Headache最新文献

{"title":"Comparative bioavailability of single-dose zavegepant during and between migraine attacks: A phase 1, randomized, open-label, fixed-sequence, two-period study.","authors":"Richard J Bertz, Julie L Collins, Jennifer Madonia, Rajinder Bhardwaj, Lisa Kamen, Kyle T Matschke, Jing Liu","doi":"10.1111/head.14856","DOIUrl":"10.1111/head.14856","url":null,"abstract":"<p><strong>Objective: </strong>To compare the rate and extent of absorption of zavegepant 10 mg (therapeutic dose) or 20 mg (supratherapeutic dose) nasal spray during a migraine attack versus non-migraine period, assess safety, and explore efficacy and the relationship between zavegepant concentration and therapeutic response.</p><p><strong>Background: </strong>Physiologic changes occurring during a migraine attack could affect the pharmacokinetics of treatments for migraine.</p><p><strong>Methods: </strong>This was a Phase 1, multicenter, open-label, randomized, single-dose, two-period, fixed-sequence, comparative bioavailability study. Participants with a history of 2-8 migraine attacks per month of moderate or severe pain intensity were randomized to a single dose of zavegepant 10 or 20 mg, administered intranasally during a migraine attack (Period 1) and in a non-migraine period (Period 2). Blood samples were collected pre-dose and at pre-specified intervals up to 24 h post-dose for plasma zavegepant concentration measurement. Safety was monitored throughout, and efficacy (migraine pain intensity score, nausea, photophobia, phonophobia, aura, and functional disability) assessed during Period 1. Plasma zavegepant pharmacokinetic parameters were calculated by standard noncompartmental methods, including maximum plasma concentration (C<sub>max</sub>), area under plasma concentration-time curve from time zero to infinity (AUC<sub>0-inf</sub>), and time of C<sub>max</sub> (T<sub>max</sub>).</p><p><strong>Results: </strong>A total of 37 participants were evaluable for pharmacokinetics. Following administration of zavegepant 10 mg, geometric mean ratios for Period 1/Period 2 were 82.8% (90% confidence interval [CI] 60.5-113.2) for C<sub>max</sub> and 90.1% (90% CI 70.2-115.5) for AUC<sub>0-inf</sub>. Following administration of zavegepant 20 mg, geometric mean ratios for Period 1/Period 2 were 72.5% (90% CI 57.9-90.8) for C<sub>max</sub> and 73.4% (90% CI 58.8-91.7) for AUC<sub>0-inf</sub>. Averaging over the study period, geometric mean ratios for zavegepant 20 mg/10 mg were 142.5% (90% CI 118.6-171.4) for C<sub>max</sub> and 157.0% (90% CI 133.6-184.5) for AUC<sub>0-inf</sub>. Median T<sub>max</sub> was 0.5 h for both doses regardless of Period. Zavegepant was well tolerated in both study periods and effective during Period 1 at both dose levels. There was no apparent correlation between concentration at 0.5 h or 2 h post-dose and efficacy outcomes.</p><p><strong>Conclusion: </strong>Zavegepant exposure was comparable during a migraine attack and a non-migraine period, particularly at the therapeutic dose of 10 mg. When averaging over migraine and non-migraine periods, there was a less-than-dose proportional increase in zavegepant exposure when the dose was doubled from 10 to 20 mg. The median T<sub>max</sub> was 0.5 h regardless of migraine attack or dose. Zavegepant 10 and 20 mg exhibited favorable safety profiles during migraine attacks and non","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"484-494"},"PeriodicalIF":5.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604400","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":"Occipital condyle syndrome due to small-cell lung carcinoma: A case report.","authors":"Satoshi Yamashita, Toru Kinouchi, Tomoyuki Otsu, Makoto Tsumura, Akihiko Taira, Masaki Tomura, Yuri Mizuno, Naoki Akamatsu, Hiroyuki Murai","doi":"10.1111/head.14833","DOIUrl":"10.1111/head.14833","url":null,"abstract":"<p><p>Skull base metastases, including those from small-cell lung carcinoma (SCLC), can present with various syndromes depending on the site of involvement, such as orbital syndrome, parasellar syndrome, middle fossa syndrome, jugular foramen syndrome, and occipital condyle syndrome (OCS). One such example is OCS, which consists of unilateral occipital headache accompanied with ipsilateral hypoglossal palsy. This case report describes a 51-year-old man initially diagnosed with OCS, which led to the discovery of systemic bone metastases from SCLC. Magnetic resonance imaging showed lesions in the occipital condyle and hypoglossal canal, while positron emission tomography-computed tomography identified a lung mass and widespread metastases. SCLC is highly aggressive and metastatic, with the bone being a common site of spread. In this case, the OCS preceded the diagnosis of the underlying malignancy. Prompt diagnosis and treatment are crucial, as patients with OCS often have advanced disease. This case highlights the importance of considering SCLC as a potential etiology for OCS, given the propensity for bone metastases. Early recognition and evaluation of OCS is essential to initiate appropriate management.