Cephalalgia最新文献

{"title":"Differential thalamic GSH/Glu ratios Among primary headache subtypes and clinical implications: A cross-sectional magnetic resonance spectroscopy study.","authors":"Yinhua Jin, Rui Wang, Hongying Huang, Zhongrouwen Ren, Gen Yan","doi":"10.1177/03331024261462792","DOIUrl":"10.1177/03331024261462792","url":null,"abstract":"<p><p>BackgroundGlutathione (GSH) and glutamate (Glu) have been individually implicated in migraine pathophysiology, but their ratio as a marker of oxidative-excitatory balance in the thalamus-a key pain-processing hub-remains unexplored. This study investigated thalamic GSH/Glu ratios across primary headache subtypes and evaluated their diagnostic utility.MethodsThis cross-sectional study included 131 participants: 36 healthy controls (HC), 17 migraine with aura (MwA), 46 migraine without aura (MwoA), and 32 tension-type headache (TTH). Single-voxel proton magnetic resonance spectroscopy was performed at 3T using a MEGA-PRESS sequence targeting bilateral thalami. Metabolite concentrations were quantified with LCModel and corrected for partial volume effects using an established tissue correction framework. Group differences were analyzed using ANOVA with Tukey HSD correction; diagnostic performance was assessed using ROC analysis with bootstrap resampling.ResultsThe GSH/Glu ratio differed significantly across groups (F = 9.41, p < 0.001, η² = 0.183), confirmed by bootstrap validation. MwA (0.250 ± 0.038, p < 0.001, Cohen's d = 1.47) and MwoA (0.280 ± 0.052, p = 0.006, d = 0.79) showed significantly lower ratios than HC (0.320 ± 0.055), whereas TTH (0.318 ± 0.068) did not differ from HC. This reduction was driven by decreased GSH levels, with Glu concentrations unchanged across groups. Exploratory ROC analysis yielded apparent AUCs of 0.874 for GSH and 0.758 for the GSH/Glu ratio; these estimates require independent validation.ConclusionsMigraine is characterized by reduced thalamic GSH levels and decreased GSH/Glu ratios, reflecting diminished antioxidant buffering capacity against normal excitatory neurotransmission. This metabolic alteration distinguishes migraine from TTH, supporting distinct pathophysiological mechanisms.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 7","pages":"3331024261462792"},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403718","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":"Abstracts from the 2026 China Headache Congress, 15-17 May 2026, Xi'an, China.","authors":"","doi":"10.1177/03331024261461082","DOIUrl":"https://doi.org/10.1177/03331024261461082","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 1_suppl","pages":"3331024261461082"},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444683","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":"Migraine care across borders: Need, disparity, and the transcultural reality of a global disorder.","authors":"Mario F P Peres, Francesca Puledda, Teshamae S Monteith","doi":"10.1177/03331024261474132","DOIUrl":"https://doi.org/10.1177/03331024261474132","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 8","pages":"3331024261474132"},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629627","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":"Burning mouth syndrome and oral dysaesthetic/perceptual symptoms: Toward clinically actionable boundaries.","authors":"Takayuki Suga, Trang Thi Huyen Tu, Motoko Watanabe, Akira Toyofuku","doi":"10.1177/03331024261464166","DOIUrl":"https://doi.org/10.1177/03331024261464166","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 7","pages":"3331024261464166"},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351106","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":"Endocannabinoid cerebrospinal fluid levels in migraine and its relation to symptoms of depression.","authors":"Aster V E Harder, Xinyu Di, Wendy M Winter, Bingshu He, Robin M Van Dongen, Gerrit L J Onderwater, Erik W Van Zwet, Elke H J Krekels, Isabelle Kohler, Michel D Ferrari, Amy C Harms, Arn M J M Van Den Maagdenberg, Thomas Hankemeier, Gisela M Terwindt","doi":"10.1177/03331024261451250","DOIUrl":"10.1177/03331024261451250","url":null,"abstract":"<p><p>BackgroundDisruption of the endocannabinoid system has been implicated in both migraine and depression, which are frequently comorbid in patients. Nevertheless, supporting evidence for this hypothesis is limited. Hence, we investigated whether the endocannabinoid system is disrupted in interictal migraine patients and whether confounding factors were of influence.MethodsTo this end, we measured the levels of endocannabinoids N-arachidonoylethanolamine (AEA) and 2-arachidonoylglycerol (2-AG), and the endocannabinoid analogue docosahexaenoylethanolamine (DHEA) in the cerebrospinal fluid (CSF), obtained from 194 individuals with episodic migraine between attacks (97 migraine with aura and 97 migraine without aura individuals) and from 94 healthy volunteers, using micro-liquid chromatography - tandem mass spectrometry (micro-LC-MS/MS). Groups were age- and sex-matched. Timing and processing of sampling was protocolized. Multivariate linear regression analyses for log₁₀-transformed endocannabinoid concentrations were performed to compare groups. Covariates that were included were sex, age, BMI, substance use and depressive symptoms.ResultsNo differences