Headache最新文献

{"title":"Global epidemiology and burden of headache disorders in children and adolescents from 1990 to 2021.","authors":"Guangshuang Lu, Shaobo Xiao, Yun Wang, Qiujie Jia, Shengnan Liu, Shengyuan Yu, Ruozhuo Liu, Wu Yang","doi":"10.1111/head.14937","DOIUrl":"https://doi.org/10.1111/head.14937","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to present an updated epidemiological overview of headache disorders among children and adolescents, utilizing the latest data from the Global Burden of Disease (GBD) 2021.</p><p><strong>Background: </strong>Large-sample epidemiological studies on headache disorders in children and adolescents have been limited due to their demographic uniqueness, with previous GBD studies rarely focusing on this age group, until the GBD 2021 study provided a significant update.</p><p><strong>Methods: </strong>A secondary analysis of headache disorder data from the GBD 2021 for individuals aged 0-<20 years was conducted. The analysis focused on estimating the prevalence, incidence, and disability-adjusted life-years (DALYs), as well as the estimated annual percentage changes (EAPCs). Data from 204 countries and regions, stratified by sociodemographic index (SDI), were included to assess variations in headache disorder metrics across different age groups, sexes, and socioeconomic settings.</p><p><strong>Results: </strong>Between 1990 and 2021, the global prevalence, incidence, and DALYs of headache disorders in children and adolescents rose by 22.79% (95% uncertainty interval [UI] 21.68-23.82%), 5.21% (95% UI 4.26-6.10%), and 24.27% (95% UI 20.35-26.91%) per 100,000 population, respectively. In 2021, 545,824,485 (95% UI 448,777,920-641,644,106) children and adolescents were affected, with a prevalence of 20.71% (95% UI 17.03-24.34%). Migraine affected 205,729,235 (95% UI 158,825,540-265,306,014) with a prevalence of 7.81%, and tension-type headache (TTH) affected 394,543,039 (95% UI 300,611,322-499,598,953) with a prevalence of 14.97%. The DALYs totaled 8,102,465 (95% UI 716,310-19,266,508), with migraine at 7,515,775 (95% UI 486,575-18,715,548), and TTH at 586,690 (95% UI 94,646-2,924,761). The 15-19 years age group had the highest prevalence (41.38%, 95% UI 32.73-50.58%), while the 10-14 years age group had the highest incidence (12.75%, 95% UI 9.09-16.72%). High SDI regions had the highest prevalence and DALYs; however, low-middle SDI regions experienced the fastest growth. Brazil had the highest prevalence (30.55%, 95% UI 26.44-34.65%); India had the most DALYs (1,716,049, 95% UI 138,743-4,051,479); the Northern Mariana Islands had the largest prevalence increase (EAPC 0.97, 95% confidence interval [CI] 0.67-1.26), and Norway had the highest DALYs increase (EAPC 1.31, 95% CI 0.98-1.64).</p><p><strong>Conclusions: </strong>Headache disorders in children and adolescents are emerging as critical public health challenges, especially in regions where resources are limited. It is essential to strengthen public health education and advocate for evidence-based strategies to reduce the burden.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763891","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 cortical spreading depression/migraine aura hypothesis - Finally some definitive evidence.","authors":"Andrew C Charles, Peter J Goadsby","doi":"10.1111/head.14932","DOIUrl":"10.1111/head.14932","url":null,"abstract":"","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"537-538"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656944","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":"Machine learning models and classification algorithms in the diagnosis of vestibular migraine: A systematic review and meta-analysis.","authors":"Pablo D Suarez-Barcena, Alberto M Parra-Perez, Juan Martín-Lagos, Alvaro Gallego-Martinez, Jose A Lopez-Escámez, Patricia Perez-Carpena","doi":"10.1111/head.14924","DOIUrl":"10.1111/head.14924","url":null,"abstract":"<p><strong>Objectives: </strong>To perform a systematic review and meta-analysis to evaluate the effectiveness of machine learning (ML) algorithms in the diagnosis of vestibular migraine.</p><p><strong>Background: </strong>Due to the absence of defined biomarkers for diagnosing vestibular migraine (VM), it is valuable to determine which clinical, physical, and exploratory information is most crucial to diagnosing this disease. The use of artificial intelligence tools could streamline this process.</p><p><strong>Methods: </strong>This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and searched for records from PubMed, Scopus, and Web of Science. Observational (case-control and cohort) studies were included to assess the ability of artificial intelligence (AI) to distinguish VM from other vestibular disorders. Risk of bias and applicability concerns were assessed using the Quality Assessment of Diagnostic Accuracy Studies-AI tool.