Cephalalgia最新文献

{"title":"Chronic cluster headache is a rare disease: Implications for diagnosis, treatment and public health.","authors":"Hsiangkuo Yuan, Jan Hoffmann, Elena Ruiz de la Torre, Michael J Marmura, Mario F P Peres","doi":"10.1177/03331024251369752","DOIUrl":"https://doi.org/10.1177/03331024251369752","url":null,"abstract":"<p><p>Cluster headache (CH) is a rare and painful primary headache disorder characterized by severe unilateral pain and cranial autonomic symptoms. This perspective examines the epidemiological evidence supporting the classification of chronic cluster headache (CCH) as a rare disease, noting a prevalence of CH of approximately 124 per 100,000 individuals, with only 3.5-13.7% manifesting CCH. This prevalence meets criteria established by both the US Food and Drug Administration and European Medicines Agency for rare disease designation. The rarity of CCH creates substantial clinical and research challenges, including prolonged diagnostic delays, limited research funding and a dearth of approved treatments. The economic burden is particularly notable, with annual costs exceeding €20,000 per patient. Addressing these challenges requires a coordinated approach focusing on increased research funding, enhanced policy advocacy, improved diagnostic training and the development of comprehensive disease registries to advance both patient care and scientific understanding of this devastating neurological condition.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 8","pages":"3331024251369752"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945047","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":"Reviewing the complex relationship between circadian rhythms and cluster headache.","authors":"Mark Burish, Seung Ae Kim, Caroline Ran, Seung-Hee Yoo, Mi Ji Lee, Andrea Carmine Belin","doi":"10.1177/03331024251365858","DOIUrl":"10.1177/03331024251365858","url":null,"abstract":"<p><p>Cluster headache attacks display uniquely rhythmic patterns in their manifestations. Multiple international studies have shown circadian and even circannual timing of attacks, although we do not yet fully understand the effects of culture, sleep, chronotype, seasonal changes, temperature or inter-individual changes over time. Multiple cluster headache treatments alter the core circadian oscillator, although they affect the oscillator differently and are not well understood. Multiple small genetic studies have shown core circadian gene variants to be cluster headache susceptibility genes, whereas larger genetic studies have not shown core circadian gene variants but have also not documented the presence or absence of circadian rhythmicity. In this narrative review, we describe the multi-level circadian features of cluster headache and propose future circadian directions, including a clinical definition of circadian attacks, a potential animal model of circadian headache and study design changes to incorporate circadian features into larger genetic studies.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 8","pages":"3331024251365858"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844726","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":"Reply to Wasserman et al.: Elucidating the \"Triggers\" versus \"Maintenance\" in burning mouth syndrome/oral dysaesthetic and perceptual disorder.","authors":"Takayuki Suga, Trang Thi Huyen Tu, Daniela Adamo, Akira Toyofuku","doi":"10.1177/03331024251369533","DOIUrl":"10.1177/03331024251369533","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 8","pages":"3331024251369533"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882218","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":"Is PACAP the next big thing in migraine therapy?","authors":"Lars Edvinsson","doi":"10.1177/03331024251368748","DOIUrl":"10.1177/03331024251368748","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 8","pages":"3331024251368748"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871652","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":"Long-term safety, efficacy and functional outcomes of atogepant for the preventive treatment of migraine.","authors":"Sait Ashina, Messoud Ashina, Dagny Holle-Lee, Cristina Tassorelli, Soo-Jin Cho, Molly Yizeng He, Rosa De Abreu Ferreira, Pranav Gandhi, Jonathan H Smith, Kimberly Pfleeger, Joel M Trugman","doi":"10.1177/03331024251365206","DOIUrl":"10.1177/03331024251365206","url":null,"abstract":"<p><p>AimLong-term data for oral calcitonin gene-related peptide receptor antagonist, atogepant, in episodic migraine (EM) has been reported. This is the first report on one-year outcomes in participants with chronic migraine (CM) and in the EM population with prior preventive treatment failures. Here, we report the long-term safety, tolerability, efficacy and functional outcomes of one-year preventive treatment of EM or CM with atogepant.MethodsThis is an interim analysis of an ongoing, open-label, multicenter, 156-week, safety extension study that enrolled completers from phase 3 PROGRESS and ELEVATE trials. The participants completing week 52 or early termination were evaluated. Eligible adults with at least a one-year history of migraine, with either CM (PROGRESS) or EM who previously had inadequate response to two to four classes of conventional oral preventive treatments (ELEVATE). All participants received atogepant 60 mg once daily. The primary outcome was safety and tolerability of atogepant. Efficacy and functional outcomes were prespecified exploratory analyses.ResultsOf 596 participants, 595 (PROGRESS, n = 325; ELEVATE, n = 270) were treated and included in the safety population and 524 (PROGRESS, n = 284; ELEVATE, n = 240) were included in the modified intent-to-treat population. In this interim analysis, mean duration of atogepant exposure was 496.5 days. Treatment-emergent adverse events (TEAEs) occurred in 79.0% of participants; most were mild/moderate and not related to atogepant. Common TEAEs (≥5%) included COVID-19 (28.7%), nasopharyngitis (10.9%) and constipation (8.2%). TEAEs leading to discontinuation occurred in 5.9% of participants. One death attributed to asphyxia by housefire was observed. Other serious TEAEs occurred in 5.5% of participants and none were related to atogepant. Alanine aminotransferase and/or aspartate aminotransferase ≥3× upper limit of normal occurred in two participants; neither met Hy's law criteria. Improvements in efficacy and functional outcomes from lead-in study baseline were observed at weeks 13-16 in this open-label study and were consistent through 48 and 52 weeks, respectively.ConclusionsOverall safety results were consistent with the known safety profile of atogepant and the drug was well-tolerated over the course of the study. No new safety signals were identified. Improvements in efficacy and functional outcomes were consistent during the study.Trial RegistrationClinicalTrials.gov identifier: NCT04686136.