Cephalalgia最新文献

{"title":"Intact white matter in adults with migraine: A REFORM MRI study.","authors":"Cédric Gollion, Håkan Ashina, Rune Häckert Christensen, Haidar M Al-Khazali, Daniel Tolnai, Messoud Ashina, Faisal Mohammad Amin","doi":"10.1177/03331024251339423","DOIUrl":"https://doi.org/10.1177/03331024251339423","url":null,"abstract":"<p><p>BackgroundDiffusion tensor imaging (DTI) provides valuable insights into the white matter integrity of people with migraine. The present study compares the microstructural white matter integrity between a large sample of people with migraine and healthy controls, as well as across different migraine subtypes.MethodsThis cross-sectional case-control study included adults with migraine and age- and sex-matched healthy controls. Each participant and control underwent a single brain magnetic resonance imaging session, including DTI, to assess microstructural white matter integrity using tract-based spatial statistics by voxel-wise comparison using a general linear model (GLM). The DTI outcome measures included fractional anisotropy, mean diffusivity, axial diffusivity and radial diffusivity. Comparisons were made between participants with migraine and controls, as well as among different migraine subtypes (migraine with aura, migraine without aura, episodic migraine and chronic migraine). Additional comparisons were conducted between participants during and outside of migraine attacks, as well as between hemispheres ipsilateral and contralateral to the pain side in those scanned during unilateral migraine attacks.ResultsIn total, 293 participants with migraine and 154 healthy controls provided DTI data eligible for analysis. Among the participants, 181 (61.7%) had chronic migraine, 103 (35.1%) had migraine with aura and 79 (26.9%) were scanned during a migraine attack. No significant differences in white matter integrity were identified between participants with migraine and controls, nor among the different migraine subtypes.ConclusionsOur results suggest that migraine does not result in microstructural alterations within the cerebral white matter. Further research is necessary to explore other potential radiologic biomarkers and pathophysiologic mechanisms underlying migraine.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 5","pages":"3331024251339423"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179745","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":"Behavioral, non-pharmacological intervention modalities to alleviate persistent headache attributable to traumatic brain injury: A systematic review of patient pain outcomes in the context of the mutual maintenance model.","authors":"Elizabeth M Sanford, Kristin N Sramek, Donald D McGeary, Paul S Nabity","doi":"10.1177/03331024251341237","DOIUrl":"10.1177/03331024251341237","url":null,"abstract":"<p><p>BackgroundPersistent post-traumatic headache (PPTH) is a disabling sequela of traumatic brain injury (TBI). Many individuals seek behavioral interventions to supplement pharmacological treatment. This systematic review describes behavioral interventions for treatment of PPTH and psychosocial factors related to outcomes in adults.MethodsA systematic search for behavioral interventions for adult patients who suffered headache attributable to mild TBI was conducted across PubMed, CINAHL, Scopus, PsycINFO and Cochrane Library in June 2024. Studies were excluded if they (a) did not evaluate outcomes related to PPTH pain; (b) evaluated pediatric populations; (c) used animal models; (d) evaluated interventions other than behavioral modalities; and (e) TBI was moderate or severe. Risk of bias was assessed for included randomized controlled trials (RCTs) using Cochrane's Risk of Bias II (RoB2).ResultsThe search and evaluation process identified 12 articles evaluating 2293 individuals with PPTH. Study designs included randomized controlled trials (n = 4) and observational studies (n = 8). Behavioral intervention modalities included cognitive behavioral therapy (n = 5), education/counseling (n = 3), exercise (n = 2) and integrated managed care (n = 2). Three included RCTs were assessed to have low risk of bias and one had some concerns of potential bias.ConclusionsCognitive behavioral interventions within interdisciplinary systems of care may be the optimal combination. Mutual maintenance may explain and contextualize the high comorbidity between PPTH and affective distress. Treatment for PPTH in adults with mild TBI should incorporate treatment for psychological distress.Trial RegistrationThis systematic review was registered in Prospero (CRD42024556014).