</p><p><strong>Results: </strong>A total of 14 articles were included in the systematic review, and 10 were eligible for meta-analysis. The main inputs included for the ML algorithms were anamnesis (medical history), physical examination, results from audiological and vestibular tests, and imaging. The global sensitivity was 0.85 (95% confidence interval [CI] 0.73-0.92, I² = 96%), while the global specificity was 0.89 (95% CI 0.84-0.93, I² = 95%). The pooled diagnostic odds ratio was 48.15 (95% CI 17.64-131.43, I² = 97%). Using the bivariate model, the area under the curve and for the summary receiver operating characteristic curve, using the 10 available studies, was 0.94 (95% CI 0.86-0.96).</p><p><strong>Conclusion: </strong>Machine learning algorithms could be used as effective tools for the diagnosis process in VM. The use of models trained with three to four inputs yield the highest accuracy, compared to other strategies. However, the design and validation of these studies could be improved to ensure the reproducibility and generalizability of results.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"695-708"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioral interventions for migraine prevention: A systematic review and meta-analysis.","authors":"Jonathan R Treadwell, Amy Y Tsou, Benjamin Rouse, Ilya Ivlev, Julie Fricke, Dawn C Buse, Scott W Powers, Mia Minen, Christina L Szperka, Nikhil K Mull","doi":"10.1111/head.14914","DOIUrl":"10.1111/head.14914","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives/background: &lt;/strong&gt;This study was undertaken to synthesize evidence on the benefits and harms of behavioral interventions for migraine prevention in children and adults. The efficacy and safety of behavioral interventions for migraine prevention have not been tested in recent systematic reviews.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An expert panel including clinical psychologists, neurologists, primary care physicians, researchers, funders, individuals with migraine, and their caregivers informed the scope and methods. We searched MEDLINE, Embase, PsycINFO, PubMed, the Cochrane Database of Systematic Reviews, clinicaltrials.gov, and gray literature for English-language randomized trials (January 1, 1975 to August 24, 2023) of behavioral interventions for preventing migraine attacks. Primary outcomes were migraine/headache frequency, migraine disability, and migraine-related quality of life. One reviewer extracted data and rated the risk of bias, and a second verified data for completeness and accuracy. Data were synthesized with meta-analysis when deemed appropriate, and we rated the strength of evidence (SOE) using established methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For adults, we included 50 trials (77 publications, N = 6024 adults). Most interventions were multicomponent (e.g., cognitive behavioral therapy [CBT], biofeedback, relaxation training, mindfulness-based therapies, and/or education). Most trials were at high risk of bias, primarily due to possible measurement bias and incomplete data. For adults, we found that any of three components (CBT, relaxation training, mindfulness-based therapies) may reduce migraine/headache attack frequency (SOE: low). Education alone that targets behavior may improve migraine-related disability (SOE: low). For three other interventions (biofeedback, acceptance and commitment therapy, and hypnotherapy), evidence was insufficient to permit conclusions. We also found that mindfulness-based therapies may reduce migraine disability more than education, and relaxation + education may improve migraine-related quality of life more than propranolol (SOE: low). For children/adolescents, we included 13 trials (16 publications, N = 1444 children), but the evidence was only sufficient to conclude that CBT + biofeedback + relaxation training may reduce migraine attack frequency and disability more than education alone (SOE: low).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Results suggest that for adults, CBT, relaxation training, and mindfulness-based therapies may each reduce the frequency of migraine/headache attacks, and education alone may reduce disability. For children/adolescents, CBT + biofeedback + relaxation training may reduce migraine attack frequency and disability more than education alone. Evidence consisted primarily of underpowered trials of multicomponent interventions compared with various types of control groups. Limitations include semantic inconsistencies in the literature since 1975, d","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"668-694"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of switching strategies in CGRP monoclonal antibody therapy for migraine: A retrospective cohort study.","authors":"Alex Jaimes, Andrea Gómez, Olga Pajares, Jaime Rodríguez-Vico","doi":"10.1111/head.14865","DOIUrl":"10.1111/head.14865","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of first switching between monoclonal antibodies (mAbs) targeting calcitonin gene-related peptide (CGRP) or its receptor in the treatment of migraine.</p><p><strong>Background: </strong>Although mAbs targeting CGRP or its receptor have emerged as a leading treatment for migraine prevention, a proportion of patients do not respond. While switching between these antibodies is a common clinical practice in such cases, the effectiveness remains a subject of study.