Cephalalgia最新文献

{"title":"An analysis of diffusion tensor imaging in classical trigeminal neuralgia.","authors":"Margaret Tugend, Colby T Joncas, Katie Traylor, Marion A Hughes, Raymond F Sekula","doi":"10.1177/03331024251322505","DOIUrl":"https://doi.org/10.1177/03331024251322505","url":null,"abstract":"<p><p>BackgroundDiffusion tensor imaging (DTI) may demonstrate microstructural changes in diseased trigeminal nerves. Few prognostic indicators for long-term pain freedom after microvascular decompression (MVD) of the trigeminal nerve have been identified. The present study aimed to determine whether microstructural changes from DTI are present in the trigeminal nerve of patients with classical trigeminal neuralgia (cTN) due to arterial compression or deformation and whether they may be used to predict surgical success.MethodsPatients with a diagnosis of cTN due to arterial compression or deformation that underwent MVD from October 2013 until December 2020, with high resolution 3T magnetic resonance imaging DTI, and over two years of post-surgical follow-up were included in this study. The microstructural metrics of the symptomatic and asymptomatic trigeminal nerve were compared using a paired, two-sided Student's <i>t</i>-test. Differences between the microstructural metrics of the symptomatic nerve between treatment responders and treatment non-responders were assessed using Welch's <i>t</i>-test due to unequal variances and/or unequal sample sizes.ResultsEighty-eight patients met inclusion criteria and were analyzed. There was no significant difference in fractional anisotropy (FA) (<i>p</i> = 0.3658), mean diffusivity (MD) (<i>p</i> = 0.1734) and radial diffusivity (RD) (<i>p</i> = 0.6586) between the symptomatic and asymptomatic nerve. There was a significant difference in AD (<i>p</i> = 0.0186). However, after the sequential modified Bonferroni correction, the difference in AD no longer reached significance. There was no significant difference in FA (<i>p</i> = 0.7556), MD (<i>p</i> = 0.8915), RD (<i>p</i> = 0.4324) and AD (<i>p</i> = 0.9918) in the symptomatic nerve between the treatment responders and non-responders.ConclusionsDTI may not reliably predict outcomes of microvascular decompression in patients with cTN due to arterial compression or deformation.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251322505"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interactive CBT for headache and relaxation training (iCHART): Single-arm pilot trial of cognitive behavioral therapy for veterans with post-traumatic headache.","authors":"Amy S Grinberg, Daniel G Rogers, Olivia Datre, Sarah Anthony, Sarah W Clark, Stanley C Takagishi, Elizabeth Seng, Brenda T Fenton, John P Ney, Jason J Sico","doi":"10.1177/03331024251351598","DOIUrl":"10.1177/03331024251351598","url":null,"abstract":"<p><p>BackgroundCognitive behavioral therapy for headache (CBT-HA) improves headache-related outcomes, but accessibility barriers limit its use. This pilot study evaluated the feasibility, acceptability and clinical signal of an interactive voice response (IVR)-delivered CBT-HA intervention for veterans with post-traumatic headache (PTH).MethodsA single-arm pilot trial was conducted with 18 veterans diagnosed with PTH. Participants completed a 10-week IVR-CBT-HA program. Outcomes were assessed at baseline, immediately post-treatment and one-month follow-up. Primary outcomes included changes in headache days, interference, disability, feasibility and acceptability.ResultsFifteen participants completed the study. Headache frequency, headache-related disability, depressive symptoms, anxious symptoms, sleep quality and headache catastrophizing were not statistically significant. Self-efficacy significantly improved from baseline to post-treatment (<i>F</i>_2,12 = 8.71, <i>p</i> = 0.001), and remained stable at follow-up. Participants reported high satisfaction with the intervention (27.73/32, SD = 5.66) but low system usability (mean = 20.83/100, SD = 15.72). Study therapists rated the intervention as highly acceptable (acceptability of intervention: mean = 4.83/5, SD = 0.37) and feasible (feasibility of intervention measure: mean = 4.92/5, SD = 0.28). Interactive CBT for headache and relaxation training (i.e. iCHART) resulted in an approximately 33% cost savings compared to traditional CBT-HA.ConclusionsAsynchronous, IVR-delivered CBT-HA was feasible, acceptable and cost-effective for veterans with PTH. Although headache reductions were not statistically significant, self-efficacy improvements suggest long-term benefits. Future research should explore technology refinements and larger randomized trials.Trial RegistrationClinicalTrials.gov: NCT05093556 (registered 26 October 2021).