Cephalalgia最新文献

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

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

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

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

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

{"title":"A narrative review of app- and internet-delivered headache interventions: From ideation to implementation and the future.","authors":"Anker Stubberud, Mattias Linde, Erling Tronvik","doi":"10.1177/03331024251348651","DOIUrl":"https://doi.org/10.1177/03331024251348651","url":null,"abstract":"<p><p>BackgroundThere is an increasing trend in the use of the internet and smartphone applications to deliver headache interventions. However, their efficacies remain unclear. Moreover, developing such interventions can be cumbersome and increasingly challenging when navigating the regulatory landscape of medical devices. The present study aimed to review the literature on internet- and app-based headache interventions and discuss opportunities and challenges in the process of developing such interventions.MethodsThis narrative review was based on a comprehensive literature search of PubMed. Publications investigating internet- and app-delivered interventions for headache disorders were identified, systematically assessed and summarised.ResultsInternet- and app-delivered interventions were mainly applied to deliver behavioural change techniques and relaxation training, coordinate management plans with patients, and promote medication adherence. Eleven randomised controlled trials, including two large-scale studies, did not demonstrate clear superiority of internet-delivered behavioural therapy over other therapies or waitlist control. Internet-delivered relaxation training trials might be more promising; however, they are old and less robust. Most studies investigating app-delivered behavioural therapy and relaxation training are pilot and feasibility trials, making it difficult to conclude their efficacy. Using the Internet and apps to manage care plans and promote medication adherence seems feasible, resulting in positive impacts on individual disease burden, health care and societal costs. However, these applications require further investigation.ConclusionsWe discussed important aspects of the conceptualisation, design and development of internet- and app-delivered interventions for headaches and provided specific recommendations to develop these interventions. Thereafter, we described and discussed the regulatory pathways for software interventions, which, in most cases, are considered medical devices and are subject to stringent regulations. Adhering to these regulations and creating a usable intervention with the evidence of efficacy established through robust clinical trials is time-consuming and requires medical, technological and regulatory knowledge.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 6","pages":"3331024251348651"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265392","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":"Promoting excellence in scientific peer review: The Cephalalgia Reviewer Academy.","authors":"Simona Sacco","doi":"10.1177/03331024251346916","DOIUrl":"https://doi.org/10.1177/03331024251346916","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 6","pages":"3331024251346916"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233362","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":"Comorbidity with fibromyalgia predicted poorer outcomes in patients with chronic migraine on flunarizine: Prospective proof-of-concept study.","authors":"Yu-Hsiang Ling, Li-Ling Hope Pan, Shih-Pin Chen, Wei-Ta Chen, Hung-Yu Liu, Shuu-Jiun Wang, Yen-Feng Wang","doi":"10.1177/03331024251353412","DOIUrl":"https://doi.org/10.1177/03331024251353412","url":null,"abstract":"<p><p>AimFibromyalgia (FM) and chronic migraine (CM) are commonly comorbid. Clinical observations suggest patients with chronic migraine comorbid with fibromyalgia (CMFM) seem less responsive to migraine preventive treatment; however, evidence is still lacking. This study examined the responsiveness to migraine preventive treatment in patients with CM and CMFM.MethodsPatients with CM and CMFM were prospectively recruited. None of them received migraine prevention prior to participation. Both groups were administered with flunarizine as migraine prevention and were asked to keep headache diaries. The CMFM group received additional standard treatment for FM concomitantly, predominately pregabalin. Treatment response was defined as ≧50% reduction in monthly headache days (MHDs) at the third month post-treatment compared with baseline.ResultsEighty-four patients with CM (38.3 ± 11.5 years old, 93% female) and 38 with CMFM (40.2 ± 11.3 years old, 87% female) finished the study for final analyses. CMFM had more MHD and higher levels of depression and anxiety at baseline. After treatment, CM demonstrated better treatment outcomes (50% responder rate 52% vs. 32%, <i>p</i> = 0.033). The presence of FM in patients with CM increased the odds of non-converter to EM after controlling for baseline MHD using a logistic regression model (OR: 2.8 [1.1-7.1], <i>p</i> = 0.027). Comorbid FM in patients with CM showed limited improvement despite receiving standard treatments for both conditions.ConclusionThis proof-of-concept research underscores the importance of clinicians recognizing FM in patients with CM since they are prone to poor responses to treatment.