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study at a tertiary headache center, analyzing data from clinical records of patients treated with anti-CGRP mAbs from January 2020 to March 2024. Baseline was defined as the monthly headache days (MHDs) in the 3 months prior to the start of the second mAb. The primary endpoint was the change in MHDs at month 3 and month 6 following the switch. Additionally, we evaluated response rates in both periods. Subgroup analyses were conducted based on changes in mechanism of action. Finally, we assessed the influence of the number of doses of the first mAb and the inter-treatment interval.</p><p><strong>Results: </strong>Out of 1244 initially identified patients, 185 were included in the month-3 analysis and 123 in the month-6 evaluation. The median MHDs decreased from 27.0 (interquartile range [IQR] 16.1, 30.0; range 5.0, 30.7) at baseline to 21.0 (IQR 10.0, 30.0; range 0.0, 30.0; p < 0.001) at month 3, and to 20.0 (IQR 10.0, 30.0; range 0.0, 31.0; p < 0.001) at month 6. Subgroup analyses revealed no significant differences in MHDs between maintaining the same target or changing it (baseline: 28.0 [IQR 16.2, 30.0; range 5.0, 31.0] vs. 27.0 [IQR 6.0, 31.0; range 6.0, 31.0]; month 3: 23.0 [IQR 10.0, 30.0; range 0.0, 31.0] vs. 19.0 [IQR 11.0, 30.0; range 1.0, 31.0], p = 0.144; month 6: 24.0 [IQR 11.0, 30.0; range 0.0, 31.0] vs. 17.0 [IQR 10.0, 30.0; range 3.0, 31.0], p = 0.170). There was no association between a ≥50% reduction in MHDs and the number of previous doses of the first mAb (odds ratio [OR] 1.0; 95% confidence interval [CI] 1.0, 1.1; p = 0.189) or the inter-treatment interval (OR 1.0; 95% CI 0.9, 1.1; p = 0.914).</p><p><strong>Conclusion: </strong>Switching between anti-CGRP mAbs resulted in a reduction in MHDs, with no significant differences based on the mechanism of action. Factors such as the number of doses of the first mAb and the inter-treatment interval did not appear to predict a ≥50% reduction in MHDs at month 3. Our findings support the viability of switching as an effective treatment option for patients with migraine who do not respond to initial mAb therapy.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"619-630"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the migraine: Intracranial recording of cortical spreading depression in migraine with aura.","authors":"Graham A McLeod, Colin B Josephson, Jordan D T Engbers, Lara J Cooke, Samuel Wiebe","doi":"10.1111/head.14907","DOIUrl":"10.1111/head.14907","url":null,"abstract":"<p><p>Migraine with aura is a common neurological disorder. Cortical spreading depression is the hypothetical pathophysiologic correlate, but it has never been directly recorded during migraine in a human. A 32-year-old female with a history of migraine underwent a presurgical workup for comorbid epilepsy. While implanted for stereotactic electroencephalography with 94 electrode contacts across bilateral hemispheres, she experienced a typical migraine with aura. Stereotactic electroencephalography demonstrated low-voltage suppression starting in the left mesial occipital cortex and propagating anteriorly at 3 mm/min, clinically correlating with a contralateral right superior scintillating scotoma and ipsilateral headache. Intracranial stereotactic electroencephalographic recording demonstrated cortical spreading depression during migraine with aura. Our findings add to the body of evidence implicating cortical spreading depression in the pathophysiology of migraine with aura.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"658-665"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585261","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":"Do antithrombotic drugs have a role in migraine prevention? A systematic review.","authors":"Federico De Santis, Matteo Foschi, Michele Romoli, Vincenzo Mastrangelo, Chiara Rosignoli, Agnese Onofri, Simona Sacco, Raffaele Ornello","doi":"10.1111/head.14917","DOIUrl":"10.1111/head.14917","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the available evidence on the role of antithrombotics as migraine preventive medication.</p><p><strong>Background: </strong>In clinical practice, the use of antithrombotic drugs in individuals with migraine is sometimes considered, especially in the case of frequent auras, association with patent foramen ovale, or prothrombotic states. This paper systematically reviews evidence on antithrombotic agents' efficacy for migraine prevention.</p><p><strong>Methods: </strong>We performed a systematic literature search on PubMed and Scopus including observational and interventional studies focused on antiplatelets or anticoagulants as preventive treatments for migraine. The search included studies published until June 30th, 2024. Ongoing trials on Clinicaltrials.org were also explored. Quality assessment used the Cochrane Risk of Bias 2 (RoB-2) tool for randomized controlled trials (RCTs) and the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) for observational studies. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO identifier CRD42024501531).