Headache最新文献

{"title":"Factors associated with efficacy of occipital nerve stimulation in medically intractable chronic cluster headache.","authors":"Roemer B Brandt, Casper S Lansbergen, Linda Kollenburg, Michel D Ferrari, Frank J P M Huygen, Cecile C de Vos, Rolf Fronczek","doi":"10.1111/head.14985","DOIUrl":"10.1111/head.14985","url":null,"abstract":"<p><strong>Background/objective: </strong>Occipital nerve stimulation (ONS) has become an established therapy for medically intractable chronic cluster headache (MICCH), but unfortunately, one third of the patients do not respond satisfactorily. Reliable predictors of treatment success would help physicians improve indication for ONS in MICCH. Although a recent report suggested several factors that were associated with treatment failure (early onset of cluster headache [CH], chronic cluster headache [CCH], and smoking) this study was small, did not use a formal model, efficacy was poorly defined, and the follow-up was only of short duration. Here, we retrospectively sought: (i) reproduction of these associations and (ii) identification of possible other associations in our previously published double-blind randomized controlled \"Occipital Nerve Stimulation in Medically Intractable Chronic Cluster Headache\" (ICON) trial, and long-term follow-up, of the efficacy of ONS in MICCH.</p><p><strong>Methods: </strong>Data from the double-blind randomized controlled ICON trial, and its prospective open-label extension, were analyzed in this prospective cohort study in the Netherlands (October 12, 2010, to December 20, 2020) for: (i) relative differences in attack frequency and (ii) subjective satisfaction with effect between baseline and at 4 and 24 weeks, and 2 and 5 years, after ONS implantation. Formal statistical models were used to: (i) verify the previously detected associations and (ii) identify possible other associations.</p><p><strong>Results: </strong>Early onset of CH and smoking did not predict efficacy of ONS. Relative reduction in attack frequency at 24 weeks (B = 0.44, 95% confidence interval [CI] 0.13-0.76; p = 0.007) and the time since onset of CCH (B = 4.04, 95% CI 1.16-6.92; p = 0.007) appeared to be the only factors that were associated with objective efficacy at 2 years, and relative attack reduction after 2 years was the only factor associated with objective efficacy at 5 years (B = 0.501, 95% CI 0.186-0.815; p = 0.003). The odds of experiencing subjective satisfaction with ONS after 2 years increased with a later debut of CCH (adjusted odds ratio [aOR] 1.06, 95% CI 1.01-1.12; p = 0.033) and greater relative reduction in attack frequency at 24 weeks (aOR 1.02, 95% CI 1.00-1.04; p = 0.017).</p><p><strong>Conclusion: </strong>In a controlled setting, early onset of CH, CCH, and smoking were not associated with treatment success of ONS for MICCH, as previously suggested by others in an uncontrolled setting. Early response at 24 weeks after initiation of ONS was the only factor that was associated with long-term efficacy, which was identified. Since a large proportion of patients with MICCH improve with ONS, we recommend offering ONS to all patients with MICCH.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"1626-1633"},"PeriodicalIF":4.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266125","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":"Perceptions of health, cognition, and pain among middle-aged and older adults with migraine: A population-based cross-sectional study examining findings from the Canadian Longitudinal Study on Aging.","authors":"Makenna K N Jensen, Megan E O'Connell, Marla J S Mickleborough","doi":"10.1111/head.14953","DOIUrl":"10.1111/head.14953","url":null,"abstract":"<p><strong>Objective: </strong>The study compared middle-aged and older Canadians with and without migraine, examining how self-perceptions of health, cognition, and pain relate to objective health metrics.</p><p><strong>Background: </strong>Migraine, a debilitating neurological disorder, affects 8.3% of Canadians and 14.0% of the global population. Research has primarily focused on those aged 18-50 years, leaving middle-aged and older adults understudied. Individuals' perceptions of their health, cognition, and pain can tangibly impact their well-being, with negative health self-perceptions linked to higher hospitalization, illness, and mortality rates.