Journal of Headache and Pain最新文献

{"title":"Artificial neural networks applied to somatosensory evoked potentials for migraine classification.","authors":"Gabriele Sebastianelli, Daniele Secci, Francesco Casillo, Chiara Abagnale, Cherubino Di Lorenzo, Mariano Serrao, Shuu-Jiun Wang, Fu-Jung Hsiao, Gianluca Coppola","doi":"10.1186/s10194-025-01989-2","DOIUrl":"10.1186/s10194-025-01989-2","url":null,"abstract":"<p><strong>Background: </strong>Finding a biomarker to diagnose migraine remains a significant challenge in the headache field. Migraine patients exhibit dynamic and recurrent alterations in the brainstem-thalamo-cortical loop, including reduced thalamocortical activity and abnormal habituation during the interictal phase. Although these insights into migraine pathophysiology have been valuable, they are not currently used in clinical practice. This study aims to evaluate the potential of Artificial Neural Networks (ANNs) in distinguishing migraine patients from healthy individuals using neurophysiological recordings.</p><p><strong>Methods: </strong>We recorded Somatosensory Evoked Potentials (SSEPs) to gather electrophysiological data from low- and high-frequency signal bands in 177 participants, comprising 91 migraine patients (MO) during their interictal period and 86 healthy volunteers (HV). Eleven neurophysiological variables were analyzed, and Principal Component Analysis (PCA) and Forward Feature Selection (FFS) techniques were independently employed to identify relevant variables, refine the feature space, and enhance model interpretability. The ANNs were then trained independently with the features derived from the PCA and FFS to delineate the relationship between electrophysiological inputs and the diagnostic outcome.</p><p><strong>Results: </strong>Both models demonstrated robust performance, achieving over 68% in all the performance metrics (accuracy, sensitivity, specificity, and F1 scores). The classification model trained with FFS-derived features performed better than the model trained with PCA results in distinguishing patients with MO from HV. The model trained with FFS-derived features achieved a median accuracy of 72.8% and an area under the curve (AUC) of 0.79, while the model trained with PCA results showed a median accuracy of 68.9% and an AUC of 0.75.</p><p><strong>Conclusion: </strong>Our findings suggest that ANNs trained with SSEP-derived variables hold promise as a noninvasive tool for migraine classification, offering potential for clinical application and deeper insights into migraine diagnostics.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"67"},"PeriodicalIF":7.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Combining treatments for migraine prophylaxis: the state‑of‑the‑art.","authors":"Lanfranco Pellesi, David Garcia-Azorin, Eloisa Rubio-Beltrán, Wook-Seok Ha, Roberta Messina, Raffaele Ornello, Igor Petrusic, Bianca Raffaelli, Alejandro Labastida-Ramirez, Ruth Ruscheweyh, Claudio Tana, Doga Vuralli, Marta Waliszewska-Prosół, Wei Wang, William Wells-Gatnik","doi":"10.1186/s10194-025-02007-1","DOIUrl":"10.1186/s10194-025-02007-1","url":null,"abstract":"","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"66"},"PeriodicalIF":7.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is migraine a common manifestation of CADASIL? Arguments Pros.","authors":"Hugues Chabriat","doi":"10.1186/s10194-025-01980-x","DOIUrl":"10.1186/s10194-025-01980-x","url":null,"abstract":"<p><strong>Background: </strong>Migraine with aura (MA) is a hallmark feature of CADASIL, a hereditary small-vessel disease caused by NOTCH3 mutations. While MA is prevalent in CADASIL, its underlying mechanisms remain unclear, and the links observed can be questioned or debated. This study examined the prevalence, clinical characteristics, and pathophysiology of MA in patients with CADASIL.</p><p><strong>Methods: </strong>Clinical and experimental data were reviewed to assess MA prevalence, aura characteristics, sex differences, and pathophysiological insights from CADASIL models to confirm the indisputable pathophysiological links between migraine and aura and this unique genetic model of cerebral small vessel disease.</p><p><strong>Results: </strong>MA was 10-20 times more prevalent in patients with CADASIL than in the general population, with frequent atypical and prolonged auras. The altered sex distribution and delayed onset suggest disease-specific mechanisms. Experimental data also revealed heightened susceptibility to cortical spreading depression (CSD) in preclinical CADASIL models, linked to greater fragility in maintaining cortical ionic homeostasis.</p><p><strong>Conclusion: </strong>The high prevalence and distinct MA features, as well as the data obtained at the preclinical level, strongly support a causal relationship mediated by neurovascular dysfunction in CADASIL. Accumulating data in this condition sheds new light on the much-debated relationship between migraine and cerebrovascular diseases.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"64"},"PeriodicalIF":7.