Headache最新文献

{"title":"Potential association of cluster headache with certain COVID-19 vaccines: An assessment from the pharmacovigilance databases.","authors":"Elise K Van Obberghen, Laura Parigny, Nouha Ben-Othman, Elliot Ewig, Milou-Daniel Drici, Alexandre O Gérard, Sophie Gautier, Michel Lanteri-Minet","doi":"10.1111/head.70170","DOIUrl":"10.1111/head.70170","url":null,"abstract":"<p><strong>Objectives/background: </strong>The main objective of our study was to assess the potential association between coronavirus disease 2019 (COVID-19) vaccination and cluster headache (CH) using a pharmacovigilance approach. A secondary objective was to determine whether COVID-19 vaccines predominantly triggered onset or worsening of the disease. Recent pharmacovigilance studies and case reports have suggested an association between COVID-19 vaccines and cluster headache. In order to evaluate whether COVID-19 vaccines could possibly elicit the onset of cluster headache or be responsible for worsening of the disease, we conducted a retrospective case-non-case pharmacovigilance study using the international VigiBase pharmacovigilance database and analyzed the reported cases of cluster headache in the Base Nationale de Pharmacovigilance, French National Pharmacovigilance Database (BNPV).</p><p><strong>Methods: </strong>VigiBase was queried up to February 23, 2025, for all reports related to cluster headache and COVID-19 vaccines. To evaluate the potential association, we performed a disproportionality analysis. This analysis relied on the calculation of the information component, for which a 95% confidence interval lower-bound positivity was required for signal detection. The narratives of the reported cases of cluster headache in the BNPV were analyzed to determine whether COVID-19 vaccination was responsible for the onset or worsening of the disease.</p><p><strong>Results: </strong>When focusing on the different COVID-19 vaccines, Vaxzevria was found to be the strongest signal (IC₀₂₅: 3.05). Lower signals were observed for the other COVID-19 vaccines, including Comirnaty (IC025: 1.62), Spikevax (IC₀₂₅: 1.24), and Jcovden (IC₀₂₅: 0.05). The analysis of the 55 CH cases reported in the BNPV revealed a slight predominance of onset (24/55 cases classified as CH) over worsening of the disease (17/55 cases classified as CH).</p><p><strong>Conclusions: </strong>Our study supports the possibility of a potential association between COVID-19 vaccines and cluster headache through an updated pharmacovigilance analysis. The signal appears to be more pronounced with the Vaxzevria vaccine.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"1722-1729"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390745","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":"Stress and fasting for inducing migraine attacks: A randomized 2 × 2 factorial crossover trial.","authors":"Timothy T Houle, Katie Sexton, Adriana Lebowitz, Ivana Chtay, Twinkle Patel, Lisa Leffert, Dana P Turner","doi":"10.1111/head.70105","DOIUrl":"10.1111/head.70105","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to evaluate the independent and joint effects of acute stress and fasting on the likelihood of headache onset in individuals with migraine.</p><p><strong>Background: </strong>Stress and fasting are two of the most frequently cited triggers of migraine headache, but experimental evidence regarding their individual and combined effects remains limited.</p><p><strong>Methods: </strong>This was a partially randomized, 2 × 2 factorial crossover trial conducted in a controlled laboratory setting in Boston, MA, between March 2017 and August 2020. Participants were 18 to 65 years old with episodic migraine. Enrollment was halted early due to recruitment delays. Participants were exposed to two joint experimental manipulations involving stress and fasting: (1) a randomized 12-h fasting or nonfasting condition, and (2) a fixed sequence administration of the Trier Social Stress Test (stress) or a time-matched control task (control), each administered on separate study visits. The primary outcome was an incident headache attack rated ≥4/10 or treated with abortive or analgesic medication within the 6-h laboratory session.</p><p><strong>Results: </strong>Among 131 analyzable sessions from N = 74 participants, eight (6%) incident headache attacks were observed. Predicted probabilities of a laboratory headache were 3.8% (95% credible intervals [CrI]: 0.3% to 13.9%) for Control/No-Fast, 5.6% (95% CrI: 0.5% to 21.3%) for Control/Fast, 2.7% (95% CrI: 0.2% to 12.5%) for Stress/No-Fast, and 6.8% (95% CrI: 0.6% to 24.3%) for Stress/Fast. Compared to Control/No-Fast, adjusted posterior odds ratios were 1.54 (95% CrI: 0.39 to 6.5) for Control/Fast and 1.86 (95% CrI:0.48 to 8.1) for Stress/Fast. Secondary outcomes mirrored the primary findings, with the highest cumulative incidence of attacks in the Stress/Fast condition.</p><p><strong>Conclusion: </strong>Fasting and stress were each associated with a modest alteration in migraine risk, and the combination of both exposures was consistent with a greater likelihood of acute headache onset. Given the wide credible intervals, these findings should be interpreted as preliminary evidence for a possible synergistic interaction between stress and fasting.