Journal of Headache and Pain最新文献

{"title":"Genetic influence of the brain imaging phenotypes, brain and cerebrospinal fluid metabolites and brain genes on migraine subtypes: a Mendelian randomization and multi-omics study.","authors":"Ping-An Zhang, Jie-Lin Wang, Mei-Hua Dong, Xiang-Chun Huang, Nai-Jian Li, Run-Dong Qin, Jing Li","doi":"10.1186/s10194-025-02063-7","DOIUrl":"10.1186/s10194-025-02063-7","url":null,"abstract":"<p><strong>Background: </strong>Migraine is a complex neurological disorder with high prevalence but unclear pathogenesis. Numerous studies have suggested that migraine is associated with alterations in brain imaging phenotypes (BIPs) and dysregulation of cerebrospinal fluid (CSF) and brain metabolism; however, causal evidence remains limited. Mendelian randomization (MR) offers a powerful approach for inferring causality using genetic instruments.</p><p><strong>Methods: </strong>Firstly, we conducted linkage disequilibrium score regression (LDSC) to evaluate genetic correlations between migraine, including the migraine with aura (MA) and migraine without aura (MO) subtypes, and BIPs, CSF, and brain metabolites. Traits that showed genetic correlations with migraine, MA, or MO were retained for subsequent MR analysis with the corresponding migraine phenotype. Traits showing significant correlations were analyzed using bidirectional two-sample MR (TSMR), followed by two-step TSMR to identify cross-omics mediation effects. Additionally, We also applied summary-data-based MR (SMR) to detect brain-region-specific genes with potential causal effects. Enrichment analyses (KEGG, GO, PPI, transcription factor, and miRNA networks) were conducted to further explore underlying mechanisms.</p><p><strong>Results: </strong>LDSC identified significant genetic correlations with 73 BIPs and 40 metabolites for overall migraine, 71 BIPs and 37 metabolites for MA, and 49 BIPs and 62 metabolites for MO. Enrichment analysis revealed that genetically associated metabolites were predominantly involved in amino acid metabolic pathways. TSMR identified 6 BIPs and 2 metabolites causally linked to overall migraine, 3 BIPs and 3 metabolites to MA, and 2 BIPs and 5 metabolites to MO. Most migraine-related BIPs mapped to the parietal lobe. Reverse MR analysis showed that overall migraine causally influenced 4 BIPs and 3 metabolites, while MA and MO affected 1 BIP and 1 metabolite, and 3 BIPs and 1 metabolite, respectively. Mediation analysis revealed five significant mediation pathways were identified. SMR analysis identified FAM83B and CIB2 consistently showing inhibitory effects across most regions. Enrichment analysis showed that these genes were predominantly involved in immune activation and cell adhesion.</p><p><strong>Conclusions: </strong>Our study integrates cross-omics analyses to investigate the causal links between brain structure, metabolic alterations, gene expression, and migraine including its MA and MO subtypes. These findings provide novel insights into the pathophysiological mechanisms and potential targets for intervention across migraine subtypes.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"124"},"PeriodicalIF":7.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110925","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":"Dysfunctional mesocorticolimbic circuitry in cluster headache.","authors":"Stefania Ferraro, Greta Demichelis, Jean Paul Medina Carrion, Dan Liu, Benjamin Becker, Michael Maes, Davide Fedeli, Giuseppe Ciullo, Susanna Usai, Marina Grisoli, Luisa Chiapparini, Alberto Cecchini Proietti, Luca Giani, Anna Nigri, Massimo Leone","doi":"10.1186/s10194-025-02017-z","DOIUrl":"10.1186/s10194-025-02017-z","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to identify mesocorticolimbic functional abnormalities in cluster headache (CH) patients, disentangling the roles of chronification and affective symptoms.</p><p><strong>Methods: </strong>Using the monetary incentive delay fMRI task to directly engage these pathways, we investigated functional alterations in key regions of this network in chronic (n = 23) and episodic CH patients (n = 49) compared to a control group (n = 32). After processing the fMRI data, we extracted beta values from selected regions and for contrasts of interest and entered them into logistic regression models adjusted for potential confounders (such as depressive and anxiety symptoms and smoking habit) to test their association with the diagnoses (chronic CH and control subjects, episodic CH and control subjects).