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is migraine a common manifestation of CADASIL-Cons.","authors":"Yen-Feng Wang","doi":"10.1186/s10194-025-01981-w","DOIUrl":"10.1186/s10194-025-01981-w","url":null,"abstract":"<p><p>Headaches and transient neurological symptoms that bear resemblances to clinical manifestations of migraine, especially migraine with aura, are common among patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) or cysteine-altering NOTCH3 genetic variants. However, according to the International Classification of Headache Disorders, Third Edition (ICHD-3), these patients should be diagnosed as headache attributed to cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) rather than migraine with or without aura. Although transient focal neurological symptoms are often labeled as migraine aura, these symptoms are often atypical and complicated, and could not easily conform to the criteria for migraine with aura. Besides, the association between migraine and CADASIL could not be supported by population-based genetic studies, and cysteine-altering NOTCH3 genetic variants are not more common among patients with migraine with or without aura compared with non-migraine controls. In addition, the underlying pathophysiology may be different between migraine and CADASIL. Although increased cortical spreading depression (CSD) susceptibility in mice harboring a human pathogenic Notch3 variant is often regarded as supportive evidence for the association, CSD could been seen in conditions other than migraine, such as cerebral ischemia. The role of calcitonin gene-related peptide (CGRP), one of the most important molecules in migraine pathophysiology, in CADASIL patients with migraine-like manifestations is yet to be determined. To sum up, there remain uncertainties whether headache and migraine aura-like manifestations in CADASIL correspond to \"ordinary\" migraine with or without aura seen in routine clinical practice. Therefore, we are still a number of steps from a firm conclusion about the association between CADASIL and migraine.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"65"},"PeriodicalIF":7.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between proton pump inhibitor use and migraine: a systematic review and meta-analysis.","authors":"Prakasini Satapathy, Mahalaqua Nazli Khatib, Nasir Vadia, Soumya V Menon, Kattela Chennakesavulu, Rajashree Panigrahi, Muhammed Shabil, Mahendra Singh, Sanjit Sah, Doddolla Lingamaiah, Khang Wen Goh, Edward Mawejje, Ganesh Bushi","doi":"10.1186/s10194-025-02000-8","DOIUrl":"https://doi.org/10.1186/s10194-025-02000-8","url":null,"abstract":"<p><strong>Background: </strong>Migraine is a common neurological disorder with potential pharmacological triggers. Proton pump inhibitors (PPIs), commonly prescribed for managing gastroesophageal reflux disease and other acid-related gastrointestinal disorders, have been linked to headaches. However, their association with migraine remains unclear. This systematic review and meta-analysis assessed the association between PPI use and the incidence of migraine.</p><p><strong>Method: </strong>A systematic search of PubMed, Embase, and Web of Science was conducted in accordance with the PRISMA framework and registered with PROSPERO (ID: CRD42025644604) to enhance transparency. The search, conducted up to January 2024, included studies focusing on the association between migraine and PPI use. Data screening and extraction were performed using Nested Knowledge software. Meta-analyses were conducted in R software, with heterogeneity assessed through the I² statistic. Pooled adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Sensitivity analyses were also performed to assess the robustness of the results. Gender and migraine subtype were considered in subgroup analyses. Additionally, the GRADE approach was applied to assess the certainty of the evidence across the pooled outcomes.</p><p><strong>Results: </strong>Five studies involving over 1.5 million participants met the inclusion criteria. The overall pooled adjusted odds ratio (aOR) was 2.508 (95% CI, 0.790-7.969; I² = 91.2%). However, there was a significant association in males (aOR, 3.875; 95% CI, 2.413-6.222; I² = 0%) but not in females (aOR, 2.475; 95% CI, 0.563-10.890; I² = 91.1%). No significant differences were found between migraine types: with aura (aOR, 2.079; 95% CI, 0.945-4.576; I² = 25.4%) and without aura (aOR, 2.524; 95% CI, 0.807-7.896; I² = 96.5%). The GRADE assessment indicated a very low certainty of the evidence.</p><p><strong>Conclusion: </strong>This review found no significant overall association between PPI use and migraine. However, a significant association was observed in males but not in females. Further research is needed to clarify this association and explore the underlying causality mechanisms, and migraine subtypes, particularly why the association appears more pronounced in males.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"63"},"PeriodicalIF":7.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Global Campaign against Headache, aged 21: a critical self-appraisal, and plans for phase 2.","authors":"Timothy J Steiner, Raquel Gil-Gouveia, Andreas K Husøy, Rigmor Jensen, Zaza Katsarava, Paolo Martelletti, Lars Jacob Stovner, Derya Uluduz","doi":"10.1186/s10194-025-02003-5","DOIUrl":"https://doi.org/10.1186/s10194-025-02003-5","url":null,"abstract":"","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"59"},"PeriodicalIF":7.