</p><p><strong>Methods: </strong>This population-based cross-sectional study used 2015-2018 data from the Canadian Longitudinal Study on Aging during the first follow-up, including the Comprehensive cohort (n = 27,765; 14.0% migraine) and Tracking cohort (n = 17,052; 13.3% migraine). Participants in the Comprehensive cohort were interviewed at one of 11 in-person sites across seven provinces, located 25-50 km from their homes. Those in the Tracking cohort completed a 60-min telephone interview.</p><p><strong>Results: </strong>Females were more than twice as likely to report having a migraine diagnosis. Individuals with migraine rated their physical, mental, and oral health lower than those without migraine and had higher rates of anxiety, depression, and mood disorders. Those with migraine perceived their memory as declining and worried about that decline, yet results displayed only trivial differences in objective memory performance between those with a migraine diagnosis and those without. However, more than twice as many individuals with migraine reported that a physician had told them that they have memory problems. Individuals with migraine reported a higher frequency and intensity of pain and discomfort, resulting in a higher occurrence of missed activities, and higher functional impairment scores.</p><p><strong>Conclusion: </strong>By exploring how individuals with migraine perceive their health, cognition, and pain, this study highlights the gap between self-reported health perceptions and objective health assessments. For example, individuals with migraine tend to report poorer mental health, a trend that aligns with the higher prevalence of anxiety, depression, and mood disorders observed within this population. Interestingly, despite individuals with migraine rating their memory as lower than those without migraine, objective memory testing reveals either no difference or even slightly improved scores among those with migraine. Finally, our findings support a Canadian lifetime prevalence rate in this older adult cohort of 13.7%, which aligns with the global prevalence rates of 14.0%.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"1511-1525"},"PeriodicalIF":4.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109798","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":"Treatment effectiveness of galcanezumab versus traditional oral migraine preventive medications at 3 months: Results from the TRIUMPH study.","authors":"Richard B Lipton, Miguel J A Láinez, Zubair Ahmed, Carlos Vallarino, Diego Novick, Maurice Vincent, Lars Viktrup, Rebecca L Robinson","doi":"10.1111/head.15045","DOIUrl":"https://doi.org/10.1111/head.15045","url":null,"abstract":"<p><strong>Objective: </strong>This study assesses the 3-month effectiveness of the calcitonin gene-related peptide monoclonal antibody galcanezumab versus traditional oral migraine preventive medications.</p><p><strong>Background: </strong>Studies comparing the effectiveness of calcitonin gene-related peptide monoclonal antibodies versus traditional oral migraine preventive medications are limited. However, such comparisons in real-world settings are useful for decision-making by patients, healthcare providers, and policymakers.</p><p><strong>Methods: </strong>TRIUMPH is an ongoing, international, prospective observational cohort study of adult patients with migraine, initiating or switching to new preventive medication with a focus on galcanezumab versus traditional oral migraine preventive medications. Data for this analysis were collected from February 25, 2020, through February 9, 2023. All treatment decisions were at the physicians' discretion. The primary outcome was a 3-month response based on reductions in physician-recorded monthly migraine headache days: ≥50% (episodic migraine) or ≥30% (chronic migraine). The difference in the proportion of responders between treatments was assessed after adjusting for baseline cohort differences.</p><p><strong>Results: </strong>Of 2813 patients, 1105 received galcanezumab and 1293 received traditional oral migraine preventive medications. The weighted response rate at 3 months was greater with galcanezumab versus traditional oral migraine preventive medications (46.6% vs. 34.5%; p < 0.001). Additional 3-month mean changes from baseline for galcanezumab versus traditional oral migraine preventive medications included a reduction in monthly migraine headache days (-5.7 [95% confidence interval (CI), -6.2 to -5.2] vs. -4.1 [95% CI, -4.5 to -3.7]), and an improvement in Migraine-Specific Quality of Life-Role Function Restrictive score (19.4 [95% CI, 17.6-21.3] vs. 10.2 [95% CI, 8.6-11.8]), respectively (both p < 0.001).