were detected between individuals with migraine with or without aura and healthy controls in the CSF for AEA (<i>p</i> = 0.46, <i>p</i> = 0.08), 2-AG (<i>p</i> = 0.46, <i>p</i> = 0.90) and DHEA (<i>p</i> = 0.58, <i>p</i> = 0.79), respectively. For 2-AG, levels were, however, positively correlated with depressive symptoms (β = 0.053; 95% CI: 0.014 to 0.093, <i>p</i> = 0.008).ConclusionCSF endocannabinoids (AEA, 2-AG, and DHEA) may not serve as effective biomarkers for distinguishing interictal episodic migraine patients from controls. Instead, CSF levels of 2-AG are linked to depressive symptoms, shedding further light on the relevance of endocannabinoids in patients with migraine and depression. This study highlights the intricate nature of the endocannabinoid system concerning episodic migraine and confounding factors.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 7","pages":"3331024261451250"},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419220","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":"Letter to the editor regarding \"The effects of angiotensin receptor blockers as prophylactic migraine treatment: A systematic review and meta-analysis\".","authors":"Raffaele Ornello, Francesca Gabriele, Federico De Santis","doi":"10.1177/03331024261471180","DOIUrl":"https://doi.org/10.1177/03331024261471180","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 7","pages":"3331024261471180"},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548062","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":"Optimized diagnostic criteria for burning mouth syndrome should remain clinically grounded.","authors":"Takayuki Suga, Motoko Watanabe, Daniela Adamo, Michele Davide Mignogna, Akira Toyofuku","doi":"10.1177/03331024261467715","DOIUrl":"https://doi.org/10.1177/03331024261467715","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 7","pages":"3331024261467715"},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410838","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":"<i>In Vivo</i> confocal microscopy evaluation of corneal layer alterations in patients with trigeminal neuralgia.","authors":"Gokhan Aydoğan, Murat Kasikci, Gülnihal Kutlu, Sabahattin Sul, Göksu Alaçamlı","doi":"10.1177/03331024261466134","DOIUrl":"10.1177/03331024261466134","url":null,"abstract":"<p><p>PurposeTo investigate corneal microstructural alterations in patients with trigeminal neuralgia using <i>in vivo</i> confocal microscopy and to compare these findings with healthy controls.MethodsIn this prospective, cross-sectional study, sixty patients with unilateral trigeminal neuralgia and sixty matched healthy controls underwent central corneal imaging using <i>in vivo</i> confocal microscopy. Images were obtained from all corneal layers. Quantitative analysis of the subbasal nerve plexus assessed corneal nerve fiber density (CNFD), corneal nerve fiber length (CNFL), and corneal nerve branch density (CNBD). Qualitative evaluation of epithelial morphology, dendritic cell density, stromal keratocyte activation, and endothelial features was performed. Associations between corneal findings and disease duration were analyzed.ResultsCompared with controls, trigeminal neuralgia patients demonstrated significant reductions in CNFD, CNFL, and CNBD (all p < 0.001), accompanied by increased nerve tortuosity, fragmentation, and focal nerve dropout. Dendritic cell density and anterior stromal keratocyte activation were increased, particularly in patients with longer disease duration, while posterior stromal layers and endothelial morphology remained preserved. Disease duration was independently associated with greater subbasal nerve loss and inflammatory changes.ConclusionsTrigeminal neuralgia is associated with significant neurodegenerative and inflammatory alterations of the cornea, primarily involving the subbasal nerve plexus<i>. In vivo</i> confocal microscopy provides a sensitive, non-invasive tool for detecting these changes and may aid in assessing disease severity and progression. To our knowledge, this is the first study to demonstrate disease duration-dependent multilayer corneal microstructural alterations in trigeminal neuralgia using <i>in vivo</i> confocal microscopy.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 7","pages":"3331024261466134"},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403770","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":"Migraine and the unpaid workload: Sex-specific patterns of domestic labor - insights from the SMILE project, a cohort study.","authors":"Yair Zlotnik, Ido Peles, Shaked Sharvit, Michal Gordon, Victor Novack, Ronit Waismel-Manor, Gal Ifergane","doi":"10.1177/03331024261464573","DOIUrl":"10.1177/03331024261464573","url":null,"abstract":"<p><p>AimMigraine substantially affects daily functioning, yet its impact on unpaid domestic labor, an essential and sex-structured component of home life, remains poorly characterized. Domestic tasks require sustained physical and cognitive effort and may be sensitive to illness-related functional limitations, particularly in households were gendered expectations shape baseline role allocation.MethodsAs part of the SMILE project, 675 adults with migraine (544 females and 131 males) and 232 non-migraine controls (186 females and 46 males) completed a survey including