Cephalalgia最新文献

{"title":"Periaqueductal gray matter echogenicity: An irreversible marker of chronic migraine?","authors":"Belén Flores-Pina, Dolores Vilas Rolán, José Ríos Guillermo, Mireia Gea Rispal, Sara Rubio-Guerra, María Hernández Pérez, Laura Dorado Bouix","doi":"10.1177/03331024261467732","DOIUrl":"10.1177/03331024261467732","url":null,"abstract":"<p><p>AimAlthough periaqueductal grey matter (PAG), assessed by transcranial sonography, has been proposed as a biomarker of migraine chronification, its longitudinal evolution remains unknown. This study aimed to evaluate whether changes in clinical diagnosis-from chronic migraine to episodic migraine (CM-EM) or from episodic migraine to chronic migraine (EM-CM)-were associated with modifications in PAG echogenicity.MethodsIn a prospective longitudinal cohort study we reanalysed a cohort of 115 participants (65 patients with migraine and 50 controls) previously assessed in a baseline study. The follow-up was performed three years after the initial evaluation, collecting demographic, clinical (migraine-related), and sonographic variables.ResultsNinety-four of the 115 participants were re-evaluated at the longitudinal follow-up. Patients who converted from episodic to chronic migraine (EM-CM, <i>n</i> = 3) showed a significantly larger PAG area (0.22 [0.16-0.23] cm² vs. 0.13 [0.12-0.16] cm²; <i>p</i> = 0.043), a greater reduction in PAG echogenicity (-0.52 [-0.52 to -0.24] vs. -0.03 [-0.21 to 0.17]; <i>p</i> = 0.008), and higher heterogeneity (33.88 [31.85-36.72] vs. 26.67 [23.33-38.9]; <i>p</i> = 0.0344) at baseline compared with patients who remained episodic at the follow-up assessment (n = 18). Among patients with chronic migraine at baseline, no significant differences in PAG area, heterogeneity, or echogenicity intensity were observed between those who remained chronic and those who were classified as episodic migraine at follow-up.ConclusionPatients with chronic migraine who clinically improved (CM-EM) did not show relevant between-assessment differences in the previously described PAG alterations, suggesting the persistence of these alterations despite clinical improvement. In contrast, the small group of patients who underwent EM-CM transformation exhibited increased PAG heterogeneity and area at the follow-up assessment. Further studies with a larger sample size should be performed to confirm these results.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 7","pages":"3331024261467732"},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469336","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":"Headache in the emergency department: Sex differences in triage, diagnostic evaluation, and treatment.","authors":"Cornelius Angerhöfer, Carolin Luisa Hoehne, Mira Pauline Fitzek, Jonas Götz, Maria Terhart, Sarah Hoffmann, Christian H Nolte, Heinrich J Audebert, Rajan Somasundaram, Eike Christian Kühn, Bianca Raffaelli","doi":"10.1177/03331024261462493","DOIUrl":"10.1177/03331024261462493","url":null,"abstract":"<p><p>AimHeadache is a common neurological complaint in emergency departments (EDs). However, potential sex-related differences in triage assessment, diagnostic evaluation, and management remain poorly understood. This study examined sex differences across the emergency care pathway among patients presenting with headache.MethodsWe conducted a cross-sectional observational study of adult patients presenting with headache to a large university hospital ED between 5 May 2023, and 5 May 2025. Sex differences were analyzed across key stages of emergency care, including Manchester Triage System (MTS) assignment, pain intensity, ED process times, diagnostic procedures, acute treatment, and final diagnoses. Multivariable logistic regression models were used to assess associations between sex and clinical management outcomes while adjusting for potential confounders. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated.ResultsAmong 95,150 ED presentations during the study period, 1825 adults (1.9%) presented with headache (61.9% women; mean age 48.5 ± 19.7 years). Women were more frequently assigned higher-urgency triage categories, whereas male sex was associated with lower odds of higher-urgency triage (aOR 0.79, 95% CI 0.62-0.99). Use of cranial CT and lumbar puncture did not differ by sex, while men had lower odds of cranial MRI (aOR 0.48, 95% CI 0.26-0.90). Men were more likely to be diagnosed with secondary headache due to serious pathology (aOR 1.54, 95% CI 1.08-2.19) and less likely with primary headache disorders (aOR 0.73, 95% CI 0.54-0.98). Women more often received repeated non-opioid analgesics (aOR 1.60, 95% CI 1.06-2.44) and antiemetics (aOR 1.69, 95% CI 1.16-2.45). No evidence of systematic sex-based delays in ED care delivery was observed.ConclusionSex differences in emergency headache care emerge early in the clinical pathway. Lower perceived urgency despite a higher likelihood of serious pathology among men suggests a potential mismatch between triage assessment and underlying clinical risk. These findings highlight the need to further evaluate sex-related factors in triage and diagnostic pathways for patients presenting to the ED with headache.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 7","pages":"3331024261462493"},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548005","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: Tariq N, Awais Amir, M. Letter to Editor: Methodological considerations regarding smoking, psychological distress, and medication-overuse headache.","authors":"Mona Hussein, Amr Hassan, Rehab Magdy, Ahmed Dahshan, Osama Yacoub, Mohamed Abdelghaffar, Nourhan Abdelmohsen Taha, Ahmed Essmat, May M Fayez, Nahla Merghany, Anas Elgenidi, Ramez Reda Moustafa, Anter Mothenna Abdullah Nasser, Alaa Elmazny","doi":"10.1177/03331024261471846","DOIUrl":"https://doi.org/10.1177/03331024261471846","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 8","pages":"3331024261471846"},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648380","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 for migraine prevention in clinical practice: A multicenter study including patients with prior anti-CGRP monoclonal antibody failure (GEMA project).","authors":"Ana Beatriz Gago-Veiga, Ana Belen Lopez-Rodriguez, Marina Sanchez Jimenez, Alvaro Iglesias Rubio, Nuria Montes, Javier Camiña Muñiz, Marta Dominguez Gallego, Carlos Calle De Miguel, Germán Latorre, Jaime Rodriguez-Vico, Alex Jaimes, Andrea Gomez Garcia, Sarai Urtiaga, Marta Gonzalez Salaices, Michele Dileone, Nuria Gonzalez-García, Jesús Porta-Etessam, María-Luz Cuadrado, Sonia Santos Lasaosa, Javier Díaz-De-Terán, Leonardo Portocarrero-Sánchez, Javier Casas-Limón, Iris Fernández-Lázaro","doi":"10.1177/03331024261462836","DOIUrl":"10.1177/03331024261462836","url":null,"abstract":"<p><p>BackgroundRimegepant is a calcitonin gene-related peptide (CGRP) receptor antagonist approved for both acute and preventive treatment of episodic migraine. Real-world data on its preventive use remain limited, particularly in patients with multiple prior preventive failures. This study evaluated the effectiveness and tolerability of rimegepant in routine clinical practice, focusing on a highly treatment-resistant population.MethodsWe conducted a prospective, multicenter real-world cohort study within the GEMA (GEpants in MigrAine) Project across nine tertiary Headache Units in Spain. Adults initiating rimegepant for migraine prevention were consecutively enrolled and followed for up to 6 months. The primary endpoint was the 3-month change in monthly headache days (MHD). Secondary endpoints included the change in monthly migraine days (MMD), response rates, predictors of response, and tolerability. Baseline characteristics, prior preventive failures, medication overuse, adverse events, and patient-reported outcomes (Headache Impact Test-6 (HIT-6), HADS, and Insomnia Severity Index) were recorded.ResultsIn total, 150 patients completed 3-month follow-up and 64 reached 6 months. The cohort was predominantly female (85.3%), with 70.7% episodic migraine, a median age of 48 years (interquartile range (IQR) = 39-57), and a median of 6 prior preventive failures (IQR = 4-8), reflecting high treatment resistance. At 3 months, median MHD decreased from 12 to 7.5 and MMD from 10 to 6 (<i>p</i> < 0.05), with significant improvement in HIT-6. Overall, 36% and 43% achieved ≥ 50% reduction in MHD and MMD, respectively (≥ 75%: 15% and 20%). Among patients with 6-month data, further reductions were observed (MHD, 6 days; MMD, 5 days), with ≥ 50% response rates increasing to 48% and 58%. Clinical responders showed greater improvements