</p><p><strong>Results: </strong>Out of 1854 records, we found 12 RCTs and 8 observational studies investigating the impact of antithrombotic drugs in migraine prevention. Due to heterogeneity of data, a meta-analysis was not feasible. RCTs tested acetylsalicylic acid (ASA) alone (seven), ASA in combination with other preventive treatments (two), clopidogrel (one), dual antiplatelet treatment (one), and vitamin K antagonists (one). Observational studies tested ASA (three), vitamin K antagonists (three), and clopidogrel (two). No clear evidence of efficacy was found for the overall population of individuals with migraine. Limited evidence from old RCTs-not specifically addressing the role of antithrombotic drugs for migraine prevention-and observational studies showed a potential improvement of migraine with the use of antiplatelet agents, mostly ASA, in special populations, including males, individuals with migraine with aura, and those with patent foramen ovale.</p><p><strong>Conclusions: </strong>Evidence supporting the effectiveness of antithrombotic drugs as a preventive treatment for patients with migraine is insufficient. As preliminary data show potential improvements in special populations in whom those agents act indirectly by ameliorating vascular function, RCTs are worth conducting.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"709-727"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of periodontitis and periodontal parameters with migraine and mortality in people with migraine disease: A nationally representative observational study.","authors":"Lingjun Yan, Yu Huang, Bingqin Xie, Zilin Liu, Lan Luo, Baochang He, Chenyu Ding, Wenhua Fang, Yuanxiang Lin, Dezhi Kang, Fa Chen","doi":"10.1111/head.14893","DOIUrl":"10.1111/head.14893","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association of periodontitis and clinical periodontal parameters with migraine as well as mortality among people with migraine disease.</p><p><strong>Background: </strong>Periodontitis has been shown to increase the systemic inflammatory burden thereby promoting various systemic health outcomes; however, the evidence regarding the relationship between periodontitis and migraine is scarce.</p><p><strong>Methods: </strong>A cross-sectional study was performed, and it included 13,108 participants from the National Health and Nutrition Examination Survey (1999-2004). Weighted logistic regression analysis was used to evaluate the association between periodontitis/clinical periodontal parameters and migraine. Mediation analysis was performed to explore the potential mediating role of inflammatory response. A cohort study including 1909 participants with migraine disease was further conducted to assess the associations between periodontitis/clinical periodontal parameters and mortality from all causes, cardiovascular disease (CVD), and cancer in participants with migraine disease using Cox proportional hazards models. Death outcomes were ascertained by linkage to National Death Index records through December 31, 2018.</p><p><strong>Results: </strong>Periodontitis was positively associated with migraine (odds ratio [OR] 1.29, 95% confidence interval [CI] 1.01-1.65). Each 1-unit rise in attachment loss and pocket depth was linked to a 17.5% (OR 1.18, 95% CI 1.08-1.29) and 28.1% (OR 1.28, 95% CI 1.08-1.51) increase in migraine risk, respectively. Mediation analyses revealed that leukocyte, monocyte, and lymphocyte counts mediated 17.9%, 7.3%, and 20.1%, respectively, of the association between periodontitis and migraine. During a median follow-up of 17.7 years among 1909 participants with migraine disease, periodontitis was associated with greater all-cause mortality (hazard ratio 1.82, 95% CI 1.25-2.66), but was not significantly associated with mortality from CVD or cancer among participants with migraine disease. Similar association patterns were also observed for attachment loss and pocket depth.</p><p><strong>Conclusions: </strong>This study provides evidence that periodontitis and clinical periodontal parameters were significantly associated with migraine as well as all-cause mortality in people with migraine disease. These findings underscore the importance of considering periodontal health in the prevention and management strategies for migraine disease.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"578-588"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909542","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":"Associations of comorbid headache disorders and depression with leisure-time physical activity among 14,088 adults in The Brazilian Longitudinal Study of Adult Health.","authors":"Arão Belitardo de Oliveira, Mario Fernando Prieto Peres, Juliane Prieto Peres Mercante, André R Brunoni, Yuan-Pang Wang, Maria Del Carmen B Molina, Lucas K Uchiyama, Paulo A Lotufo, Isabela M Benseñor, Alessandra C Goulart","doi":"10.1111/head.14868","DOIUrl":"10.1111/head.14868","url":null,"abstract":"<p><strong>Background: </strong>While headache disorders are linked to low physical activity levels, the impact of depression on this relationship is unclear.