</p><p><strong>Conclusion: </strong>Findings from this study showed that patients receiving galcanezumab had greater treatment effectiveness after 3 months than those receiving traditional oral migraine preventive medications across multiple measures, including migraine headache days, various responder rate thresholds, change in Migraine-Specific Quality of Life-Role Function Restrictive scores, and types of migraine. These findings are representative of clinical practice settings and may help physicians in making treatment decisions.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185493","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":"Association between wildfire smoke exposure and pediatric emergency department visits for headache.","authors":"Hannah F J Shapiro, Amy A Gelfand, Daniel J Shapiro, Holly Elser, Chen Chen, Joan A Casey","doi":"10.1111/head.15056","DOIUrl":"https://doi.org/10.1111/head.15056","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The purpose of this study was to determine whether short-term exposure to wildfire smoke is associated with emergency department visits for headache in children and adolescents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Wildfires are becoming increasingly common and are associated with numerous adverse health outcomes. However, we currently do not know how wildfire smoke exposure affects children and adolescents with primary headache disorders. Headache disorders in youth are a major contributor to frequently missed school days and youth with headache disorders have high medical care utilization and total healthcare costs. Therefore, understanding factors that may contribute to headache exacerbations and potential increases in healthcare utilization is of particular interest.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a time-stratified case-crossover study linking daily health data from the California Department of Health Care Access and Information to daily ZIP code-level wildfire PM&lt;sub&gt;2.5&lt;/sub&gt; concentrations between 2006 and 2019. We included all visits for headache to emergency departments in California among youth 5-19 years old during the study period. The primary exposure was the ZIP code-level daily wildfire-specific PM&lt;sub&gt;2.5&lt;/sub&gt; concentration, modeled as a continuous and binary (wildfire-specific PM&lt;sub&gt;2.5&lt;/sub&gt; ≥15 μg/m&lt;sup&gt;3&lt;/sup&gt;) variable. The primary outcome was an emergency department visit for headache. We identified relevant encounters according to the International Classification of Diseases, 9th/10th revision codes assigned in the first diagnostic position. To capture a potential delayed impact, we estimated odds ratios for the association for days 0 to 6 between the exposure and outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We identified 206,230 unique emergency department encounters for primary headache disorders. Most visits were in female patients (61.4%) 15-19 years old (58.5%) who identified as Hispanic (48.8%) and lived in a very low-opportunity (37.7%) or low-opportunity (21.6%) neighborhood. The adjusted odds of an emergency department visit incrementally decreased per unit increase in wildfire-specific PM&lt;sub&gt;2.5&lt;/sub&gt; concentrations from days 0 to 6 after wildfire smoke exposure (same-day adjusted odds ratio [aOR], 1.00; 95% confidence interval [CI], 0.998-1.001; day +6 aOR, 0.995; 95% CI, 0.993-0.997). Using a binary exposure, the adjusted odds of an emergency department visit incrementally decreased from days 0 to 6 after a wildfire smoke day (same day aOR, 0.99; 95% CI, 0.92-1.08; day +6 aOR, 0.84; 95% CI, 0.78-0.92).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Children are less likely to seek care in the emergency department for primary headache in the days following exposure to wildfire smoke, suggesting that healthcare utilization changes during wildfires. Clinicians should ensure youth with headache disorders who experience worsening symptoms associated with air pollution are equipped with strat","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174716","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 \"Optimizing triptan safety in emergency settings under cardiovascular risk uncertainty\".","authors":"Ido Peles, Gal Ifergane","doi":"10.1111/head.15059","DOIUrl":"https://doi.org/10.1111/head.15059","url":null,"abstract":"","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124407","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":"Patients with chronic post-dural puncture headache do not have typical imaging features of intracranial hypotension: An MRI study using the Bern score.","authors":"Charlotte Zander, Christian Fung, Amir El Rahal, Florian Volz, Katharina Wolf, Alexander Rau, Hansjörg Mast, Jürgen Beck, Horst Urbach, Niklas Lützen","doi":"10.1111/head.15057","DOIUrl":"https://doi.org/10.1111/head.15057","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated cranial magnetic resonance imaging (MRI) signs in patients with post-dural puncture headache (PDPH) using an established assessment score developed for spontaneous intracranial hypotension (Bern score). We hypothesize that patients with chronic PDPH do not have typical imaging features of intracranial hypotension.