in anxiety and depressive symptoms. Medication overuse, chronic migraine, and prior exposure to anti-CGRP monoclonal antibodies and onabotulinumtoxinA were independent predictors of poorer outcomes, with response declining with increasing prior anti-CGRP exposure, although a relevant proportion still achieved meaningful benefit. Rimegepant was well tolerated, with predominantly mild adverse events (nausea 13%, constipation 8%) and low discontinuation (7% at 3 months), and with nausea being the most frequent cause.ConclusionsRimegepant showed meaningful preventive effectiveness and good tolerability in routine clinical practice, including in highly treatment-resistant patients with prior anti-CGRP monoclonal antibody exposure. The response was influenced by baseline disease burden and prior treatment exposure. These findings suggest that earlier use of rimegepant in the treatment course may be associated with greater clinical benefit.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 7","pages":"3331024261462836"},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148389764","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":"Prediction of migraine treatment response with clinical and genetic data: A machine learning analysis of the HUNT study.","authors":"Håkon Kvisle Abildsnes, Antonios Danelakis, Samita Giri, Dominic Giles, Manjit Matharu, Parashkev Nachev, Marte Helene Bjørk, Bendik S Winsvold, Knut Hagen, Sigrid Børte, Joan Crespi Vidal, Erling Tronvik, Anker Stubberud","doi":"10.1177/03331024261467723","DOIUrl":"10.1177/03331024261467723","url":null,"abstract":"<p><strong>Aim: </strong>Migraine is highly heritable, yet no machine learning models for predicting treatment responses have incorporated genetic data. We aimed to develop machine learning models including both genetic and clinical information to predict treatment responses of migraine preventives and treatment retention of triptans.</p><p><strong>Methods: </strong>This was a cross-sectional population-based machine learning analysis of the Trøndelag Health Studies and the national prescription registry. Clinical predictors included demographics, serum metabolic measures, comorbidities, mental health and lifestyle factors. Genetic predictors included 108 migraine risk loci. Preventive response was defined as ≥50% reduction in triptan dispensations after first preventive dispensation, and triptan retention as ≥3 dispensations. The dataset was split into training (70%), validation (10%) and test set (20%). A series of standard and causal machine learning architectures were trained and optimized on the training and validation set, and the best model was evaluated on the held-out test data. Shapley Additive exPlanation values identified key predictors.</p><p><strong>Results: </strong>In total, 475 participants tried a preventive (amitriptyline, beta-blocker, candesartan or topiramate) and 565 a triptan (371 sumatriptan) during the project period. Using only clinical features, the best models achieved area under curve of 0.56-0.69 for the preventives, and 0.56 for triptans. When combining clinical and genetic data, the area under curve was unchanged or reduced in all cases except for amitriptyline (0.80) and sumatriptan (0.55). The most important predictors were hormone-related features, lipid levels and hemodynamic parameters.</p><p><strong>Conclusion: </strong>We developed models that predicted treatment responses to amitriptyline, beta-blockers, candesartan and topiramate with modest accuracy. Incorporating genetic data did not enhance performance, although the limited sample size and the uncertain accuracy of cohort definition and treatment response assessment prevent firm conclusions.