</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 5","pages":"3331024251341237"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126714","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":"Effectiveness of transcranial direct current stimulation and monoclonal antibodies acting on the CGRP as a combined treatment for migraine (TACTIC): Results of a randomized controlled trial.","authors":"Raffaele Ornello, Aurora D'Atri, Roberto De Icco, Federico De Santis, Chiara Rosignoli, Agnese Onofri, Gloria Vaghi, Francescantonio Cammarota, Carla Brancaccio, Michele Corrado, Federico Bighiani, Valentina Grillo, Grazia Sances, Domenico Corigliano, Federico Salfi, Cristina Tassorelli, Michele Ferrara, Simona Sacco","doi":"10.1177/03331024251325567","DOIUrl":"10.1177/03331024251325567","url":null,"abstract":"&lt;p&gt;&lt;p&gt;BackgroundMigraine pathogenesis involves both central and peripheral mechanisms. Although calcitonin gene-related peptide monoclonal antibodies have shown efficacy over placebo in migraine prevention, a proportion of individuals with migraine may experience a substantial residual burden while on treatment. Transcranial direct current stimulation is a non-invasive neuromodulation technique that can target central migraine mechanisms and may therefore complement calcitonin gene-related peptide monoclonal antibodies. The present study aimed to assess the efficacy of transcranial direct current stimulation as an adjunctive treatment to calcitonin gene-related peptide monoclonal antibodies in migraine prevention and to investigate its neurophysiological effects.MethodsThis is a multicenter, randomized double-blind, sham-controlled, parallel-group trial including subjects with migraine on treatment with calcitonin gene-related peptide monoclonal antibodies for ≥90 days and with ≥8 monthly migraine days in the last 30 days. Subjects were randomized to active or sham transcranial direct current stimulation. The transcranial direct current stimulation protocol consisted of five daily 20-minute sessions of bilateral cathodal stimulation on the occipital area and anodal stimulation on the M1 area. High-density electroencephalographic recordings were performed before the first and after the last transcranial direct current stimulation session. The primary endpoint was the number of headache days during the 28-day follow-up period controlling for the 28-days baseline value. Secondary endpoints included the number of migraine days during the follow-up period, disability measures and electroencephalographic spectral power. The active and sham groups were compared using analysis of covariance. For clinical outcomes with significant differences between groups, we also ran paired &lt;i&gt;t&lt;/i&gt;-tests comparing baseline and follow-up assessment within groups.ResultsThirty participants were randomized (15 to active and 15 to sham group). Headache days during the 28-day follow-up period did not differ significantly between groups (&lt;i&gt;p&lt;/i&gt; = 0.560, η&lt;sub&gt;p&lt;/sub&gt;&lt;sup&gt;2 &lt;/sup&gt;= 0.017). However, participants receiving active transcranial direct current stimulation reported fewer migraine days during follow-up compared to the sham group (&lt;i&gt;p&lt;/i&gt; = 0.008, η&lt;sub&gt;p&lt;/sub&gt;&lt;sup&gt;2 &lt;/sup&gt;= 0.241). Paired &lt;i&gt;t&lt;/i&gt;-tests indicated that the active tDCS group reported a reduction in migraine days during the follow-up period compared to baseline (&lt;i&gt;t&lt;/i&gt; = 2.557, &lt;i&gt;p&lt;/i&gt; = 0.023, Cohen's &lt;i&gt;d&lt;/i&gt; = 0.660), while no difference was found in the sham group. Referring to neurophysiological endpoints, active transcranial direct current stimulation induced a significant decrease in delta power at frontal regions compared to sham.ConclusionsThis randomized-controlled trial suggests that transcranial direct current stimulation is a promising potentially effective treatment that may give a","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 5","pages":"3331024251325567"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092598","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":"OnabotulinumtoxinA treatment for chronic migraine in pregnancy: An updated report of real-world headache and pregnancy outcomes over 14 years in Hull.","authors":"Ho Tin Wong, Rafiullah Khan, Alina Buture, Modar Khalil, Fayyaz Ahmed","doi":"10.1177/03331024251327387","DOIUrl":"https://doi.org/10.1177/03331024251327387","url":null,"abstract":"<p><p>BackgroundOnabotulinumtoxinA is widely used for patients with chronic migraine, but its safety and efficacy in pregnancy remain unclear. In 2020, we published a report of 45 subjects who became pregnant on OnabotulinumtoxinA treatment for chronic migraine. Although numbers were small, the results suggested that OnabotulinumtoxinA treatment was effective in pregnancy without evidence of adverse pregnancy outcome. We now have an additional 81 subjects to add to the database.MethodThis is a tertiary centre (Hull) prospective study between 2010-2024. Subjects who became pregnant during treatment with OnabotulinumtoxinA for chronic migraine were recruited. Subjects were provided informed consent whether to continue treatment with OnabotulinumtoxinA. All subjects were followed up 12-weekly with headache and pregnancy outcomes collected.ResultsBetween 2010-2024, 126 subjects became pregnant during OnabotulinumtoxinA treatment for chronic migraine. Of these, 97/126 (77.0%) opted to continue treatment with OnabotulinumtoxinA. All 97/97 (100.0%) subjects who continued OnabotulinumtoxinA treatment remained in migraine remission, compared to only 9/29 (31.0%) who discontinued treatment. 2/97 (2.1%) subjects who continued treatment suffered miscarriages whereas 1/29 (3.4%) subjects who discontinued treatment suffered a miscarriage. No foetal malformations were reported.ConclusionIn our small descriptive study, subjects who continued OnabotulinumtoxinA in pregnancy continued to have migraine remission with no adverse pregnancy outcomes in our cohort.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 5","pages":"3331024251327387"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983398","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":"Prevalence and impact of headaches in workers of a palm plantation in Cameroon.","authors":"Annick Melanie Magnerou, Victor Sini, Ulrich Arthur Nganwa Nono, Serge Honoré Tchoukoua, Prisca Rolande Bassole, Daniel Massi Gams, Jacques Narcisse Doumbe, Eric Lamou Bila Gueumekane, Yacouba Njankouo Mapoure, Noël-Emmanuel Essomba, Callixte Kuate-Tegueu","doi":"10.1177/03331024251343312","DOIUrl":"10.1177/03331024251343312","url":null,"abstract":"<p><p>BackgroundHeadaches are a worldwide health issue that impact almost all social strata, with a particular effect on the working population, leading to substantial financial cost to society. However, despite their significant socio-professional impact, data on this topic remain scarce in sub-Saharan Africa. The present study aims to assess the prevalence and impact of headaches among workers.MethodsFrom November 2023 to June 2024, we conducted a cross-sectional analytical study of workers at the Société Camerounaise de Palmeraie (SOCAPALM), Dibombari plantation I Cameroon. Data were collected using the HARDSHIP (i.e. Headache-Attributed Restriction, Disability and Impaired Participation) questionnaire, with headache impact measured by the Headache Impact Test (HIT-6) and Headache-Attributed Lost Time (HALT-90) scores, and quality of life evaluated by the World Health Organization Quality of Life (WHOQoL-8) score. Qualitative variables were compared using chi-squared or Fisher's exact test, and quantitative variables were compared with analysis of variance. <i>p</i> < 0.05 was considered statistically significant.ResultsIn total, 732 workers participated, 77% were male and they were aged 35.43 ± 9.15 years (mean ± SD). The 12-month prevalence of headache was 80.4%, with primary headaches being the most common (73%), including 21.7% with tension-type headache (TTH) and 16.9% with migraine. Over the last three months, there were 279 days of absenteeism due to headaches (0.47 ± 0.95 days), with migraine accounting for 48.0% of these days (1.08 ± 1.24 days). Impact scores (HIT-6 and HALT-90) showed that patients with migraine experienced the most significant effects (53.1% and 34.7%, respectively) and a poorer quality of life (odds ratio = 12.63; 95% confidence interval = 7.33-21.75; <i>p</i> < 0.001) compared to general headache and TTH sufferers. Female sex was associated with higher rates of headaches (odds ratio = 1.78; 95% confidence interval = 1.05-3.02; <i>p</i> < 0.001).ConclusionsHeadaches affect three-quarters of workers and has a significant socio-professional impact, including a higher rate of absenteeism among those affected. Migraine is the most disabling type of headache among workers.