</p><p><strong>Background: </strong>PDPH is a well-known complication following an intentional or unintentional lumbar dural puncture with positional headache, neck stiffness, and hearing disturbances usually resolving within 14 days. However, the chronic course of PDPH is poorly represented in the third version of the International Classification of Headache Disorders (ICHD-3). Moreover, data on the role of cranial MRI in this cohort are lacking, but could facilitate care and management of chronic PDPH.</p><p><strong>Methods: </strong>In this post hoc retrospective case series based on a chart review, we identified 86 consecutive patients from a tertiary medical care center in Freiburg, Germany between 01/2018 and 10/2024 with chronic PDPH, defined as persisting symptoms for >14 days post puncture and/or persisting after one or more epidural blood patches (EBP). Inclusion criteria were history of lumbar puncture (LP) or unintended dural puncture (UDP) and contrast enhanced cranial MRI for assessment of Bern score in all patients. Presence of epidural lumbar fluid was evaluated using heavily T2-weighted MRI or computed tomography (CT) myelography, whenever available (83/86 patients). Data were reviewed independently and blinded by two radiologists.</p><p><strong>Results: </strong>Eighty-six patients with chronic PDPH (66 females; mean age of 38.8 ± 11.2 SD years) were included with LP as primary cause in 72% (n=62) and UDP while peridural (synonymous epidural) anesthesia (PDA) in 28% (n = 24). Median symptom duration was 220.0 (interquartile range [IQR] 94.0-474.0) days. Overall median Bern score was 2.0 (IQR 1.0-3.0) with no significant differences between LP versus PDA (p = 0.379). Local epidural fluid was present in 9/83 (11%) cases with adequate imaging and accompanied by higher median Bern scores (5.0 vs. 2.0; p = 0.026). Prior EBP was linked to lower median Bern scores (1.0 vs. 3.5; p < 0.001).</p><p><strong>Conclusion: </strong>Patients with chronic PDPH predominantly present a low Bern score and rarely exhibit spinal epidural fluid. If present, spinal epidural fluid is accompanied by higher Bern score. Our findings highlight the unreliability of current MRI diagnostics to detect patients with chronic PDPH, which must not lead to a mitigation of the diagnosis or a refusal of treatment. Further research on MRI markers is needed here.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130641","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":"Cardiovascular risk considerations in triptan therapy for migraine: Reflections on the study by Peles et al.","authors":"Nav La, Schawanya K Rattanapitoon, Nathkapach K Rattanapitoon","doi":"10.1111/head.15063","DOIUrl":"https://doi.org/10.1111/head.15063","url":null,"abstract":"","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124456","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":"Insomnia severity in migraine: The role of headache frequency, aura status, and comorbidities-A cross-sectional study.","authors":"Kuang-Heng Lee, Chih-Sung Liang, Po-Kuan Yeh, Chia-Kuang Tsai, Chia-Lin Tsai, Yu-Kai Lin, Guan-Yu Lin, Ming-Chen Tsai, Yi Liu, Yuan-Zhen Ruan, Fu-Chi Yang","doi":"10.1111/head.15055","DOIUrl":"https://doi.org/10.1111/head.15055","url":null,"abstract":"<p><strong>Objective: </strong>This study was conducted to investigate the association between migraine frequency and insomnia severity.</p><p><strong>Background: </strong>Migraine and insomnia frequently co-occur, yet the relationship between migraine characteristics and insomnia severity remains poorly understood. Both conditions substantially impair quality of life and daily functioning, potentially because of shared pathophysiological mechanisms. In this study, we investigated the association between migraine frequency and insomnia severity and examined the impact of aura, psychological factors, and restless legs syndrome (RLS).