demographics, MIDAS, DASS-21, and a ten-domain domestic labor module adapted from the Who Does What questionnaire. Participants rated the current division of each task and their preferred redistribution of responsibilities. Analyses were stratified by sex. Group differences were quantified using standardized mean differences (SMDs). Associations between MIDAS and chore scores were examined using Spearman correlations and multivariable linear regression adjusted for age and DASS-21 subscales.ResultsParticipants with migraine had substantial disability (median MIDAS 30 [IQR 15-64]; 65% severe), and a median of 10 headache days in the preceding three months [IQR 5-20]. Females with migraine reported greater partner involvement in several female-dominated tasks compared with controls, including cleaning after meals (mean 4.12 vs 3.47; SMD 0.32), laundry (3.16 vs 2.59; SMD 0.27), and general cleaning (3.59 vs 3.18; SMD 0.19). Males with migraine showed increased involvement in a different subset of chores, most notably trash disposal (3.42 vs 5.18; SMD 0.87). Females with migraine also expressed stronger preferences for increased partner involvement across multiple domains. Among males, MIDAS correlated with greater partner involvement (r up to 0.29), whereas among females, MIDAS showed weaker, more variable associations; regression models confirmed task-specific relationships.ConclusionMigraine is associated with distinct sex-specific patterns in the structure and desired redistribution of domestic labor. These findings highlight household functioning as an overlooked dimension of migraine-related disability and fit within the SMILE Resource-Role Strain framework.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 7","pages":"3331024261464573"},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148560876","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":"Efficacy of digital therapeutic sinCephalea for personalised nutrition versus control for migraine prevention: A 12-week open-label randomised clinical trial.","authors":"Stefan Evers, Hanna C B Grube, Astrid Gendolla, Charly Gaul, Kristian Ewald, Oliver Witt, Jenny Voggel, Matthias Nitschke, Christian Sina, Diamant Thaçi, Inke R König, Torsten Schröder","doi":"10.1177/03331024261459744","DOIUrl":"10.1177/03331024261459744","url":null,"abstract":"<p><p>BackgroundLow-glycaemic diet may alleviate migraine; however, individual blood glucose variability can affect efficacy. In this open-label randomised controlled trial in Germany, we assessed whether the digital therapeutic (DTx) sinCephalea, which delivers personalised low-glycaemic nutritional recommendations supported by intermittent continuous glucose monitoring (CGM), reduces migraine frequency compared with a design-matched control application.MethodsThis open-label trial in Germany assessed the DTx sinCephalea for migraine prevention. Adults aged 18-65 years with episodic migraine were randomised 1:1 (in addition to standard treatment) to the digital therapeutic (intervention) or a design-matched control application. Patients completed a daily headache and medication diary, and 4-weekly patient-reported outcome questionnaires. Adherence to nutritional recommendations was monitored. Primary endpoint (Week 12): change from baseline in monthly migraine days (every 4 weeks) for intervention versus control. Secondary endpoints: change from baseline in monthly migraine days in patients with ≥50% adherence to nutritional recommendations, 30% response rates, migraine- and headache-related impairment, quality-of-life, and acute medication use for intervention versus control. Adverse events were recorded.Results842 patients were randomised between July 2021 and August 2023 (full analysis set: intervention = 416; control = 419). There were significantly greater reductions in monthly migraine days at week 12 for intervention versus control (mean [SD] change: 1.7 [3.4] versus 1.2 [3.2] days; between-group difference estimate: -0.53 [95% CI -0.98 to -0.09]; p = 0.0195) with similar monthly migraine days reductions observed in adherent patients (p = 0.0062; adjusted α = 0.05). Response rate was 54.9% (185/337) in intervention versus 42.9% (168/392) in control (odds ratio: 1.63 [95% CI 1.21-2.19]; p = 0.0012; adjusted α = 0.0125). Migraine- and headache-related impairment were lower at week 12 for intervention versus control (p = 0.0247, adjusted α = 0.0167and p = 0.0001, adjusted α = 0.01, respectively). There was no significant difference in quality-of-life or acute medication use and no digital therapeutic-related adverse events.ConclusionPersonalised nutrition, supported by intermittent CGM, via the DTx sinCephalea, was efficacious for migraine prevention without DTx-related adverse events. This study provides evidence in support of the link between diet and migraine frequency and symptoms. Additionally, as this is a non-pharmacological treatment with no DTx-related side effects, it may be an attractive option for patients. DTx could also reduce the burden of migraine on healthcare systems by providing a scalable, remote, non-invasive and convenient treatment option.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 7","pages":"3331024261459744"},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350907","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}