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 6","pages":"3331024251353412"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504988","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":"Cortical thickness studies in migraine: Current evidence and future directions.","authors":"Basit Ali Chaudhry, Samaira Younis, Roberta Messina, David García-Azorín, Nazia Karsan, Gianluca Coppola, Rune Häckert Christensen, Mohammad Mahdi Al-Karagholi, Patricia Pozo-Rosich, Faisal Mohammad Amin","doi":"10.1177/03331024251341204","DOIUrl":"https://doi.org/10.1177/03331024251341204","url":null,"abstract":"<p><p>BackgroundStructural imaging offers insight into migraine pathogenesis. Magnetic resonance imaging (MRI) morphometry plays a crucial role in identifying these alterations, yet the clinical significance remains debated. While gray matter volume and cortical curvature are commonly analyzed, cortical thickness offers a more direct measure of cytoarchitectural differences and neuroplastic changes in migraine. Advanced structural MRI techniques, including surface-based morphometry and voxel-based morphometry, have provided insights into cortical thickness alterations in migraine. These methods enable high-resolution assessment of brain morphometry, revealing dynamic changes associated with migraine phases and treatment.MethodsThis narrative review synthesizes findings from cortical thickness studies, focusing on methodological approaches, variations in imaging sequences and study designs, including cross-sectional and longitudinal studies.ResultsStudies using surface-based morphometry (i.e. SBM) and voxel-based morphometry (i.e. VBM) have reported inconsistent findings. Increased thickness is frequently observed in pain-processing regions, such as the somatosensory cortex, insula and anterior cingulate cortex reflecting hyperexcitability or maladaptive neuroplasticity. by contrast, cortical thinning has been noted in regions such as the orbitofrontal cortex, posterior cingulate cortex and visual cortex, suggesting neuronal loss or impaired cortical integrity. Differences between episodic and chronic migraine further highlight progressive structural changes associated with disease burden. Emerging evidence also suggests that preventive treatments, including calcitonin gene-related peptide monoclonal antibodies and botulinum toxin A, may reverse some of these cortical alterations, particularly in treatment responders.ConclusionsCortical thickness analysis provides valuable insights into migraine pathophysiology, offering a potential biomarker for disease progression and treatment response. However, inconsistencies across studies highlight the need for standardized MRI protocols and larger longitudinal investigations to clarify the clinical relevance of cortical thickness changes in migraine.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 6","pages":"3331024251341204"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233361","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":"Retrospective cohort study of anti-CGRP monoclonal antibody unresponsive migraine individuals treated with atogepant: The RESCUE study.","authors":"Alex Jaimes, Jaime Rodríguez-Vico, Olga Pajares, Ignacio Eguilior Caffarena, Anna Lena Nystrom Hernández, Andrea Gómez, Jesús Porta-Etessam","doi":"10.1177/03331024251346925","DOIUrl":"https://doi.org/10.1177/03331024251346925","url":null,"abstract":"<p><p>BackgroundA subset of individuals with episodic migraine (EM) and chronic migraine (CM) does not respond to anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs), even after switching agents. Although atogepant is effective in EM and CM, its role in individuals unresponsive to anti-CGRP mAbs remains to be elucidated. We hypothesize that atogepant may be a viable preventive option in these cases.MethodsWe conducted a retrospective cohort study in EM and CM individuals who discontinued anti-CGRP mAbs due to lack or loss of efficacy and were subsequently treated with atogepant. The primary endpoint was the ≥50% response rate in monthly headache days (MHDs). Secondary outcomes included ≥30% and ≥75% response rates in MHDs, response rates in monthly moderate-to-severe headache days (MSHDs), and changes in MHDs, MSHDs, acute medication days (AMDs) and Headache Impact Test (HIT-6). Patient Global Impression (PGI) scores and adverse events (AEs) were recorded.ResultsOf 213 screened records, 44 participants met inclusion criteria; 39 (88.6%) were female and 39 (88.6%) had CM. Prior use of anti-CGRP mAbs included erenumab in 11.4% of participants, galcanezumab in 52.3% and fremanezumab in 86.3%. After three months, 18.2% achieved a ≥50% reduction in MHDs; ≥30% and ≥75% response rates were 25.0% and 6.8% respectively. For MSHDs, ≥30%, ≥50% and ≥75% response rates were 47.6%, 33.3% and 19.0%, respectively. Median MHDs decreased from 24.5 (interquartile range (IQR) = 16.0-30.0; range 9.0-31.0) to 21.5 (IQR = 10.0-30.0; range 3.0-31.0; <i>p</i> = 0.011), and median MSHDs from 15.0 (IQR = 10.0-25.5; range 5.0-30.0) to 12.0 (IQR = 5.9-19.0; range 0.0-30.0; <i>p</i> = 0.001). AMDs and HIT-6 scores also showed significant reductions. According to the PGI scale, 59.1% of individuals reported some degree of improvement. AEs occurred in 50.0% of participants, most commonly constipation (31.8%). Five (11.4%) participants discontinued treatment due to side effects.ConclusionsAfter three months of treatment, atogepant led to a clinically meaningful improvement in a subset of participants. It may be a valuable preventive option for individuals unresponsive to anti-CGRP mAbs and warrants further investigation in prospective studies.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 6","pages":"3331024251346925"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274290","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}