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"1801-1811"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769852","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":"Safety of migraine prophylaxis with calcitonin gene-related peptide monoclonal antibodies in comorbid chronic inflammatory central nervous system disease: A case series.","authors":"Nedelina Slavova, Andrew Chan, Franz Riederer, Christoph Schankin, Adrian Scutelnic","doi":"10.1111/head.70137","DOIUrl":"10.1111/head.70137","url":null,"abstract":"","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"1923-1925"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294728","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":"HALO program marks another year of growth and collaboration.","authors":"Patricia A Olson, Nan Cheng","doi":"10.1111/head.70205","DOIUrl":"10.1111/head.70205","url":null,"abstract":"","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"1714-1717"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850388","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":"Acute migraine treatments in patients above age 65.","authors":"Tulsi Shah, Jessica Ailani, Carrie Dougherty, Arathi Nandyala","doi":"10.1111/head.70177","DOIUrl":"10.1111/head.70177","url":null,"abstract":"<p><strong>Background: </strong>Migraine remains a prevalent and disabling condition in older adults, yet there are limited data guiding acute treatment in patients over the age of 65 years. This population is often underrepresented in clinical trials and there are special considerations to take with management in this population including age-related pharmacokinetic changes, comorbidities, and increased risk of medication-related adverse effects.</p><p><strong>Objective: </strong>In this narrative review, we aim to highlight the current acute treatments for migraine and considerations that should be taken when choosing medications in older adults, including assessing vascular risk factors, polypharmacy, declining kidney function, delayed gastric emptying, and impaired liver metabolism.</p><p><strong>Methods: </strong>This is a narrative review on the current literature and evidence for the use of acute medications in patients with migraine who are 65 years old or older. The authors queried both PubMed and Google Scholar for relevant publications in February-March 2025.</p><p><strong>Results: </strong>The authors provide a breakdown of acute medication treatment options and include special considerations by class. The classes discussed include non-steroidal anti-inflammatory drugs, acetaminophen, triptans, ergotamines, gepants, ditans, neuromodulation, and nerve blocks.</p><p><strong>Conclusion: </strong>Ultimately, effective and safe acute migraine management in patients over age 65 years requires applying the best available evidence, understanding knowledge gaps, and engaging in shared decision making. Better data and guidelines are needed to enable clinicians to make informed treatment decisions and to safely provide reassurance to patients who benefit from these therapies.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"1898-1905"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148445742","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":"Nummular headache responsive to suzetrigine, a novel, selective sodium channel antagonist.","authors":"Noelle Kobayashi, Shawn Conger-Love","doi":"10.1111/head.70109","DOIUrl":"10.1111/head.70109","url":null,"abstract":"","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"1926-1927"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308018","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":"Redundant pharmacovigilance disproportionality analyses: Navigating between Scylla and Charybdis.","authors":"Charles Khouri, Alex Hlavaty, Francesco Salvo, Monia Donati, Emanuel Raschi","doi":"10.1111/head.70128","DOIUrl":"10.1111/head.70128","url":null,"abstract":"","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"1718-1719"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602266","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":"Acupuncture for acute treatment of migraine without aura: A randomized clinical trial.","authors":"Yuanzheng Deng, Shumin Zhang, Fayuan Yao, Siwen Zhao, Gaoyangzi Huang, Ruqin Yang, Hongyang Wang, Xin Tang, Ya Huang, Qifu Li, Xianmei Pei, Zili Liu, Fanrong Liang, Taipin Guo","doi":"10.1111/head.70144","DOIUrl":"10.1111/head.70144","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the immediate analgesic efficacy of acupuncture in acute migraine without aura.</p><p><strong>Background: </strong>Patients with acute migraine without aura require prompt relief from headache. Acupuncture has the potential to provide rapid pain relief; however, its analgesic efficacy warrants further validation.</p><p><strong>Methods: </strong>We designed a single-blind, sham-controlled, randomized controlled trial and randomly allocated 80 patients with acute migraine without aura to the real acupuncture or the sham acupuncture group at a 1:1 ratio. Both groups received 10 min of real acupuncture or nonpenetrating blunt needling. The primary outcome was the analgesic response rate of patients at 10 min.</p><p><strong>Results: </strong>This trial was conducted at the Second Affiliated Hospital, Yunnan University of Chinese Medicine from January 2023 to December 2024. All 80 patients provided complete data. At the primary end point of 10 min, the analgesic response rate was 92.5% (37 of 40) in the real acupuncture group compared to 12.5% (5 of 40) in the sham acupuncture group, with a between-group difference of 80.0% (95% confidence interval [CI], 64.4%-95.6%; p < 0.001). The real acupuncture group also demonstrated higher response rates from 2 to 8 min (differences ranging from 27.5% to 75.0%, all p < 0.05). At 1 min, the difference was 12.5% (95% CI, -0.2% to 25.2%; p = 0.995). Regarding pain intensity, the real acupuncture group exhibited a greater reduction in pain visual analog scale scores compared to the sham acupuncture group starting from 1 min (mean difference: -1.0; 95% CI, -1.3 to -0.6; p < 0.001) and peaking at 10 min (mean difference: -2.6; 95% CI, -3.0 to -2.2; p < 0.001). For accompanying symptoms, the real acupuncture group showed significantly lower scores for nausea/vomiting at 10 min (median [interquartile range (IQR)] 0.0 [0.0-1.0] vs. 1.0 [0.0-2.0]; p = 0.006), whereas no significant differences were observed for photophobia/phonophobia (median [IQR]: 0.0 [0.0-1.0] vs. 0.5 [0.0-2.0]; p = 0.098). No adverse events were observed during the trial.