</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251351598"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of the persistence of acute treatment with rimegepant versus oral triptans in patients with migraine: A retrospective analysis of US claims data.","authors":"Stewart J Tepper, Aaron Jenkins, Carl Henriksen, Feng Dai, Jo Atkinson, Lucy Abraham, Astrid Gendolla","doi":"10.1177/03331024251352849","DOIUrl":"10.1177/03331024251352849","url":null,"abstract":"<p><p>BackgroundThis study compared persistence of patients initiating rimegepant versus oral triptans for the acute treatment of migraine.MethodsA retrospective cohort analysis was conducted using US MarketScan claims data (1 March 2019 to 30 June 2023) among commercially- and US federal Medicare-insured migraine patients initiating rimegepant or oral triptans. Persistence was defined as having ≥1 refill within 12 months of initial prescription and was compared between propensity score-matched rimegepant and triptan cohorts.ResultsBefore matching, 13,599 patients were identified in the rimegepant cohort and 38,127 in the triptan cohort. After matching, each cohort included 9909 patients. Significantly more rimegepant patients were persistent (75.8%) versus triptan patients (53.5%) (odds ratio [OR] 2.72, 95% confidence interval [CI] 2.56-2.90). Subgroup analyses showed similar trends for rimegepant versus specific triptans (rizatriptan: OR 2.49 [95% CI 2.33-2.67], and sumatriptan: OR 2.92 [95% CI 2.73-3.12]) and in patients with chronic migraine (OR 2.86 [95% CI 2.53-3.23]).ConclusionsThis study provides compelling evidence that rimegepant is associated with greater persistence than oral triptans for real-world acute treatment of migraine. Rimegepant is a favorable option for patients seeking effective and tolerable long-term treatment, particularly for those with insufficient response, intolerability, or contraindications to triptans.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251352849"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on comment on \"Toward ICHD-4: Proposing a broader diagnostic framework for burning mouth syndrome\".","authors":"Gilad Wasserman, Iftah Biran, Ayelet Zlotogorski Hurvitz","doi":"10.1177/03331024251362822","DOIUrl":"https://doi.org/10.1177/03331024251362822","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251362822"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized open-label study to evaluate the effectiveness and safety of once-daily rimegepant 75 mg orally disintegrating tablet for the short-term preventive treatment of fasting-triggered headache in individuals with migraine.","authors":"Taoufik Alsaadi, Reem Suliman, Jiyue Yang, Ekta Agarwal, Terence Fullerton, Denise E Chou, Ed Whalen, Caline El Jadam, Ibrahim Al Qaisi, Youssef Amin, Athra Alkhateri, Kareem Alsaffarini, Lucy Abraham, Zahra Zunaed, Haytham M Ahmed, Mohamed Fathy, Mohamed Hegab, Nora Vainstein","doi":"10.1177/03331024251355947","DOIUrl":"https://doi.org/10.1177/03331024251355947","url":null,"abstract":"<p><p>AimTo evaluate rimegepant, a calcitonin gene-related peptide receptor antagonist, for short-term prevention of fasting-triggered headache during Ramadan.MethodsParticipants, aged 18-65 years and diagnosed with migraine or headache attributed to fasting, were randomized to open-label once-daily (QD) rimegepant 75 mg orally disintegrating tablet (ODT) from weeks 1-4 of the fast (Immediate Start arm; n = 52) or weeks 2-4 of the fast (Staggered Start arm; n = 53). The primary endpoint was the difference in number of headache days of any intensity between the Immediate Start and Staggered Start arms during week 1. Other endpoints included headache days during weeks 2-4, moderate-to-severe headache days during weeks 1-4, headache duration (any intensity and moderate-to-severe) during weeks 1-4, rescue medication use during weeks 1-4 and treatment satisfaction. Treatment comparisons utilized nominal <i>p</i> values. Safety endpoints included adverse events (AEs), serious AEs and discontinuations due to AEs.ResultsAll participants (n = 105) had a diagnosis of migraine and a history of headaches during fasting. The number of headache days of any intensity during week 1 (primary endpoint) was lower in the Immediate Start arm vs. the Staggered Start arm (LS mean (95% confidence interval) = 1.74 (1.16-2.31) days vs. 2.92 (2.34-3.49) days; <i>p</i> = 0.005). There were no significant differences between arms during weeks 2-4. Total duration of headaches of any intensity was shorter in the Immediate Start arm vs. the Staggered Start arm during week 1 (LS mean (95% confidence interval) = 10.1 (5.9-17.5) hours vs. 20.0 (13.0-28.3) hours; <i>p</i> = 0.041) and week 4 (LS mean (95% confidence interval) = 0.9 (0.2-3.7) hours vs. 4.6 (2.2-15.5) hours; <i>p</i> = 0.035). The number and duration of moderate-to-severe headaches was significantly (<i>p</i> < 0.05) lower in the Immediate Start arm vs. the Staggered Start arm during week 1. For the overall 4-week study period, there was a significant