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 5","pages":"3331024251343312"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109923","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":"Advancing understanding of migraine pathophysiology and therapy by consideration of patient sex.","authors":"Frank Porreca, Edita Navratilova, David W Dodick","doi":"10.1177/03331024251339466","DOIUrl":"10.1177/03331024251339466","url":null,"abstract":"<p><p>Recent reports support the startling conclusion that peripheral nociceptors, the first link in pain transmission, are sexually dimorphic. The mechanisms promoting pain in men and women are therefore likely to be different, suggesting the need to consider patient sex as a factor in managing pain and painful conditions such as migraine. Many patients do not achieve sufficient benefit from available therapies and migraine therefore remains a major unmet medical need. The concept of sexual dimorphism in pain mechanism reveals previously unrecognized gaps in knowledge of migraine pathophysiology and in treatment outcomes. As migraine is highly female prevalent, our knowledge is based on studies conducted predominately in women. Data from these studies have rarely been analyzed and reported based on sex, limiting our interpretation of the occurrence, timing and severity of disease symptoms as well as possible differences in treatment efficacy in men. Inclusion of a higher proportion of men in both mechanistic investigations and clinical trials is therefore needed. Advancing our knowledge and improving therapeutic outcomes will require both preclinical and clinical investigations that address the contribution of sex in headache pain and other non-painful symptoms of migraine that impact the quality of life for patients. This viewpoint highlights the importance of considering sex as a variable in advancing our understanding of migraine pathophysiology and therapy. Consideration of patient sex could influence current clinical practice and the design of clinical studies.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 5","pages":"3331024251339466"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to \"What is the evolutionary disadvantage of migraine?\"","authors":"Umberto Pensato, Sabina Cevoli, Giulia Pierangeli, Pietro Cortelli","doi":"10.1177/03331024251327377","DOIUrl":"https://doi.org/10.1177/03331024251327377","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 4","pages":"3331024251327377"},"PeriodicalIF":5.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762952","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":"Methodological considerations in assessing the impact of CGRP monoclonal antibodies on blood pressure: The need for a broader perspective.","authors":"Davide Mascarella, Valentina Favoni, Giulia Pierangeli, Sabina Cevoli","doi":"10.1177/03331024251329513","DOIUrl":"https://doi.org/10.1177/03331024251329513","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 4","pages":"3331024251329513"},"PeriodicalIF":5.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779321","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":"Effectiveness of anti-CGRP monoclonal antibodies and onabotulinumtoxinA in menstrually-related migraine: The unmet need of perimenstrual headache days.","authors":"Rut Mas-de-Les-Valls, Laura Gómez-Dabó, Edoardo Caronna, Victor J Gallardo, Alicia Alpuente, Marta Torres-Ferrus, Patricia Pozo-Rosich","doi":"10.1177/03331024251332519","DOIUrl":"https://doi.org/10.1177/03331024251332519","url":null,"abstract":"<p><p>BackgroundData on the effectiveness of preventive treatments on menstrually-related migraine (MRM) is scarce. Our objective was to analyze the efficacy of anti-calcitonin gene-related peptide monoclonal antibodies (anti-CGRP mAbs) and onabotulinumtoxinA (BTX-A) in the reduction of perimenstrual headache days (PHD) and perimenstrual migraine days (PMD) compared to non-perimenstrual headache days (non-PHD) and non-perimenstrual migraine days (non-PMD) per month in women with MRM.MethodsA retrospective study was conducted including females with menstruation and