</p><p><strong>Conclusion: </strong>The results of this study demonstrate that acupuncture can rapidly alleviate headache and accompanying symptoms in patients with acute migraine without aura attacks within 10 min, with the analgesic effect of the real acupuncture group being significantly superior to that of the sham acupuncture group. Future trials are needed to verify the reliability and generalizability of our findings.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"1779-1787"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210971","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":"Hypothalamus as a conductor of the migraine prodrome: A narrative review.","authors":"Shane Root, Todd J Schwedt","doi":"10.1111/head.70161","DOIUrl":"10.1111/head.70161","url":null,"abstract":"<p><strong>Objectives/background: </strong>This narrative review summarizes evidence implicating a role for the hypothalamus in the prodrome phase of a migraine attack. Prodrome is the earliest phase of the migraine attack. Understanding the migraine prodrome could lead to a better description of how migraine attacks are initiated and identification of targets for acute and preventive migraine treatment. The hypothalamus has been implicated in migraine prodrome via (1) localization of common prodrome symptoms to the hypothalamus; (2) identification of neurotransmitters, peptides, and hormones important in migraine pathophysiology for which the hypothalamus influences their production or release; and (3) brain neuroimaging studies identifying changes in hypothalamic activity and functional connectivity during the prodrome and preheadache phases of the migraine attack.</p><p><strong>Methods: </strong>For this narrative review, PubMed was searched for relevant English language articles using the terms \"hypothalamus, prodrome,\" \"hypothalamus, premonitory,\" \"hypothalamus, migraine,\" \"migraine, prodrome,\" and \"migraine, premonitory.\" The PubMed search was performed on October 29, 2025. Full articles were chosen for review based on their relevance to the three areas defined just above: symptom localization, neuropeptide/neurotransmitter release, and brain imaging.</p><p><strong>Results: </strong>Those with migraine commonly, and often consistently, experience prodrome symptoms, including hypersensitivities to visual and auditory stimuli, neck pain, fatigue, sleep-wake disturbances, changes in appetite, mood changes, and alterations in thermoregulation perception. Many of these symptoms can be localized to functions of hypothalamic subregions and nuclei. Several neuropeptides, neurotransmitters, and hormones that contribute to prodrome and other migraine attack symptoms, including calcitonin gene-related peptide, dopamine, orexins, and pituitary adenylate cyclase-activating polypeptide, are either produced by the hypothalamus or their release is mediated by the hypothalamus. Functional neuroimaging studies of spontaneous and triggered migraine attacks have identified increased hypothalamic activity and altered hypothalamic functional connectivity before migraine headache onset, including during the prodrome.</p><p><strong>Conclusion: </strong>There is compelling evidence that the hypothalamus plays a role in the migraine prodrome and likely in migraine attack initiation. This is supported by many migraine prodrome symptoms localizing to hypothalamic function and functional neuroimaging studies demonstrating increased activity and altered connectivity of the hypothalamus during the prodrome phase. Further evidence and research are required to understand the hypothalamus' contribution relative to other brain regions.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"1906-1915"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360077","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":"Potential role of tirzepatide, a dual GLP-1 and GIP receptor agonist, for preventive treatment of migraine: A case series.","authors":"Tulsi Shah, Carrie Dougherty, Jessica Ailani, Thomas Kerrigan","doi":"10.1111/head.70152","DOIUrl":"10.1111/head.70152","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a known comorbidity of migraine that can increase attack frequency and severity and lead to disease chronification. Glucagon-like peptide-1 (GLP-1) receptor agonists and related medications have demonstrated benefits beyond glycemic control and weight management, with emerging evidence suggesting a potential role in pain modulation. Clinical observations have also suggested the role of GLP-1 based therapies for the treatment of idiopathic intracranial hypertension, but their role in migraine has not been established.</p><p><strong>Case series: </strong>Here, we report two cases of patients with migraine who experienced a reduction in migraine headache frequency following initiation of tirzepatide, a dual GLP-1 and glucose-dependent insulinotropic polypeptide receptor agonist.</p><p><strong>Discussion: </strong>These cases suggest that GLP-1 receptor agonists and dual GLP-1 and glucose-dependent insulinotropic polypeptide receptor agonists may have potential therapeutic relevance in migraine management. Notably, both patients experienced weight loss with treatment, which represents a significant confounding factor that limits conclusions about a direct migraine-specific effect. These cases should be interpreted as preliminary observations. Future studies evaluating migraine outcomes in patients treated with these medications are needed to better understand the underlying mechanism and explore their potential role as novel therapeutic pathways for migraine.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"1916-1919"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390759","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}