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 8","pages":"3331024251365206"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882217","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 psychometric properties of an e-headache diary in migraine.","authors":"Nancy van Veelen, Nadine Pelzer, Britt W H van der Arend, Natasha Waslam, Daphne S van Casteren, Erik J Giltay, Gisela M Terwindt","doi":"10.1177/03331024251359222","DOIUrl":"https://doi.org/10.1177/03331024251359222","url":null,"abstract":"<p><p>ObjectiveTo evaluate the psychometric characteristics of a previously validated electronic headache diary with automated algorithm for the purpose of identifying migraine days.MethodsThe psychometric properties of 13 variables in this e-diary were analyzed using item response theory (IRT) in migraine patients from the Leiden Headache Center. The included items were headache presence, duration, unilaterality, severity, pulsating, aggravation by physical activity, visual aura, aura duration, nausea, vomiting, photophobia or phonophobia and triptan usage. The added value to the end-diagnosis of an already validated migraine day of the individual items was assessed. A generalized partial credit model was used to evaluate the items. A discriminative value α ≥ 1.70 indicated an excellent discrimination.ResultsIn total 1418 migraine patients were analyzed with a mean age of 43 years, 89% were women and 38% reported aura symptomatology. All items demonstrated excellent discriminative value [α: 1.82-54.1], except for aura duration [α:0.86], which was moderate. Cronbach's alpha was 0.91. The answers options of headache duration, photophobia, phonophobia, nausea and vomiting did not reach the probability threshold of 0.5.ConclusionsThe items in this e-headache diary demonstrated good overall psychometric performance, although certain items, particularly aura-related and multi-categorical items, may benefit from category merging or further refinement.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 8","pages":"3331024251359222"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774769","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":"Overlap between perceived triggers, premonitory symptoms and symptom persistence across migraine phases: A REFORM study.","authors":"Janu Thuraiaiyah, Rune H Christensen, Haidar M Al-Khazali, Astrid Wiggers, Messoud Ashina, Håkan Ashina","doi":"10.1177/03331024251364234","DOIUrl":"https://doi.org/10.1177/03331024251364234","url":null,"abstract":"<p><p>AimTo evaluate the overlap between commonly reported trigger factors and corresponding premonitory symptoms in individuals with migraine.MethodsThis cross-sectional study analyzed data based on participant recall obtained through semi-structured interviews. Individuals diagnosed with migraine were enrolled from September 2020 to June 2022. Participants underwent semi-structured interviews to record their usual trigger factors, premonitory symptoms, non-headache symptoms during the headache and postdromal symptoms. The primary outcome was to assess whether reporting specific trigger factors increased the likelihood of experiencing corresponding premonitory symptoms. Furthermore, the presence of non-headache symptoms across migraine phases was examined.ResultsAmong the 632 participants (mean age 44.6 ± 12.0 years; 89% female), the most frequent triggers were sleep disturbances (70.1%), stress (67.7%) and alcohol consumption (59.0%). Common premonitory symptoms included tiredness (39.9%), concentration difficulties (35.0%) and neck pain (33.2%). Significant associations were found between specific triggers and premonitory symptoms: bright light with premonitory photophobia (odd ratio (OR)  = 2.79; 95% confidence interval (CI) = 1.90-4.12; <i>p</i> < 0.001), loud noise with premonitory phonophobia (OR = 4.26; 95% CI = 2.77-6.59; <i>p</i> < 0.001) and sleep disturbances with premonitory tiredness (OR = 1.74; 95% CI = 1.15-2.64; <i>p</i> = 0.009).ConclusionsOur results reveal a notable overlap between specific migraine triggers and corresponding premonitory symptoms, implicating that some perceived triggers could be early signs of an impending attack. Moreover, the continuation of most premonitory symptoms into the postdromal phase suggest that migraine-related symptoms extend across a broader temporal continuum than previously recognized.Trial RegistrationNCT04603976.