headache records, treated with either anti-CGRP mAbs or BTX-A. Patients completed e-Diary one month before and three months after preventive treatment. We collected clinical data and analyzed PHD/PMD and non-PHD/non-PMD before and after treatment. Additional analyses included PHD/PMD and non-PHD/non-PMD comparisons grouped by aura, episodic/chronic migraine, treatment and contraceptive intake.ResultsWe analyzed data from 113 females with a median (range) age of 39.0 (33.0-45.0) years. When combining patients treated with anti-CGRP mAbs or BTX-A, a median (range) of 2.0 (2.0-3.0) PHD/month (corresponding to 13.6% baseline monthly headache days (MHD)) and 13.0 (9.0-17.0) non-PHD/month pre-treatment was observed. From these, 2.0 (1.0-3.0) were PMD/month, and 7.0 (4.0-11.0) were non-PMD/month. After treatment, the median PHD/month was 2.0 (1.0-3.0) (corresponding to 16.67% of MHD) (<i>p</i> = 0.085), and 8.0 (5.0-13.0) were non-PHD/month (<i>p</i> < 0.001); from these, 1.0 (0.0-3.0) were PMD/month (proportion difference, <i>p</i> = 0.035) and 4.0 (2.0-7.0) were non-PMD (proportion difference, <i>p</i> < 0.001). When analyzing grouped by treatment, only patients treated with anti-CGRP experienced a reduction in PMD. No statistically significant differences in clinical factors (aura, migraine diagnosis, contraceptive intake) between PHD/non-PHD or PMD/non-PMD, either pre- or post-treatment. A higher probability risk of headache and migraine during the perimenstrual window was observed independently of the treatment received (odds ratio = 1.637, 95% confidence interval = 1.356-1.984, <i>p</i> < 0.001).ConclusionsThree-month treatment with anti-CGRP mAbs or BTX-A effectively reduced non-PHD and non-PMD but had limited effect on PHD/PMD because headache probability risk was higher during the perimenstrual window after treatment.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 4","pages":"3331024251332519"},"PeriodicalIF":5.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965971","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":"No evidence of intracranial hypotension in persistent post-traumatic headache: A magnetic resonance imaging study.","authors":"Henrik W Schytz, Emil Smilkov, Ian Carroll, Tomas Dobrocky, Haidar M Al-Khazali, Daniel Tolnai, Rigmor H Jensen, Faisal Mohammad Amin","doi":"10.1177/03331024251325556","DOIUrl":"https://doi.org/10.1177/03331024251325556","url":null,"abstract":"<p><p>BackgroundPersistent post-traumatic headache (PTH) is frequent, and intracranial hypotension may be an important cause of PTH. The present study aimed to examine whether magnetic resonance imaging (MRI) signs of intracranial hypotension are more frequent in people with persistent PTH than in healthy controls (HCs).MethodsAdults with persistent PTH attributed to mild traumatic brain injury and age- and sex-matched HCs attended a single non-contrast, brain MRI 3T session. Fluid attenuated inversion recovery T1- and T2-weighted sequences were acquired to assign a modified Bern score. The score ranges from 0 to 9 points, with higher scores indicating a greater probability of cerebrospinal fluid (CSF) leakage leading to intracranial hypotension. The primary outcome was the difference in modified Bern score between participants with persistent PTH and HCs. All images were examined by a certified neuroradiologist who was blinded to the group status.ResultsImaging data from 97 participants with persistent PTH and 96 age- and sex-matched HCs were eligible for analyses. A modified Bern score of ≤2 was present in 90 (93%) participants with persistent PTH and 85 (89%) HCs, indicating a low probability of CSF leak. None of the persistent PTH participants or the HCs had a score of >4. There were no significant differences in modified Bern scores between participants with persistent PTH and HCs.ConclusionsThere is a low prevalence of typical MRI Bern score signs of intracranial hypotension in PTH or HCs. Thus, intracranial hypotension is unlikely to be an underlying factor in persistent PTH attributed to mild traumatic brain injury.Trial RegistrationThe study was registered on ClinicalTrials.gov (identifier: NCT03791515). Date of registration 2018-12-29.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 4","pages":"3331024251325556"},"PeriodicalIF":5.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966682","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}