</p><p><strong>Methods: </strong>This cross-sectional controlled study included 2155 participants (1954 individuals with migraine and 201 controls) who visited the neurology outpatient department of a tertiary medical center between January 2019 and October 2023. Migraine diagnosis adhered to the International Classification of Headache Disorders, 3rd edition criteria, with all participants evaluated by a board-certified neurologist and headache specialist. Insomnia severity was assessed using the Insomnia Severity Index (ISI), and psychological factors were measured using the Beck Depression Inventory-II and Hospital Anxiety and Depression Scale. RLS was diagnosed as per international criteria, and individuals with migraine were stratified by headache frequency (1-7, 8-14, or ≥15 days/month) and aura status.</p><p><strong>Results: </strong>High migraine frequency was associated with increased ISI scores (adjusted regression coefficient [β] = 0.75, 95% confidence interval [CI], 0.50-1.01) and increased prevalence of clinical insomnia (ISI ≥ 15) (adjusted odds ratio [aOR] = 1.34; 95% CI, 1.17-1.53) after controlling for demographic, lifestyle, and clinical factors. In the univariate analysis, patients with migraine with aura showed higher ISI scores than those without aura (p < 0.001); however, this difference was no longer significant after adjustment for migraine frequency, depression, anxiety, RLS, and other confounders (adjusted β = 0.48; 95% CI, -0.24 to 1.20; p = 0.191). Multivariable analyses revealed significant associations between ISI total score and depression (adjusted β = 0.21; 95% CI, 0.17-0.24), anxiety (adjusted β = 0.34; 95% CI, 0.27-0.41), and RLS (adjusted β = 1.02; 95% CI, 0.53-1.51). RLS prevalence was significantly higher in the migraine group than in the control group (32.4% vs. 12.9%).</p><p><strong>Conclusions: </strong>Migraine frequency showed a graded association with insomnia severity, with additional independent contributions from psychological factors and RLS, but not from aura status. These findings underscore the multifactorial nature of sleep disturbances in migraine and the need for comprehensive management strategies that address both headache-specific factors and comorbid conditions.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086044","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":"Evidence for increased background neural noise in migraine with aura: Hyperactive but not hyperresponsive.","authors":"Louise O'Hare, Paul B Hibbard, Arnold J Wilkins","doi":"10.1111/head.15046","DOIUrl":"https://doi.org/10.1111/head.15046","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study had two aims: (1) to investigate the contrast gain in migraine and compare it to that in photosensitive epilepsy; (2) to explore any effects of colored spectacles (precision ophthalmic tints [POT]) on contrast gain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Individuals with migraine with aura (MA) typically show high amplitude electrophysiological responses, but poor performance on visual tasks. One possible explanation is increased neural \"noise\" in the visual cortex in MA. \"Noise\" is neural activity that does not carry information about the stimulus.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a case-control study of individuals with MA and controls with no family history of migraine, as there is a tendency for migraine to run in families. We measured the steady-state visual evoked potential in response to a sinewave grating (striped pattern) that varied in contrast (appeared to flicker on and off) at 5 and 17 Hz in 15 MA and 15 control participants. The maximum contrast (stimulus intensity) increased progressively from 10% to 90% in nine equal steps. We also measured the effect of colored spectacles (POTs) on the electroencephalogram (EEG) response. The experiment was a mixed factorial design, with one between-participants factor (experimental vs. control group) and two within-participants factors (contrast and lens type [none, POT, or control]). The dependent variables were the steady-state visual evoked potential response, and the background EEG activity. In experiment 2, discomfort judgments on a rating scale of 0-9 from a separate set of 12 MA and 12 control participants were also collected during the EEG session. Data were collected between February 2022 and August 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;At the faster flicker rate of 17 Hz (appearing on and off 17 times per second), the electrophysiological response of the MA group showed increased background activity (EEG power at frequencies other than the stimulation frequency) (experiment 1: mean for the migraine group = -666.45 dB/Hz, standard error [SE] = 116.69; mean for the