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 8","pages":"3331024251364234"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112324","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":"Acute confusional migraine: Proposal for inclusion in the International Classification of Headache Disorders - 4th edition (ICHD-4).","authors":"Karen Dos Santos Ferreira, Ana Miriam Velly","doi":"10.1177/03331024251370305","DOIUrl":"10.1177/03331024251370305","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 8","pages":"3331024251370305"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882316","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":"Preclinical and clinical evaluation of LY3451838, a PACAP-neutralizing monoclonal antibody, in randomized, double-blind, placebo-controlled phase 1 and phase 2 studies involving healthy adults and adults with treatment-resistant migraine.","authors":"Michael P Johnson, Judith Krikke-Workel, Chetan N Patel, S Michelle Morin, P Kellie Turner, Kristie A Clark, David Donley, Yan Jin, Kirk W Johnson, Maurice Vincent, John R Stille, Lisa M Broad, Ashok Patel","doi":"10.1177/03331024251368757","DOIUrl":"https://doi.org/10.1177/03331024251368757","url":null,"abstract":"<p><p>AimLY3451838 is a monoclonal antibody against pituitary adenylate cyclase-activating peptide (PACAP), a target in migraine research. The present study aimed to evaluate LY3451838 as a preventive treatment for participants with treatment-resistant migraine.MethodsFollowing preclinical assessment of LY3451838, including pharmacokinetic and pharmacodynamic studies, safety was evaluated in a phase 1 study of LY3451838 (n = 33) versus placebo (n = 13) in healthy participants. A phase 2 trial was carried out in treatment-resistant participants with chronic migraine (CM) (n = 16) or episodic migraine (EM) (n = 22). In phase 2, participants received a single intravenous (IV) dose of 1500 mg LY3451838 (n = 19) or placebo (n = 19) and completed ePRO daily diaries. Participants were followed for safety for 140 days.ResultsIn phase 2, at one-month post-dose, patients who had received a single IV dose of LY3451838 exhibited greater changes from baseline than placebo in mean monthly migraine headache days in both the CM and EM subgroups (CM: -4.7 days vs. -3.0 days; EM: -1.7 days vs. -1.2 days), but the treatment contrast was not statistically significant in either subgroup. Similar non-significant results were seen at the three-month time point. The percentage of participants reporting treatment-emergent adverse events was similar for LY3451838 and placebo, with one serious adverse event of B-cell lymphoma in an LY3451838-treated participant that led to study discontinuation.ConclusionsLY3451838 did not demonstrate superior efficacy over placebo in patients with treatment-resistant CM or EM. However, the difference observed between LY3451838 and placebo among CM patients is similar to the statistically significant difference reported in the recent HOPE trial, which primarily consisted of CM patients. Further clinical research with larger sample sizes is needed to inform on the utility of blocking PACAP in various migraine populations.Trial RegistrationClinicalTrials.gov: NCT03692949 (phase 1); NCT04498910 (phase 2).</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 8","pages":"3331024251368757"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945074","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 of headache consultations in Danish chiropractic practice: A cross-sectional study.","authors":"Kristina Boe Dissing, Henrik Hein Lauridsen, Mette Mouritsen Sørensen, Henrik Wulff Christensen, Rikke Krüger Jensen","doi":"10.1177/03331024251362126","DOIUrl":"https://doi.org/10.1177/03331024251362126","url":null,"abstract":"<p><p>BackgroundHeadache is a leading cause of disability and a major public health problem worldwide. Although most patients with headaches are managed in primary care settings, including chiropractic clinics, there are few studies describing the prevalence of headache and headache diagnoses in primary care. The present study aimed to: (1) estimate the prevalence of headache consultations in chiropractic practice; (2) estimate the prevalence of different headache diagnoses used in chiropractic practice; and (3) determine the association between the prevalence of headache consultations and chiropractor characteristics.MethodsAll chiropractors in Denmark, who were members of the Danish Chiropractic Association, (n = 695) were invited to participate. Data collection for this cross-sectional study was based on a survey and a 20-day logbook and took place in 2022. The survey collected information on various characteristics of the chiropractors who completed the logbook. The logbook recorded the total number of consultations, whether the reason for the consultation was related to headache, the type of diagnosis, the type of consultation (e.g. new patient, maintenance care), and whether the headache was the primary or secondary reason for the consultation. We used weighted linear regression analyses with robust standard errors for determining associations between prevalence and chiropractor characteristics.ResultsIn total, 76 chiropractors participated, reporting a prevalence of 12% for consultations including any type of headache. The response rate was 10.9%. The prevalence of headache-related consultations per chiropractor varied from 0% to 38% (median = 12.1; interquartile range = 8.2-15.5). In 43.6% of all headache consultations, headache was the main reason for consulting a chiropractor. The most common type of headache was tension-type (36.2%), followed by combinations of headache types (34.4%), with the most common combination being tension-type and cervicogenic headache. Headaches were reported in 12% of all new consultations and 25% of all maintenance care consultations. There were no associations between the prevalence of headache consultations and chiropractor characteristics.ConclusionsPatients with headaches, especially tension-type headaches and patients with more than one type of headache, were common in chiropractic clinics, with 12% of all consultations related to headaches. In two out of every five consultations related to headaches, the headache itself was the primary reason for visiting the chiropractor, rather than a secondary symptom accompanying another condition such as neck pain<b>.</b> No specific characteristics of chiropractors were associated with the frequency of headache consultations. This study may raise awareness of headache patients seeing chiropractors and help understand their healthcare needs.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 8","pages":"3331024251362126"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774767","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}