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"516-520"},"PeriodicalIF":5.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153711","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":"Patient reported outcomes and the real-world use of calcitonin gene-related peptide medications in migraine.","authors":"Samuel K Peasah, Yu Hyeon Soh, Yan Huang, Jennifer Nguyen, Janel Hanmer, Chester Good","doi":"10.1111/head.14843","DOIUrl":"10.1111/head.14843","url":null,"abstract":"<p><strong>Objective: </strong>To assess patient reported outcomes of patients with migraine receiving preventative medications, and to compare patient reported outcomes and unplanned care of patients on calcitonin gene-related peptide inhibitors (CGRPi) with those on other preventative medications.</p><p><strong>Background: </strong>Patient reported outcome measures can be useful in conditions such as migraine with frequent disability. CGRPi are newer migraine preventative medications that can improve patients' quality of life.</p><p><strong>Methods: </strong>This was a retrospective cohort analysis of Patient Reported Outcomes Measurement Information System (PROMIS) data combined with administrative claims data from a large regional health plan for adult patients (≥18 years) with migraine who were on preventative medications from January 2019 to March 2022. PROMIS scores of patients on CGRPi were compared to scores of patients who switched from other preventative medications to CGRPi (pre vs. post), between patients adherent to CGRPi versus non-adherent, and changes in all-cause/migraine-related unplanned care (emergency department) use by the CGRPi cohort.</p><p><strong>Results: </strong>There were 1245 patients on other preventative medications (antiseizure [532/1245 (43%)], antidepressants [316/1245 (25%)], and beta-blockers [397/1245 (32%)]), 148 who were on CGRPi, and 112 who had switched from other preventative medications to CGRPi. The mean age was 44 years old, 88% were females, 50% were married, and 75% were on commercial insurance. Patients with migraine had higher T-scores in pain, fatigue, anxiety, and sleep disturbance than the general population. Patients on CGRPi had a statistically significant reduction in pain T-scores (60.4 [standard deviation (SD) 7.4] to 58.4 [SD 8.2], p = 0.003) post initiation of medications, especially those who switched from other preventative medications to CGRPi (61.4 [SD 6.9] to 58.7 [SD 8.3], p < 0.001). The pain T-score reduction occurred only among the adherent group. There was a lower proportion of patients with all-cause unplanned care among patients on CGRPi (43% [64/148] to 32% [47/148], p < 0.001), but the reduction in migraine-related unplanned care was not statistically significant (9% [14/148] to 6% [9/148], p = 0.197).</p><p><strong>Conclusion: </strong>Our findings suggest that patients had an improvement in pain reduction scores after initiating CGRPi. PROMIS scores could provide important information about quality-of-life improvement for prescribers.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"452-459"},"PeriodicalIF":5.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345143","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":"Preserved working memory performance along with subcortical modulation during peri-ictal phases in spontaneous migraine attacks.","authors":"Amparo Ruiz-Tagle, Gina Caetano, Ana Fouto, Inês Esteves, Inês Cabaço, Nuno Da Silva, Pedro Vilela, Pedro Nascimento Alves, Isabel Pavão Martins, Raquel Gil Gouveia, Patrícia Figueiredo","doi":"10.1111/head.14850","DOIUrl":"10.1111/head.14850","url":null,"abstract":"<p><strong>Objective: </strong>To analyze cognitive performance and brain activation during a working memory task in patients with migraine during various phases of the migraine cycle and compare to healthy participants.</p><p><strong>Background: </strong>Cognitive difficulties reported during migraine attacks remain poorly understood, despite evidence that the lateral frontoparietal network undergoes reversible disturbances and decreased activation during attacks. Recent findings in resting state functional magnetic resonance imaging suggest that brain areas involved in this network interact with subcortical regions during spontaneous migraine attacks.</p><p><strong>Methods: </strong>In this prospective, within-subject study, 10 patients with diagnosed menstrual-related episodic migraine without aura underwent 3T functional magnetic resonance imaging assessments while performing a working memory task across four phases of the natural migraine cycle: peri-ictal (preictal, ictal, postictal) phases and interictally (between attacks). Migraine prophylaxis was an exclusion criterion. Fourteen healthy controls were assessed during the corresponding phases of their menstrual cycles.