</p><p><strong>Results: </strong>Results showed that chronic CH patients exhibited reduced ventral tegmental area (VTA) activity and a tendency towards significance (p = 0.056) for an increased medial prefrontal cortex (mPFC) responsiveness during reward anticipation, alongside a significant decrease in mPFC activity during reward outcomes. Episodic patients displayed abnormal mPFC activity across both reward phases, but coupled with intact VTA responses. Importantly, these functional abnormalities were not correlated to depressive and anxiety symptoms and smoking habits.</p><p><strong>Conclusions: </strong>These findings suggest that chronic CH patients experience an imbalance in the VTA-mPFC pathway, while episodic patients may show early signs of this emerging dysfunction. Moreover, the observed reward processing alterations seem distinct from those associated with affective disorders, possibly highlighting unique mechanisms underlying the pathophysiology of CH.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"121"},"PeriodicalIF":7.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110922","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 impact of CSF venous fistula embolization on patient's quality of life, a longitudinal clinical-radiological exploration.","authors":"Malo Goapper, Liesjet E H van Dokkum, Vincent Costalat, Gaetano Risi, Lucas Corti, Olivia Portalier, Nicolas Lonjon, Emmanuelle Le Bars, Anne Ducros, Federico Cagnazzo","doi":"10.1186/s10194-025-02056-6","DOIUrl":"10.1186/s10194-025-02056-6","url":null,"abstract":"<p><strong>Background: </strong>Transvenous Onyx embolization of cerebrospinal fluid-venous fistulas (CSFVF) is an emerging and effective treatment for symptomatic spontaneous intracranial hypotension (SIH). This condition significantly impacts patients' quality of life (QoL) through a variety of debilitating symptoms.</p><p><strong>Methods: </strong>Patients were selected from a prospective database of individuals with CSFVF who underwent transvenous Onyx embolization. All participants were asked to complete 13 questionnaires assessing their QoL, before and three months after treatment. Clinical and radiological data were retrospectively collected from the database, and the impact of embolization was evaluated across multiple variables. Correlations and stepwise regression analyses were used to explore relationships between QoL and specific domains including headache, audio-vestibular and psychological symptoms, and spiritual well-being.</p><p><strong>Results: </strong>The study included 30 patients (mean age: 60.4 ± 14.1; female-to-male ratio: 2:1) diagnosed with SIH and CSFVF, that were treated successfully with Onyx embolization. There was no treatment-related morbidity. All 28 patients with headache reported symptom improvement, with 64% achieving complete resolution. The response rate was 100% for VAS-QoL, HIT-6, MIDAS grade, VAS-HI, and monthly headache days; lower rates were observed for SF-36 (56.6%), MSQ (96.7%), DHI and THI (90%), and psychological questionnaires (80-90%). Global QoL scores (VAS-QoL: p < 0.001, SF-36: p < 0.05) and QoL scores related to headache significantly improved post-treatment (HIT-6: p = 0.0119; MSQ: p = 0.0004; MIDAS: p = 0.0236). Psychological symptoms like depression and anxiety significantly decreased, while suicidal ideation resolved when present. Significant audio-vestibular QoL improvements were noted for dizziness (p = 0.002) and hearing disturbances (p = 0.021), but not for tinnitus (p = 0.101). MRI findings showed a significant reduction in SIH-related brain abnormalities (mean Bern-score: 6.3 ± 1.9 to 1.7 ± 1.5 post-treatment). However, changes in overall Bern-scores did not correlate with clinical variables, although brain sagging showed a trend toward correlation with headache intensity reduction (r = 0.37, p = 0.06).</p><p><strong>Conclusion: </strong>CSFVF embolization is associated with significant radiological and clinical improvements, leading to enhanced global quality of life for patients with SIH.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"120"},"PeriodicalIF":7.