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcutaneous occipital nerve stimulation alleviated migraine related pain by regulating synaptic plasticity and CGRP expression in the periaqueductal gray of male rats.","authors":"Yinglu Liu, Shengli Guo, Yang Li, Jingrui Mao, Xiaoxue Lin, Ruozhuo Liu, Dengfa Zhao, Zhao Dong, Shengyuan Yu, Xun Han","doi":"10.1186/s10194-025-02006-2","DOIUrl":"https://doi.org/10.1186/s10194-025-02006-2","url":null,"abstract":"<p><strong>Background: </strong>Clinical observations have shown that transcutaneous occipital nerve stimulation (tONS) is effective in treating migraine. However, the underlying mechanisms are poorly understood. This study employs a rodent model to investigate the therapeutic effects of tONS on migraine-related pain and to explore potential mechanisms.</p><p><strong>Methods: </strong>The SD rats were used to establish the migraine model by repeated epidural infusions of inflammatory soup (IS). Modified bilateral electrodes were attached noninvasively for tONS treatments. Periorbital mechanical thresholds were assessed using von-Frey filaments, and other pain-related nociceptive behaviors were analyzed through video recordings. The expressions of c-Fos, synaptophysin (Syp) and calcitonin gene-related peptide (CGRP) in the trigeminal nucleus caudalis (TNC) and/or periaqueductal gray (PAG) area were measured by immunofluorescence and western blotting analyses. The excitatory synaptic transmission in the PAG was detected by whole-cell patch-clamp recording among migraine rats.</p><p><strong>Results: </strong>The reduction in periorbital mechanical thresholds induced by repeated IS infusions was partially reversed by tONS treatments in migraine rats. Other pain-related behaviors, including exploration, rest, and unilateral grooming, consistently improved following tONS treatment. The TNC and PAG area were activated after IS modeling, and the CGRP expressions in the PAG significantly decreased after tONS treatments. tONS could inhibit the enhanced excitatory synaptic transmission in the PAG of migraine rats.</p><p><strong>Conclusions: </strong>Our findings suggest that tONS has therapeutic potential in treating migraine, with the PAG excitability and CGRP expression playing a role in its mechanisms of action. tONS may represent a promising non-invasive neuromodulation approach for the management of migraine in the future.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"61"},"PeriodicalIF":7.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential fMRI neural synchrony associated with migraine during naturalistic stimuli with negative emotional valence.","authors":"Keva Klamer, Joshua Craig, Christina Haines, KiAnna Sullivan, Peter Seres, Chelsea Ekstrand","doi":"10.1186/s10194-025-01993-6","DOIUrl":"https://doi.org/10.1186/s10194-025-01993-6","url":null,"abstract":"<p><p>Migraine is a common neurological disorder that impacts approximately 12% of the general population and is characterized by moderate to severe headaches, nausea, mood changes, and fatigue. It impacts lower-level visual and auditory processing, causing hypersensitivities that lead to heightened audiovisual multisensory integration. However, the impact of migraine on the processing of complex, audiovisual stimuli is still unclear. Additionally, migraine may induce hypersensitivities to emotional arousal and valence, though the relative significance of these factors remains unknown. The current study seeks to identify how migraine impacts synchronous neural processing of complex, audiovisual stimuli, and how this differs based on the emotional arousal and valence of the stimulus. To do so, we collected functional magnetic resonance imaging data (fMRI) from 22 migraineurs and 21 healthy controls during the passive viewing of three audiovisual films of differing emotional arousal and valence. We identified that, in response to a negative valence, high arousal emotional stimulus, the migraine group showed greater neural synchrony in regions associated with multisensory integration, including the bilateral posterior superior temporal gyrus (pSTG), superior parietal lobule (SPL), and left middle temporal gyrus (MTG). There were no significant differences in neural synchrony between the migraine and control groups in response to positive valence, high arousal and neutral valence, low arousal stimuli. These findings suggest that migraine involves hypersensitivity to audiovisual movies as a function of negative emotional valence, where negative/aversive emotional states may drive greater synchrony in multisensory integration. Overall, this research highlights distinct pathways through which emotion and arousal impact neural processing in migraine.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"62"},"PeriodicalIF":7.