</p><p><strong>Results: </strong>The protocol was completed by 24 female participants aged 21 to 47 years: 10 with migraine (four sessions each) and 14 healthy controls (two sessions each) yielding a total of 68 analyzed datasets. Patients and controls showed similar performance on the working memory task and displayed increased brain activity in regions linked to this function, namely the middle frontal gyrus, inferior parietal lobe, and anterior cingulate cortex, during all phases of the migraine/menstrual cycle. Patients with migraine (N = 10) exhibited a significant decrease in hypothalamic activity (p = 0.007) as measured by the percent signal change (PSC) during the postictal phase compared to perimenstrual controls (N = 14), with -2 (16) and 31 (35) PSC, respectively. Comparing across the migraine cycle, the change in hypothalamic activity relative to controls in the postictal phase -0.33 (0.2) ΔPSC was significantly different from the ones in the interictal (0.006 [0.5] ΔPSC; p = 0.002) and preictal (-0.08 [0.4] ΔPSC; p = 0.034) phases.</p><p><strong>Conclusion: </strong>During a working memory task, cognition-related brain activation was present across all phases of the migraine cycle similarly to healthy control participants. Patients with migraine, however, displayed lower neural activity at the subcortical level in the postictal phase. Nonetheless, the sample size is a limitation for the generalization of our results. More research is needed to fully understand how the brain copes with cognitive demands during spontaneous migraine attacks.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"407-419"},"PeriodicalIF":5.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463321","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":"Relationship of dihydroergotamine pharmacokinetics, clinical efficacy, and nausea-A narrative review.","authors":"Richard B Lipton, John A Kollins, Detlef Albrecht","doi":"10.1111/head.14877","DOIUrl":"10.1111/head.14877","url":null,"abstract":"<p><strong>Objective: </strong>To assess the relationships between dihydroergotamine (DHE) pharmacokinetic (PK) parameters, clinical efficacy, and nausea incidence to determine a DHE PK profile that optimizes efficacy while minimizing adverse events (AEs), particularly nausea.</p><p><strong>Background: </strong>Dihydroergotamine is a widely used option for the acute treatment of migraine. Although multiple DHE dosage forms, with varying PK and AE profiles, have been evaluated in randomized controlled trials (RCTs), the relationships between PK profile, efficacy, and the common DHE-related AE, nausea, have not been comprehensively evaluated.</p><p><strong>Methods: </strong>A literature search identified RCTs evaluating the efficacy (2-h pain relief [2hPR]) of different DHE dosage forms. The PK profiles for these DHE dosage forms were determined from published literature. Univariate regression analyses were performed to determine the PK parameters that best predicted 2hPR across DHE dosage forms. The relationship between maximum plasma concentration (C_max) and nausea incidence for various dosage forms was determined from published Phase 1 trials.</p><p><strong>Results: </strong>The literature search identified nine RCTs with DHE dosage forms that reported 2hPR: DHE liquid nasal spray (four studies), DHE administered subcutaneously (three), and DHE administered via oral pulmonary inhalation (two). The DHE PK parameters that best predicted 2hPR rates were C_max and area under the curve from time zero to 0.5 h post-dose (AUC_0-0.5h) (R² = 0.59 for each). Across Phase 1 trials, nausea incidence was minimal when C_max was <2500 pg/mL but increased in a log-linear manner when C_max exceeded ~2500 pg/mL.</p><p><strong>Conclusions: </strong>The maximum concentration and AUC over the first 30 min following DHE administration were associated with increasing rates of 2hPR and a C_max below ~2500 pg/mL was associated with low incidences of nausea. We suggest that this may be an optimal profile for a DHE delivery form. Further research to test this hypothesis is warranted.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"527-535"},"PeriodicalIF":5.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728045","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":"Deep brain stimulation for chronic refractory cluster headache: A case series about long-term outcomes and connectivity analysis.","authors":"Juan Ángel Aibar-Durán, Nerea González, Rosa M Mirapeix, Noemi Morollón Sánchez-Mateos, Clara Roig Arsequell, Maria Borrell Pichot, Robert Belvís Nieto, Gemma Piella Fenoy, Cristian de Quintana Schmidt, Fernando Muñoz Hernandez, Fernando Seijoo Fernández, Rodrigo Rodríguez Rodríguez","doi":"10.1111/head.14875","DOIUrl":"10.1111/head.14875","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to provide long-term clinical results-including \"sweet spot\" identification and connectomic imaging analysis-in a series of patients treated with deep brain stimulation for refractory chronic cluster headache.