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101814","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":"GIANT: a prospective, multicenter, real-world study on the effectiveness, safety, and tolerability of atogepant in migraine patients with multiple therapeutic failures.","authors":"Piero Barbanti, Gabriella Egeo, Francesca Pistoia, Cinzia Aurilia, Paola Scatena, Steno Rinalduzzi, Silvia Strumia, Antonio Salerno, Fabio Frediani, Andrea Galli, Massimo Autunno, Laura Di Clemente, Maurizio Zucco, Maria Albanese, Francesco Bono, Pietrantonio Bruno, Laura Borrello, Stefano Messina, Alberto Doretti, Angelo Ranieri, Cecilia Camarda, Rosario Vecchio, Valeria Drago, Giulia Fiorentini, Carlo Tomino, Stefano Bonassi, Paola Torelli, Alice Mannocci","doi":"10.1186/s10194-025-02068-2","DOIUrl":"https://doi.org/10.1186/s10194-025-02068-2","url":null,"abstract":"<p><strong>Background: </strong>Atogepant, the first oral CGRP receptor antagonist approved for migraine prevention, has demonstrated efficacy and safety in randomized clinical trials (RCT). However, prospective real-world data are lacking.</p><p><strong>Objective: </strong>To explore the effectiveness, safety, and tolerability of atogepant 60 mg at week 12 in patients with high-frequency episodic (HFEM: 8-14 days/month) or chronic migraine (CM) with multiple therapeutic failures.</p><p><strong>Methods: </strong>This ongoing, multicenter (n = 16), prospective real-world study included consecutive adults with HFEM or CM who had failed ≥3 prior preventive treatments, according to AIFA criteria. Participants received atogepant 60 mg daily, with treatment planned for up to 12 months.</p><p><strong>Primary endpoint: </strong>change from baseline to week 12 in monthly migraine days (MMD) for HFEM and monthly headache days (MHD) for CM. Secondary endpoints: changes in monthly analgesic intake (MAI), pain intensity (NRS), disability (HIT-6, MIDAS), interictal burden (MIBS-4), treatment satisfaction (PGIC), responder rates (≥ 50%, ≥ 75%, 100%), and changes in migraine frequency during the first treatment week compared to the last pre-treatment week. Adverse events were monitored throughout.</p><p><strong>Results: </strong>A total of 183 patients were enrolled and 82 completed ≥ 12 weeks of follow-up. Of these, 41.5% had previously failed anti-CGRP mAbs. At week 12, significant reductions (p < 0.001) were observed in MMD (-6.0) and MHD (-11.2). Secondary outcomes also improved significantly (p < 0.001): MAI (-10.9), NRS (-2.7), HIT-6 (-13.2), MIDAS (-61.1), and MIBS-4 (-5.4). Responder rates were 65.9% (≥ 50%), 36.6% (≥ 75%), and 6.1% (100%). PGIC documented high satisfaction (much/very much improved: 70.7%). A significant decrease (p < 0.001) in migraine frequency was already evident by week 1 (overall: - 2.5 days, HFEM: - 1.5, CM: - 3.1). In the mAb-failure subgroup, ≥ 50% and ≥ 75% response rates were 52.9% and 23.5%, with significant improvements in all primary and secondary endpoints (p < 0.001). Adverse events occurred in 5.5% of patients, and 1.6% discontinued treatment.</p><p><strong>Conclusion: </strong>The GIANT study provides real-world evidence of atogepant's effectiveness, safety, and tolerability in patients with HFEM and CM with multiple therapeutic failures and comorbidities. It extends RCT data by showing rapid onset of action, meaningful reductions in pain intensity and interictal disability, high patient satisfaction, and effectiveness even in patients with anti-CGRP mAb failures.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"122"},"PeriodicalIF":7.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208712","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":"Substance P release from rat dura mater is inversely correlated with CGRP release- experiments using glycerol trinitrate and anti-CGRP antibodies.","authors":"Mária Dux, Karl Messlinger","doi":"10.1186/s10194-025-02050-y","DOIUrl":"10.1186/s10194-025-02050-y","url":null,"abstract":"<p><strong>Background: </strong>The neuropeptides calcitonin gene-related peptide (CGRP) and substance P are important mediators of neurogenic inflammation when they are released from activated primary nociceptive afferents. It is long evident that neuropeptides play an important role in migraine pathophysiology, but the significance of neurogenic inflammation is still debated.</p><p><strong>Methods: </strong>In an approved hemisected rodent head preparation, we measured CGRP release from the cranial dura mater in parallel with substance P release using animals pre-treated with anti-CGRP antibodies or control solutions.