</p><p><strong>Objective: </strong>To assess how single and comorbid diagnoses of migraine and tension-type headache (TTH) interact with depression and leisure-time physical activity (LTPA) levels in The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).</p><p><strong>Methods: </strong>In this cross-sectional analysis based on the ELSA-Brasil baseline data, the relationship of migraine, TTH (both assessed with the International Classification of Headache Disorders, Second Edition), and depression (assessed with the Clinical Interview Schedule-Revised) with LTPA levels (International Physical Activity Questionnaire) was investigated by employing linear regression models. Models were adjusted for sociodemographic, lifestyle, and clinical covariates, and interaction terms were created to examine additive effects of comorbid conditions.</p><p><strong>Results: </strong>Among 14,088 participants, 54.4% (7668/14,088) were female, prevalence rates were: TTH = 39.6% (5573/14,088), migraine = 27.0% (3806/14,088), depression = 0.7% (94/14,088), depression + TTH = 1.1% (148/14,088), and depression + migraine = 2.5% (356/14,088). The mean (standard deviation) LTPA levels across the groups were: no headache + no depression = 148.7 (183.0) min/week, TTH = 133.5 (170.1) min/week, migraine = 110.3 (154.8) min/week, depression = 76.5 (146.3) min/week, depression + TTH = 84.5 (127.7) min/week, and depression + migraine = 64.3 (123.2) min/week. Negative associations were found for depression (β = -55.1, 95% confidence interval [CI] -93.6 to -17.0; p = 0.005), migraine (β = -24.7, 95% CI -33.2 to -15.4; p < 0.001), and TTH (β = -15.5, 95% CI -23.1 to -7.6; p < 0.001) with LTPA. No interaction effect was observed for depression + TTH (β = 36.0, 95% CI -12.6 to 84.6; p = 0.147) and depression + migraine (β = 31.7, 95% CI -11.3 to 74.7; p = 0.149), indicating no additive effect of comorbid conditions on LTPA levels. After adjusting for headache attack frequency, only depression + migraine remained negatively associated with LTPA (β = -38.7, 95% CI -71.6 to -5.8; p = 0.021).</p><p><strong>Conclusions: </strong>Headache disorders and depression were independently and inversely associated with LTPA, with the strongest effects seen in depression alone or comorbid with migraine.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"643-654"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618744","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":"Group text messaging as a residency teaching tool in outpatient neurology and headache: A mixed-methods observational study.","authors":"Anjeli Song, Joseph E Safdieh, Matthew S Robbins","doi":"10.1111/head.14870","DOIUrl":"10.1111/head.14870","url":null,"abstract":"<p><strong>Objective: </strong>To assess the feasibility and efficacy of group text messaging as a teaching tool to improve neurology resident knowledge and clinical pearl dissemination in an outpatient setting enriched with headache encounters, and to evaluate if learning points from this teaching method would influence resident care of subsequent patients.</p><p><strong>Background: </strong>Inpatient neurology teaching during training is most often accomplished in team settings during rounds or conferences such as morning report, but outpatient teaching where headache is more likely encountered may be less consistently performed in such a setting where learning points may be shared. Few studies have evaluated whether group text messaging can be an innovative tool for teaching in residency training.</p><p><strong>Methods: </strong>Neurology residents in a continuity clinic pod at New York Presbyterian-Weill Cornell were included in this cohort from December 2020 through March 2024. Group text messages deidentified of any patient information were sent to the resident pod by their preceptor after each clinic session featuring one text message regarding a takeaway learning point pertaining to each patient encounter. Residents were surveyed on their satisfaction with this teaching method and whether these text messages improved their outpatient neurology knowledge.</p><p><strong>Results: </strong>A total of 230 text messages were sent to a cohort of 21 residents across 4 academic years. Text message topics covered a variety of neurological subspecialties, most commonly headache and facial pain (44.8%), general neurology (15.7%), and neuromuscular (14.3%). In our survey, 93% of resident respondents reported that receiving clinical pearls improved their outpatient neurology knowledge and changed how they cared for subsequent patients.</p><p><strong>Conclusion: </strong>Reinforcement of traditionally one-on-one learning points in a teaching outpatient setting to engage a group of residents was feasible across visit types. There was an overall very positive response to this teaching method, and residents reported improved knowledge, which influenced their care of subsequent patients.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"539-544"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728037","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}