</p><p><strong>Background: </strong>Deep brain stimulation is a relatively recent indication for the treatment of refractory chronic cluster headache. This indication has generated substantial debate in recent years due to uncertainty surrounding the mechanism of action and the lack of long-term efficacy data.</p><p><strong>Methods: </strong>Case retrospective series of adult patients diagnosed with refractory chronic cluster headache and treated with deep brain stimulation. Demographic and clinical data were registered preoperatively and at 3, 6, 12, and 24 months. The primary endpoint was reduction in headache load, a composite score of frequency, severity, and duration of each attack. Imaging analyses (sweet spot and connectomic analyses) were performed to identify the brain regions most closely correlated with the reduction in headache load and to identify the structural networks involved. Treatment response was categorized according to the reduction in headache load, as follows: poor (<30% reduction), partial (30-50%), or high (>50%).</p><p><strong>Results: </strong>A total of 14 patients were included, with a mean (standard deviation [SD]) age of 42.4 (10.7) years and mean (SD) headache duration of 8.0 (5.8) years. Headache load scores decreased significantly from baseline to Month 24: mean (SD) 424.2 (325.9) versus 135.9 (155.7) (p = 0.001). In most patients (eight patients [58.0%]), headache load scores decreased by 50% after treatment. The other six patients showed either a partial (three [21.0%]) or poor (three [21.0%]) response. The optimized sweet spot was the lateral ventral tegmental area ((Montreal Neurological Institute) MNI coordinates of the center of mass: x = ± 9.0 mm, y = -10.6 mm, z = -3.5 mm). The connectomic analysis pointed to the probable implication of corticorubral tracts.</p><p><strong>Conclusion: </strong>These findings suggest that a substantial proportion of patients with refractory chronic cluster headache obtain significant long-term clinical benefits from deep brain stimulation. Good responders were characterized by a robust improvement in headache load within 3-6 months after surgery. The lateral ventral tegmental area was identified as the best target for this indication, with the likely participation of corticorubral tracts.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"473-483"},"PeriodicalIF":5.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728023","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":"Evaluation of white matter integrity by using diffusion tensor imaging in spontaneous intracranial hypotension.","authors":"Serdar Balsak, Bahar Atasoy, Zeynep Donmez, Ismail Yurtsever, Ahmet Akcay, Abdusselim Adil Peker, Sabahattin Yuzkan, Yagmur Basak Polat, Defne Sahin, Ozlem Toluk, Alpay Alkan","doi":"10.1111/head.14910","DOIUrl":"10.1111/head.14910","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim is to investigate whether there is a microstructural change in the white matter pathways in patients with spontaneous intracranial hypotension (SIH). Additionally, the relationship between conventional magnetic resonance imaging (MRI) findings and diffusion tensor imaging (DTI) parameters is determined.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Thirty patients diagnosed with SIH and 31 control patients (between January 2019 and February 2024) were included in the case-control study. MRI findings constituting the Bern score were evaluated in contrast-enhanced brain MRI. Ten different white matter pathways were evaluated with the following DTI parameters: fractional anisotropy (FA), apparent diffusion coefficient (ADC), axial diffusion (AD), and radial diffusion (RD). We also examined the association between MRI findings and DTI parameters.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the cingulum, a decreased FA value (Z = -3.18, p = 0.002) was observed in patients with SIH, indicating disruption of white matter integrity and weakened synaptic transmission in this region. In the corona radiata, significant reductions were observed in both FA (Z = -5.67, p &lt; 0.001) and AD (Z = -3.59, p &lt; 0.001), alongside an increase in RD (Z = -4.99, p &lt; 0.001). The concomitant increase in RD further supports the idea of potential damage to the myelin sheath, which, together with other findings, may reflect disruptions in white matter architecture that underlie the cognitive and motor deficits frequently seen in patients with SIH. In the splenium of the corpus callosum, a significant reduction in AD (Z = -3.00, p = 0.007) was also noted. In the anterior limb of the internal capsule (ALIC), both FA (Z = -4.57, p &lt; 0.001) and AD (Z = -2.73, p = 0.012) values decreased, while RD increased (Z = -2.93, p = 0.007). These alterations suggest the involvement of motor and sensory pathways. In the posterior limb of