</p><p><strong>Results: </strong>Apart from the known decrease in CGRP release following antibody treatment, we found a significant inverse correlation of basal and stimulated CGRP versus substance P release across all experiments. The results are discussed in connection with our previously published data.</p><p><strong>Conclusions: </strong>An increase in CGRP release seems to inhibit substance P release in meningeal structures possibly decreasing substance P-dependent plasma extravasation, which argues against a significant role of neurogenic inflammation in migraine.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"119"},"PeriodicalIF":7.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086358","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":"Prevalence, disability, and economic impact of migraine in Spain: a nationwide population-based study.","authors":"Margarita Sanchez-Del-Rio, David García-Azorín, Carmen Peral, Beatriz Armada, Pablo Irimia-Sieira, Jesus Porta-Etessam","doi":"10.1186/s10194-025-02069-1","DOIUrl":"10.1186/s10194-025-02069-1","url":null,"abstract":"<p><strong>Background: </strong>This study updates data on migraine prevalence in Spain, examining regional variations, healthcare resource utilization (HCRU), and patient-reported outcomes (PROs).</p><p><strong>Methods: </strong>Cross sectional study using data from the 2022 National Health and Wellness Survey, an online survey of Spanish residents aged 18 or older. Respondents diagnosed with migraine by a physician and who reported at least one migraine in the past year were considered active migraine cases.</p><p><strong>Results: </strong>The study included 7,002 respondents, 930 of whom had physician-diagnosed active migraine. The estimated one-year prevalence of migraine in Spain was 13.1% (95% confidence interval [CI] 12.8-13.4%), with higher rates in females (17.7%, 95% CI 17.2-18.3%) than in males (8.2%, 95% CI 7.8-8.6%). Migraine prevalence varied across Spain's regions, ranging from 8.1% (95% CI 5.2-11.0%) in Navarre to 19.1% in Cantabria (95% CI 15.6-22.6%). Prevalence was the highest among individuals earning below the median income (14.7%, 95% CI 14.1-15.4%). In the preceding month, 75.3% of patients experienced < 4 migraine days, 15.3% 4-9 migraine days, 4.1% 10-14 migraine days, and 5.3% ≥15 migraine days. Severe disability from migraine was reported by 20.4% of respondents. One in ten people reported using a preventive treatment for migraine. The mean SF-12 scores for mental and physical health were 37.8 and 42.1, respectively, both below the general population norm of 50. The mean EQ-5D summary score was 0.8, indicating reduced quality of life and the PHQ-9 detected severe depressive symptoms in 8.8% of individuals. Work productivity was affected by migraine, with a mean work productivity loss of 35.8%. HCRU in the preceding 6 months was high, with 68.4% having visited at least once a general practitioner, 14.2% a neurologist, 45.6% the emergency room, and 11.8% being hospitalized. The annual cost per person with migraine was estimated at €6,704, primarily driven by indirect costs related to productivity loss.</p><p><strong>Conclusions: </strong>Migraine prevalence remains high in Spain, causing a substantial burden and representing a major public health problem. Despite the availability of effective treatments, their usage is limited. Improving migraine management should be prioritized to enhance health outcomes and reduce societal burden.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"117"},"PeriodicalIF":7.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078546","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":"Astrocytic spermidine insufficiency contributes to enhanced pain sensitivity associated with ApoE4.","authors":"Kaiming Yu, Xiongyao Zhou, Baolong Li, Jialu Sun, Tuo Yang, Weizhen Li, Ningning Wang, Xiaosong Gu, Shusen Cui, Rangjuan Cao","doi":"10.1186/s10194-025-02054-8","DOIUrl":"10.1186/s10194-025-02054-8","url":null,"abstract":"<p><p>Neuropathic pain is a chronic condition with limited effective treatments, closely associated with astrocytes and their role in central sensitization. Apolipoprotein E (ApoE), predominantly expressed in astrocytes in central nervous system, exists in three ApoE isoforms (ApoE2, ApoE3, and ApoE4) in humans, with ApoE4 linked to increased susceptibility to neurological diseases. However, the relationship between ApoE4 and neuropathic pain, as well as underlying mechanisms, remains poorly understood. Here, we demonstrated that mice expressing human ApoE4 (ApoE4-TR) displayed increased pain sensitivity following spared nerve injury (SNI) compared to ApoE3-TR mice. This increased sensitivity was also observed in mice with astrocyte-specific expression of ApoE4, achieved through Cre-mediated recombination. Metabolomic profiling revealed reduced spermidine levels in the spinal dorsal horn of ApoE4-TR mice relative to ApoE3-TR mice. Daily gavage administration of spermidine alleviated mechanical pain to a comparable level in ApoE3-TR and ApoE4-TR mice, as assessed by von Frey test. However, lower dose of spermidine effectively alleviated neuropathic pain in ApoE3-TR mice but showed reduced efficacy in ApoE4-TR mice, likely due to limited spermidine retention in ApoE4 astrocytes, as demonstrated in vitro. Transcriptomic analysis identified Nos2 as a critical gene upregulated in ApoE4-TR mice. Mechanistically, spermidine suppressed Nos2 expression by inhibiting the NF-κB pathway in astrocytes, thereby alleviating neuropathic pain. These findings highlight an enhanced pain sensitivity associated with ApoE4 and suggest spermidine as a potential therapeutic strategy, emphasizing a tailored dosage approach for ApoE4 carriers.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"116"},"PeriodicalIF":7.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078545","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":"White matter and cortical gray matter microstructural alterations in migraine: a NODDI and DTI analysis.","authors":"Zhilei Li, Yanliang Mei, Lei Wang, Tianhua Fan, Cheng Peng, Kaibo Zhang, Shouyi Wu, Tong Chen, Zhenchang Zhang, Binbin Sui, Yonggang Wang, Xueying Yu","doi":"10.1186/s10194-025-02059-3","DOIUrl":"https://doi.org/10.1186/s10194-025-02059-3","url":null,"abstract":"<p><strong>Background: </strong>The pathophysiological mechanism of migraine remains elusive, thereby impeding the effective treatment of the disease. Current neuroimaging research focuses on changes in brain functional connectivity, functional networks, and macrostructural alterations, which reflect abnormal neuronal function during the disease process. The plasticity changes in neuronal structures and neurotransmitter system dysregulations potentially play a crucial role in migraine onset and chronicity of migraine. This study utilizes multimodal neuroimaging techniques to investigate the microstructural and neurotransmitter alterations in migraine and provides new insights into its pathological mechanisms and therapeutic method.</p><p><strong>Methods: </strong>Microstructural alterations in both white matter (WM) and cortical gray matter (GM) were evaluated among 40 chronic migraine (CM) patients, 35 episodic migraine (EM) patients, and 45 healthy controls (HCs) using Diffusion Tensor Imaging (DTI) and Neurite Orientation Dispersion and Density Imaging (NODDI) models. Tract-based spatial statistics (TBSS) and Surface-based analysis (SBA) were performed to compare groupwise differences in white and gray matter microstructure, respectively. Furthermore, the cross-modal toolbox JuSpace was used to analyze the correlation between cortical gray matter neurite alterations and neurotransmitter.</p><p><strong>Results: </strong>In the WM, compared to HC, a decrease in neurite density index (NDI) was identified in the migraine group, and both NDI and fractional anisotropy (FA) were decreased in the CM group. No significant alterations were observed in the EM group. An increase in radial diffusivity (RD) was found in the CM group compared to the EM group. In the cortical GM, compared to HC, the migraine group had fewer neurites in the right insula and temporal pole cortex, and the CM group showed a reduction in neurites in the right middle temporal and fusiform cortex. The cortical GM of neurite damage was negatively correlated with neurotransmitters in migraine and CM. There was no correlation between NODDI and DTI metrics of these brain regions and clinical data after the Bonferroni correction.