reduction in moderate-to-severe headache days per week in the Immediate Start arm vs. the Staggered Start arm (LS mean (95% confidence interval) = 0.60 (0.34-0.86) days vs. 1.00 (0.75-1.26) days; <i>p</i> = 0.038) and a trend towards reduction in headache days per week of any severity (LS mean (95% confidence interval) = 1.05 (0.72-1.39) days vs. 1.50 (1.17-1.84) days; <i>p</i> = 0.070). Use of rescue medication trended lower in the Immediate Start arm vs. the Staggered Start arm at all study weeks; all <i>p</i> > 0.05. Most participants (82.4%) reported being satisfied, very satisfied, or extremely satisfied with rimegepant at end of treatment. No AEs were reported.ConclusionsQD rimegepant 75 mg ODT may be effective and well tolerated for short-term prevention of fasting-triggered headache in individuals with migraine.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251355947"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The characteristics of headache in patients with epilepsy.","authors":"Yuan Chen, Chengze Wang, Haifeng Zhang, Yake Zheng, Wenchao Cheng, Yuhan Wang, Yajun Lian","doi":"10.1177/03331024251352855","DOIUrl":"https://doi.org/10.1177/03331024251352855","url":null,"abstract":"<p><p>BackgroundHeadache is a known comorbid condition of epilepsy. However, the prevalence of headache comorbidity in patients with epilepsy and its influence on the psychology and daily life of patients with epilepsy remain undefined at present.MethodsClinical data were collected from consecutive patients with epilepsy prospectively through face-to-face questionnaires. According to the temporal relationship between headache and seizures, comorbid headache in patients with epilepsy was classified as preictal headache, ictal headache, postictal headache, and interictal headache. Patients with interictal headache were divided into the migraine group and the non-migraine group, and their clinical characteristics were compared with those of patients with epilepsy but without headache (no-headache group).ResultsA total of 460 patients with epilepsy were included in the study, and 211 (45.9%) had comorbid headache, among which five cases (1.1%) had preictal headache, 134 cases (29.1%) had postictal headache, 119 cases (25.9%) had interictal headache, and 47 cases (10.2%) had both postictal and interictal headache. Additionally, HAMA and HAMD scores in the migraine group were significantly higher than those in the non-migraine group and the no-headache group, and HIT-6 score in the migraine group was significantly higher than that in the non-migraine group.ConclusionNearly half of patients with epilepsy have comorbid headache, mainly manifesting as postictal headache or interictal headache. Among patients with interictal headache, comorbid migraine has the most significant influence on their psychological state and daily life.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251352855"},"PeriodicalIF":5.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rimegepant safety and patient-reported outcomes among triptan-naïve, triptan-using, and triptan-failure participants: Subgroup analysis of an open-label, multicenter study.","authors":"Jessica Ailani, Jelena Pavlovic, Glenn C Pixton, Terence Fullerton","doi":"10.1177/03331024251343309","DOIUrl":"10.1177/03331024251343309","url":null,"abstract":"<p><p>BackgroundRimegepant was safe and well tolerated in a multicenter, open-label, phase 2/3 trial for acute treatment of migraine administered as 75 mg every other day (EOD) and as needed (PRN; EOD + PRN) for 12 weeks or PRN for 52 weeks.MethodsPost-hoc analysis of this long-term safety study in adults was conducted according to five subgroups based on current and historical triptan use: current triptan use and no historical discontinued triptans; no current triptan use and no historical discontinued triptans (triptan-naïve); and history of =1, ≥1 and ≥2 discontinued triptans. Triptan failure was defined as discontinuation of any triptan, for any reason, including insufficient response and/or tolerability.ResultsThe proportion of participants with ≥1 on-treatment adverse event (AE) was 57.6-66.3% across triptan subgroups. Rimegepant-related AEs (17.7-23.2%), treatment discontinuations (1.6-3.8%) and the most common AE (upper respiratory tract infection, 7.7-9.5%) were consistent across subgroups. After long-term treatment, the proportion of participants who preferred rimegepant to their previous medication was >75% in all triptan subgroups.ConclusionsLong-term acute treatment of migraine with rimegepant 75 mg up to once daily was safe and well tolerated in triptan-naïve participants, current triptan users and those with single or multiple historical triptan discontinuations.Trial RegistrationNCT03266588.