the internal capsule (PLIC), significant reductions were found in both FA (Z = -5.59, p &lt; 0.001) and AD (Z = -3.82, p &lt; 0.001), along with an increase in RD (Z = -5.49, p &lt; 0.001). In the corticospinal tract, patients with SIH exhibited a decrease in FA (Z = -4.15, p &lt; 0.001), an increase in ADC (Z = -2.87, p = 0.008), and an increase in RD (Z = -3.73, p &lt; 0.001). These findings represent significant microstructural changes reflecting a reduction in the integrity of motor pathways in white matter. In the middle cerebellar peduncle (MCP), patients with SIH showed increased ADC (Z = -4.78, p &lt; 0.001) and RD (Z = -3.23, p = 0.002). Similarly, in optic radiation, there was decreased FA (Z = -4.55, p &lt; 0.001) and AD (Z = -2.59, p = 0.018), with increased RD (Z = -2.95, p = 0.007). In the correlation analysis, positive correlations were found between suprasellar distance and AD values in both the ALIC (r&lt;sub&gt;s&lt;/sub&gt; = 0.451, p = 0.012) and MCP (r&lt;sub&gt;s&lt;/sub&gt; = 0.416, p = 0.022). These findings suggest that structural changes and anatomical shifts, es","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"495-505"},"PeriodicalIF":5.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440657","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":"Anxiety, depression, and headache-related disability in a large pediatric clinic-based sample.","authors":"Christina Murphy, Ali Ladak, Christina L Szperka, Blanca Marquez De Prado, Andrew D Hershey, Carlyn Patterson Gentile","doi":"10.1111/head.14849","DOIUrl":"10.1111/head.14849","url":null,"abstract":"<p><strong>Objective: </strong>To explore the relationships among anxiety, depression, and headache-related disability in a pediatric clinic-based retrospective cross-sectional study.</p><p><strong>Background: </strong>Anxiety and depression are commonly considered comorbidities of headache disorders and are frequently seen in children and adolescents. These conditions can contribute to disability and may have a cumulative impact. In this study, we tested whether self-reported anxiety and/or depression in youth were associated with headache-related disability.</p><p><strong>Methods: </strong>This was a retrospective cross-sectional study of children ages 6-17 years old who completed a headache intake questionnaire at the time of a new outpatient neurology visit. Those who reported on behavioral health symptoms, involvement of a behavioral health provider (i.e., yes/no), and the PedMIDAS (a validated metric of headache-related disability) were included. The relationship between anxiety and/or depression and headache-related disability was examined.</p><p><strong>Results: </strong>Of the 12,660 questionnaires queried, 9118 met criteria for inclusion. Respondents were 64.0% female and had a median age of 13.5 years (interquartile range [IQR] 10.3, 15.7). Compared to patients without self-reported anxiety/depression, patients with anxiety and depression reported higher headache-related disability (M = 17.0, [IQR 6.0, 41.0]) even after accounting for covariates (estimated difference = 6.0, 95% confidence interval [CI: 4.4-7.5]). For participants with anxiety and/or depression, having a behavioral health provider was associated with greater headache-related disability (estimated difference = 7.0; 95% CI 4.6-9.3).</p><p><strong>Conclusions: </strong>Patients with self-reported anxiety and/or depression reported higher headache-related disability. Having a behavioral health provider was associated with greater headache-related disability, indicating the complexity and high level of need for this population. Further research is needed to understand the directionality of these results; however, patients with headache as well as depression and or anxiety are a vulnerable group who may benefit from an integrated care model.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"420-429"},"PeriodicalIF":5.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638685","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":"Genetically proxied liability to migraine and risk of intracranial aneurysm and subarachnoid hemorrhage.","authors":"Iyas Daghlas, Pamela M Rist, Daniel I Chasman","doi":"10.1111/head.14851","DOIUrl":"10.1111/head.14851","url":null,"abstract":"<p><strong>Background: </strong>Observational studies have reported inconsistent relationships between migraine and the risk of intracranial aneurysm and subarachnoid hemorrhage (SAH).</p><p><strong>Objective: </strong>To determine whether genetic liability to migraine is associated with risk of intracranial aneurysm and aneurysmal SAH.