control group = -1100.50 dB/Hz, SE = 164.99; coefficient estimate = 434.09, p = 0.016, confidence interval [CI], 82.24-735.94; estimated Cohen's d of 0.94, CI, 0.14-1.73; experiment 2: migraine group mean = -500.01 dB/Hz, SE = 122.99; control group mean = -741.88 dB/Hz, SE = 126.12; coefficient estimate = 265.04, p = 0.049, CI, 1.52-528.56, estimated Cohen's d of 0.95, CI, 0.05-1.84). The increase in EEG power with contrast at the stimulation frequency was similar in both MA and control groups. The MA group experienced more discomfort compared to the control group (median rating for migraine group = 4, interquartile range [IQR] = 4, median rating for control group = 3, IQR = 3, coefficient estimate = 3.58, p = 0.003, CI, 1.18-6.00) and faster flicker (17 Hz) was judged more uncomfortable than slower flicker (5 Hz) by both groups (median rating for 5 Hz = 3, IQR = 3, median rating fo","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069298","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":"Persistent headache after aneurysmal subarachnoid hemorrhage: Prevalence, characteristics, and migraine history as a prognostic factor.","authors":"Laura Gómez-Dabó, Víctor J Gallardo, Daniel Campos-Fernández, Marc Rodrigo-Gisbert, Maider Iza-Achutegui, Anna Sánchez, Fuat Arikan, Estevo Santamarina, Edoardo Caronna, Patricia Pozo-Rosich","doi":"10.1111/head.15052","DOIUrl":"https://doi.org/10.1111/head.15052","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives/background: &lt;/strong&gt;Persistent headache (PH) after an aneurysmal subarachnoid hemorrhage (aSAH) and the influence of migraine history (MH) on its evolution and prognosis is poorly understood. Our study aims are to (1) determine the prevalence, characteristics, and prognostic factors of PH after aSAH; and (2) study the impact of personal MH on PH and aSAH prognosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective cohort study included all adults with confirmed aSAH from January 2019 to September 2021 at a tertiary hospital. Data collected included demographics, comorbidities (including personal MH before aSAH), complementary tests, and aneurysm characteristics. The following clinical, radiological, and functional assessment scales were used: Glasgow Coma Scale (GCS), World Federation of Neurosurgical Societies (WFNS) grading scale, Hunt and Hess grading system, modified Fisher scale, VASOGRADE score, APACHE II score, and the modified Rankin Scale (mRS). PH was defined following the definition of persistent headache attributed to past nontraumatic subarachnoid hemorrhage (6.2.4.2) in the International Classification of Headache Disorders, 3rd edition. PH characteristics were assessed via phone interviews. Descriptive analyses were conducted, along with group comparisons and regression models exploring associations between MH, PH, functional outcomes, and survival.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 130 individuals with aSAH were included with a median age of 59.0 (interquartile range, 51.0-70.0) years and 62.3% (81 of 130) were female. For PH assessment, a total of 36.9% (48 of 130) individuals were excluded due to death, and 19.5% (16 of 82) due to lack of phone availability, resulting in a final sample of 66 individuals. PH had a prevalence of 47.0% (31 of 66) at a mean-time follow up of 3.12 ± 0.83 years. PH primarily manifested with moderate intensity (median visual analogue scale, 7), bilateral localization (51.6%; 16 of 31), and oppressive quality (77.4%; 24 of 31), with a minority of individuals experiencing nausea/vomiting (29.0%; 9 of 31) or photo/phonophobia (41.9%; 13 of 31). Up to 61.3% (19 of 31), referred moderate-severe interference of PH on daily activities. A personal MH was the only risk factor for developing PH (adjusted odds ratios [aOR], 3.9; 95% confidence interval [CI], 1.24-13.2; p = 0.022), and was present in up to 48.5% individuals (32 of 66). MH was associated with decreased aSAH clinical severity risk in both Hunt and Hess (adjusted p [adj.p] = 0.038) and WFNS (adj.p = 0.038) scales, better function outcomes (mRS) at discharge and at 3 months of follow-up (adj.p = 0.002 and adj.p = 0.003), and was independently associated with aSAH survival (aOR, 3.3; 95% CI, 1.14-11.06; p = 0.037).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Persistent headache affected up to 47% individuals in the long term following aSAH and significantly impacted their quality of life. A history of migraine appeared to be mor","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064488","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}