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 7","pages":"3331024261467723"},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444700","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":"Iatrogenic harm in paediatric and adolescent populations of patients with migraine: A systematic review with meta-analysis.","authors":"Danilo Antonio Montisano, Gandini Giulia, Marcassoli Alessia, Corso Barbara, Grazzi Licia, Raggi Alberto, Parisi Alessandra","doi":"10.1177/03331024261441586","DOIUrl":"10.1177/03331024261441586","url":null,"abstract":"<p><p>BackgroundMigraine is a common condition that causes a high burden of disability even at a young age, significantly affecting various aspects of quality of life. Despite this significant burden, the pharmacological treatment of migraine is still a subject of debate, with controversial results that do not provide sufficient evidence of its effectiveness. Furthermore, the safety profile in this inherently fragile population leaves some doubts about pharmacological prophylaxis use. This study aims to provide an overview of the safety profile of the main drugs used in populations of children and adolescents with migraine, analysing the type and frequency of the main side effects reported.MethodsPubMed and Scopus were systematically searched for papers reporting adverse events (AEs) of pharmacological prophylaxis of migraine in children and adolescents, and all eligible original articles were included. A meta-analysis was carried out to define the pooled proportion of the summary safety information (i.e. the number of subjects reporting at least one AE) with 95% confidence intervals for those compounds present in at least two samples, regardless of dosage.ResultsIn total, 40 studies were included, accounting for 62 subsamples and 2742 patients (55% females). The most used compounds were topiramate (22 subsamples), propranolol and sodium valproate (six subsamples). Overall, 30% of patients reported at least one AE. Erenumab showed the highest rate of AEs, most likely due to the higher-precision detection typical of a randomized controlled trial, and cinnarizine the lowest. In total, 53 different AEs were reported, most frequently drowsiness, anorexia, fatigue and paraesthesia.ConclusionsIn accordance with the results of this systematic review with a meta-analysis, clinicians should consider that 30% of the paediatric patients with migraine will report some AEs from prevention treatment. The information on the safety profile is essential for clinicians in evaluating the choice of a specific therapy, making a better risk/benefit ratio evaluation for each single patient, which is crucial in consideration of the inconsistent efficacy profiles of preventive medications, with the exception of topiramate, in this population.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 7","pages":"3331024261441586"},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396077","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":"Corrigendum to: \"Neuroimaging-based subtyping of migraine identifies clinically distinct phenotypes\".","authors":"","doi":"10.1177/03331024261457306","DOIUrl":"10.1177/03331024261457306","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 7","pages":"3331024261457306"},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535362","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":"Early and clinically meaningful functional improvement following CGRP monoclonal antibodies in adolescents with migraine: A real-world retrospective study.","authors":"Misaki Kamogawa, Masakazu Higurashi, Akito Oshima, Norimichi Higurashi, Naoki Ikegaya","doi":"10.1177/03331024261461634","DOIUrl":"10.1177/03331024261461634","url":null,"abstract":"<p><p>BackgroundEvidence supporting calcitonin gene-related peptide monoclonal antibody (CGRP mAb) use in adolescents with migraine is limited. Rapid recovery for daily school functioning is particularly important during this stage of life. We aimed to evaluate early functional outcomes in daily and school activities, as well as headache-related outcomes after initiating CGRP mAb therapy in Japanese adolescents with migraine.MethodsThis single-center retrospective cohort study included patients aged 15-17 years who received CGRP mAb therapy (galcanezumab, fremanezumab or erenumab) for migraine between May 2021 and July 2025. The primary outcome was time to clinically meaningful improvement on the Headache Impact Test-6 (HIT-6) scores, comprising a reduction of ≥ 6 points from baseline, and was analyzed using the Kaplan-Meier method. Secondary outcomes included tracking longitudinal HIT-6 trajectories with mixed-effects models for repeated measures, exploratory univariable comparisons for early response (≥ 6-point reduction within 10-14 weeks), questionnaire-based daily functioning assessments, and safety evaluations.ResultsOf 34 adolescents who initiated CGRP mAb therapy, 33 participated in HIT-6 analyses. The