</p><p><strong>Methods: </strong>This study was designed as a two-sample Mendelian randomization (MR) analysis. Genetic associations with migraine were obtained from a large-scale meta-analysis of five population and clinic-based genome-wide association studies of migraine (102,084 cases and 771,257 controls of European ancestry). Genetic associations with intracranial aneurysm and SAH were obtained from a meta-analysis of 22 population-based genome-wide association studies (7495 cases and 71,934 controls of European ancestry). Findings were corroborated by sensitivity analyses and replicated in an independent sample of combined cases of intracranial aneurysm and SAH (3529 cases and 234,948 controls of Asian ancestry from the Biobank Japan and China Kadoorie Biobanks). In secondary analyses, we investigated the outcomes of extracranial aneurysm in the FinnGen and UK Biobank cohorts (up to 7466 combined cases of thoracic and abdominal aortic aneurysm).</p><p><strong>Results: </strong>Genetic liability to migraine was associated with increased risk of the combined outcome of unruptured intracranial aneurysm and SAH (odds ratio [OR] of outcome per doubling in migraine liability 1.19, 95% confidence interval [CI] 1.06-1.35; p = 0.005). This finding was replicated in an independent sample (OR 1.15, 95% CI 1.02-1.30; p = 0.027), and there were similar associations across the component outcomes of unruptured intracranial aneurysm (OR 1.20, 95% CI 1.01-1.42; p = 0.035) and SAH (OR 1.18, 95% 1.04-1.33; p = 0.008). These findings were consistent in sensitivity analyses robust to violations of the MR assumptions. In reverse MR analyses, genetic liability to intracranial aneurysm was not associated with migraine (OR 1.03, 95% CI 0.99-1.07; p = 0.141). In a secondary analysis, there were similar associations of genetic liability to migraine with all forms of aortic aneurysm (OR for combined thoracic and aortic aneurysm 1.18, 95% CI 1.10-1.27; p = 8.49 × 10^-6).</p><p><strong>Conclusion: </strong>Genetic liability to migraine was associated with increased risk of intracranial and extracranial aneurysms, supporting a causal relationship between liability to migraine and these traits. Further work is needed to identify the biological mechanisms and clinical relevance of these findings.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"391-398"},"PeriodicalIF":5.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604403","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":"The Chronic Headache Self-Efficacy Scale: Development and assessment of measurement properties.","authors":"Lori M Ginoza, Erica Sigman, Lori A Michener, Rachel K Straub, Soma Sahai-Srivastava, Federico Pozzi","doi":"10.1111/head.14888","DOIUrl":"10.1111/head.14888","url":null,"abstract":"<p><strong>Objective: </strong>To develop and assess the psychometrics of the Chronic Headache Self-Efficacy Scale (CHASE).</p><p><strong>Background: </strong>Existing scales assess self-efficacy in coping strategies and management of symptoms and triggers but do not measure other important self-efficacy domains, such as performing daily activities and socializing in patients with chronic daily headache (CDH).</p><p><strong>Methods: </strong>The study had two phases: (i) Development of the 14-item CHASE, with items derived from patients with CDH and a multidisciplinary healthcare team; (ii) longitudinal observational study for psychometric evaluation. Participants with CDH (N = 79) completed the CHASE, Headache Management Self-Efficacy Scale (HMSE), six-item Headache Impact Test-6 (HIT-6), and 12-item Short Form Health Survey (SF-12) at baseline, 24-72 h after baseline, and 12 weeks after baseline. The Global Rating of Change (GROC) assessed perceived change in symptoms. We assessed internal consistency, day-to-day reliability, convergent and known group discriminant validity, dimensionality, and responsiveness via minimal clinical important difference (MCID).</p><p><strong>Results: </strong>For day-to-day reliability, the CHASE intraclass correlation coefficient was 0.68 (95% confidence interval 0.49-0.81), with standard error of measurement and minimal detectable change of 10.3% and 24%, respectively. The CHASE had two independent factors (total R² = 54.5%) that can be combined into a single score (Cronbach's alpha internal consistency 0.88). For convergent validity, the CHASE score was related to the HIT-6, HMSE, and SF-12 (R²: 0.17-0.29, all p < 0.001). For known group discriminant validity, individuals with an active headache had a lower CHASE score than those without (mean [standard deviation] 47.7 [17.3]% vs. 57.2 [19.8]%, p < 0.001). Classification and regression tree analysis showed the MCID for meaningful positive symptom change on the GROC was a CHASE change of >8% or CHASE change of 8% with baseline CHASE >67%.</p><p><strong>Conclusion: </strong>The CHASE is a reliable and valid questionnaire for assessing self-efficacy in performing daily activities, socializing, managing headache symptoms and triggers, and guiding treatment plans for patients with CDH.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"460-472"},"PeriodicalIF":5.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893984","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}