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of acute sleep deprivation on the brain function of individuals with migraine: a resting-state functional magnetic resonance imaging study.","authors":"Shuqing Wang, Longteng Ma, Song Wang, Caohui Duan, Xinyu Wang, Xiangbing Bian, Deqi Zhai, Yin Sun, Siyuan Xie, Shuhua Zhang, Yingyuan Liu, Xiaoxue Lin, Ruobing Wang, Xiu Liu, Shengyuan Yu, Xin Lou, Zhao Dong","doi":"10.1186/s10194-025-02004-4","DOIUrl":"https://doi.org/10.1186/s10194-025-02004-4","url":null,"abstract":"<p><strong>Background: </strong>Sleep deprivation can trigger acute headache attacks in individuals with migraine; however, the underlying mechanism remains poorly understood. The aim of this study was to investigate the effects of acute sleep deprivation (ASD) on brain function in individuals with migraine without aura (MWoA) via functional magnetic resonance imaging (fMRI).</p><p><strong>Methods: </strong>Twenty three MWoA individuals and 23 healthy controls (HCs) were fairly included in this study. All participants underwent two MRI scans: one at baseline (prior to sleep deprivation) and another following 24 h of ASD. Images were obtained with blood-oxygen-level-dependent and T1-weighted sequences on a Siemens 7.0 T MRI scanner. We conducted analyses of changes in the low-frequency fluctuations (ALFF) values and functional connectivity (FC) between brain networks and within network before and after ASD in both MWoA group and HC group. Additionally, we investigated the relationship between the changes in ALFF before and after ASD and the clinical features (VAS and monthly headache days).</p><p><strong>Results: </strong>In the HC group, ASD led to a significant increase in ALFF values in the left parahippocampal gyrus compared to baseline (p-FDR = 0.01). In the MWoA group, ALFF values were significantly greater in 64 brain regions after ASD than at baseline. The most significant change in ALFF before and after ASD in the MWoA group was detected in the right medial pulvinar of the thalamus (p-FDR = 0.017), which showed a significant negative correlation with monthly headache days. Moreover, seed-based connectivity (SBC) analysis using the right medial pulvinar of the thalamus as the seed point revealed significantly increased connectivity with the cerebellar vermis (p-FWE = 0.035) after ASD in individuals with MWoA, whereas connectivity with the right postcentral gyrus was significantly decreased (p-FWE = 0.048). Furthermore, we performed analyses of between-network connectivity (BNC) and within-network connectivity across 17 brain networks, utilizing the Yeo-17 atlas. Both MWoA individuals and HCs showed no significant changes in BNC after ASD compared to baseline. However, our analysis in within-network revealed that MWoA individuals exhibited a reduced within-network FC in dorsal attention network (DAN) after ASD compared to baseline (p-FDR = 0.031), whereas HCs showed no significant differences in within-network FC across all networks before and after ASD.</p><p><strong>Conclusions: </strong>In comparison to HCs, MWoA individuals exhibited significant alterations in brain function after ASD, particularly within the thalamus, and MWoA individuals exhibited a reduced within-network FC in DAN after ASD compared to baseline. Brain regions and networks in MWoA individuals were more susceptible to the effects of ASD.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"60"},"PeriodicalIF":7.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of sleep patterns in migraine sufferers using the Epworth Sleepiness Scale.","authors":"Arman Hajikarim-Hamedani, Setareh Rassa, Termeh Tarjoman, Mehran Shafiei","doi":"10.1186/s10194-025-02005-3","DOIUrl":"10.1186/s10194-025-02005-3","url":null,"abstract":"<p><strong>Background: </strong>Migraine, a debilitating neurological disorder, is often co-occurring with sleep disturbances. This study used the Epworth Sleepiness Scale (ESS) to explore changes in sleep quality between individuals with migraine and healthy controls. Additionally, we examined associations between ESS scores and migraine frequency, severity, and demographic factors.</p><p><strong>Methods: </strong>This cross-sectional study included 404 participants, 204 with chronic migraine (diagnosed using ICHD-3 criteria) and 200 controls without neurological disorders. Daytime sleepiness was assessed using the Epworth Sleepiness Scale. Demographic and clinical data were analyzed using Python3 and SPSS, using t-tests and ANOVA (P < 0.05).</p><p><strong>Results: </strong>The study analyzed demographics, clinical characteristics, and daytime sleepiness in 204 migraine participants compared with 200 controls. Individuals with chronic migraine had higher Epworth Sleepiness Scale scores, with increased sleepiness associated with higher BMI, age, and female gender. Significant differences in sleepiness levels were observed with migraine severity, highlighting the impact of migraine on sleep patterns and quality, and no significant differences were found between control and migraine groups in ESS scores, sleep duration, or physical activity. Reliability testing confirmed high ESS consistency.</p><p><strong>Conclusion: </strong>This study highlights the prevalence of daytime sleepiness among individuals with chronic. Managing sleep quality emerges as an important treatment strategy. The use of standardized tools such as the Epworth Sleep Scale can guide personalized interventions, improve patient outcomes, and emphasize the role of lifestyle and overall health management.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"58"},"PeriodicalIF":7.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}