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251343309"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital phenotyping for migraine: A game-changer for research and management.","authors":"Igor Petrušić","doi":"10.1177/03331024251363568","DOIUrl":"https://doi.org/10.1177/03331024251363568","url":null,"abstract":"<p><p>Migraine is a complex neurobiological disorder characterized by diverse phenotypes and unpredictable therapy outcomes. Digital phenotyping (DP), defined as the real-time collection of behavioral and physiological data in natural environments to identify individual phenotypes, represents a promising approach with the potential to enhance clinicians' ability to identify migraine subtypes. Additionally, DP offers new insights into the intricate neurobiological and behavioral patterns, as well as environmental influences, associated with each phase of a migraine attack, including potential triggers, pre-attack symptoms, the characteristics of an attack and response to treatment. Moreover, a DP-based approach has the potential to revolutionize migraine research and clinical trials by enabling more personalized, patient-centred diagnostics and tailored acute and preventive treatments. Despite the limited literature available and the heterogeneity of study designs, migraine DP may lay the groundwork for future digital twin models and the discovery of digital biomarkers for diagnosis, therapy optimization and outcome evaluation. Furthermore, DP could serve as a predictive marker for migraine attacks, empowering patients to monitor their condition and adopt a proactive approach to treatment. Integrating DP into migraine studies could also contribute to the development of an updated international migraine classification that incorporates neurobiological and psychosocial factors alongside clinical symptomatology. To fully realize its potential in migraine research and care, experts should prioritize collaboration with artificial intelligence (AI) specialists, data scientists and medical engineers. Establishing a multidisciplinary ecosystem will be essential to developing robust and clinically meaningful DP tools for migraine research. This review aims to show the current landscape of both active and passive DP methodologies, which leverage smartphones, wearable biosensors and AI-driven analytics to capture real-time physiological, cognitive and environmental data, at the same time as pointing to the future ahead of migraine DP.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251363568"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When should the effectiveness of a botulinum toxin A for chronic migraine be assessed in the face of newest International Headache Society recommendations?","authors":"Magdalena Boczarska-Jedynak, Andrew M Blumenfeld","doi":"10.1177/03331024251363268","DOIUrl":"https://doi.org/10.1177/03331024251363268","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251363268"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurotransmitter-related functional connectivity changes in serotonin and dopamine systems after mindfulness in medication overuse headache.","authors":"Davide Fedeli, Giuseppe Ciullo, Greta Demichelis, Jean Paul Medina Carrion, Maria Grazia Bruzzone, Emilio Ciusani, Alessandra Erbetta, Stefania Ferraro, Marina Grisoli, Erika Guastafierro, Danilo Antonio Montisano, Domenico D'Amico, Alberto Raggi, Anna Nigri, Licia Grazzi","doi":"10.1177/03331024251332561","DOIUrl":"https://doi.org/10.1177/03331024251332561","url":null,"abstract":"<p><p>Background/HypothesisMindfulness practice has gained attention in managing chronic migraine with medication overuse headache (CM-MOH), showing clinical improvements and functional connectivity reorganization. However, the relationship between these effects and the underlying neurotransmitter systems remains unexplored.MethodsThirty-four CM-MOH patients were divided into treatment as usual (TaU, <i>N</i> = 17) and mindfulness-added-to-TaU (TaU + MIND, <i>N</i> = 17) groups. Participants underwent resting-state fMRI scans before treatment and after one year. We adopted the neurotransmitter-related functional connectivity framework to investigate longitudinal functional changes associated with the distribution of serotonin, dopamine, and norepinephrine systems by comparing TaU + MIND with TaU groups.ResultsWhen compared with TaU, TaU + MIND patients longitudinally showed increased serotonin-enriched functional connectivity in the caudate and accumbens nuclei, and increased dopamine-enriched functional connectivity in the right insular cortex.Conclusion/InterpretationThese regions are involved in emotional, cognitive, and sensory modulation of pain and addiction. Our findings suggest the impact of mindfulness practice on serotonin and dopamine systems with potential beneficial effects in chronic pain management.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 6","pages":"3331024251332561"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}