cumulative response rate began increasing immediately after treatment initiation, reaching 68.3% (95% confidence interval = 44.6-81.8%) within the 10-14-week period; approximately half of the responders achieved meaningful improvement by weeks 4-6. Mixed-effects models for repeated measures analyses adjusted for baseline HIT-6 scores showed a least-squares mean change of -9.4 points at 12 weeks (95% confidence interval = -14.2 to -4.6; <i>p</i> < 0.001), with benefits sustained over follow-up. Among questionnaire respondents (<i>n</i> = 27), school attendance or concentration in the classroom was the most affected activity before treatment (70.4%) and 88.9% indicated that their primary treatment goals were mostly or partially achieved. Adverse events were reported by 40.7% of participants, primarily injection-site reactions (29.6%), none of which led to therapy discontinuations or modifications.ConclusionsIn this real-world adolescent cohort, CGRP mAb therapy was associated with early and clinically meaningful improvements in headache-related impact and self-reported functioning. Safety and tolerability findings are particularly notable given the limited evidence in this age group. Further prospective controlled studies are warranted to validate these findings and to identify predictors of early functional response.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 7","pages":"3331024261461634"},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403744","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":"Response to \"Burning mouth syndrome and oral dysaesthetic/perceptual symptoms: Toward clinically actionable boundaries\".","authors":"Gennaro Musella, Daniela Adamo, Vito Carlo Alberto Caponio, Lorenzo Lo Muzio, Michele Davide Mignogna","doi":"10.1177/03331024261470425","DOIUrl":"https://doi.org/10.1177/03331024261470425","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 7","pages":"3331024261470425"},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548052","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 and clinical predictors of rimegepant for acute vertigo in vestibular migraine: A real-world cohort study.","authors":"Yingqiang Li, Lingling Yu, Dongzhou Deng, Xun Cao, Xiang Lu, Dan Bing","doi":"10.1177/03331024261463533","DOIUrl":"10.1177/03331024261463533","url":null,"abstract":"<p><p>AimIn view of limited evidence-based acute treatments for spontaneous vertigo in vestibular migraine, this real-world cohort study assessed the effectiveness of rimegepant for acute vestibular migraine-related vertigo and factors associated with treatment response.MethodsClinical data were retrospectively collected from 86 patients with documented vestibular migraine treated with rimegepant 75 mg orally disintegrating tablets for acute attacks at a tertiary referral hospital between March and November 2025. Predictors of 2-h vertigo relief, defined as improvement from moderate or severe baseline vertigo to mild or no vertigo on an 11-point numeric rating scale, and 2-h numeric rating scale scores were analyzed using regression models accounting for within-patient clustering of attacks.ResultsAmong 86 patients, 192 of 252 treated vertigo episodes (76.2%) achieved vertigo relief. At 2 h after dosing, the mean change in vertigo numeric rating scale score was -4.44 (95% CI, -4.65 to -4.23). In adjusted models, age younger than 60 years (OR, 3.45 [95% CI, 1.15 to 10.31]; P = 0.027) and lower baseline numeric rating scale (OR per 1-point increase, 0.56 [95% CI, 0.36 to 0.86]; P = 0.008) were associated with higher odds of vertigo relief. Younger age, lower baseline numeric rating scale score, and better hearing (β, -1.14 [95% CI, -2.02 to -0.26]; P = 0.013) were also associated with lower 2-h numeric rating scale scores.ConclusionRimegepant was effective for vertigo episodes in patients with vestibular migraine, and treatment responsiveness was closely associated with age, baseline vertigo severity, and auditory function. These findings support the early initiation of rimegepant for acute treatment of vestibular migraine, rather than delaying treatment until vertigo exacerbation.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"46 7","pages":"3331024261463533"},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351119","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}