjustment. Higher pain intensity was associated with lower RFR (β = −7.51 per 1 SD; 95% CI −12.18 to −2.84; p = 0.002) and RFP (β = −10.91; 95% CI −16.45 to −5.37; p <0.001). No independent association was detected for attack frequency, duration, age, or affective symptoms. The pain-intensity association was robust across influence-diagnostic, categorical-VAS (dose–response), and HURT-adjusted sensitivity analyses. Usual-attack pain intensity, rather than attack frequency or duration, was the predictor most consistently associated with migraine-specific role functioning.