</p><p><strong>Conclusion: </strong>Our findings indicated that neurite loss was detected in both WM and cortical GM of migraineurs. As the migraine progresses into chronicity, the axonal damage may become more pronounced. The neurite damage of cortical GM was negatively related to neurotransmitters.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"115"},"PeriodicalIF":7.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078547","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":"Burden of migraine among Egyptian people: prevalence and comorbidities.","authors":"Ahmed Amir Samir, Ahmed W Hageen, Ahmed Elgammal, Mostafa Meshref, Mennatullah A El-Refaay, Mohamed Medhat Taalap, Ali Elsaeed Nassef, Rawan Ali Bedewe, Ahmed Almeldein, Ibrahim Ali Kabbash","doi":"10.1186/s10194-025-02016-0","DOIUrl":"10.1186/s10194-025-02016-0","url":null,"abstract":"<p><strong>Introduction: </strong>Migraine is a prevalent debilitating neurological illness that stands among the top causes of disability and significantly impacts the quality of life. Migraine-related functional impairment involves physical, emotional, and economic consequences that frequently impact occupational, academic, social, and familial aspects of life. Depression, anxiety, and sleep disturbances are among the most common comorbid conditions associated with migraine.</p><p><strong>Objective: </strong>This study aimed to assess the prevalence of migraine among the Egyptian population and associated comorbidities.</p><p><strong>Methods: </strong>we conducted a cross-sectional study using a validated Arabic self-administered questionnaire distributed to the general population. The questionnaire was used to collect data on sociodemographic characteristics, migraine frequency, characteristic associated disability, insomnia, and psychological factors. Convenience snowball sampling method was utilized. Univariate and multivariate regression analyzes were applied.</p><p><strong>Results: </strong>A total of 2,533 participants were included in the final analysis from five Egyptian regions. Females represent 57%. More than one-half of participants (59.1%) aged 20-30 years. The prevalence of migraine was 20.9%. The most common triggers were sleep disorders (76.9%), followed by perceived noise (65%), and anxiety (59%). Among the participants diagnosed with migraine, 46.7% had a severe disability, 22% had clinical insomnia of moderate severity, 20.5% had severe depression, 29% had severe anxiety, and 20.6% had severe stress. Females, older age, and urban residents were the key predictors of migraine. Lifestyle factors including regular physical activity and good hydration were linked to reduced migraine risk. Comorbid conditions including insomnia, stress, and anxiety significantly impacted migraine severity.</p><p><strong>Conclusion: </strong>Our results showed a 20.9% prevalence of migraine, with nearly one-half of cases associated with severe disability, along with comorbidities like depression, anxiety, and insomnia. Female gender, older age, and urban residence are key predictors, while lifestyle factors such as physical exercise and good hydration reduce the risk of migraine.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"114"},"PeriodicalIF":7.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029330","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":"Unraveling the paradox: cardiovascular risk profiling in migraine- a correspondence.","authors":"Linda Al-Hassany, Ruben W A van Drie, Deirdre M Boucherie, Antoinette MaassenVanDenBrink","doi":"10.1186/s10194-025-02060-w","DOIUrl":"10.1186/s10194-025-02060-w","url":null,"abstract":"<p><p>We read with great interest the recent publication by Marston and colleagues in Nature Medicine, entitled \"Endothelial cell-related genetic variants identify LDL cholesterol-sensitive individuals who derive greater benefit from aggressive lipid lowering\" (issue 31, March 2025, pages 963-969). Among their compelling findings, the association between the endothelial cell-specific polygenic risk score (EC-PRS) - which consists of SNPs associated with coronary artery disease - and a reduced risk of migraine headaches stood out, although not being the study's primary aim. Migraine imposes a substantial individual and socioeconomic burden worldwide. Beyond its neurological manifestations as a primary headache disorder, migraine has increasingly been recognized as an independent and underappreciated cardiovascular risk factor, linked to major cardiovascular and cerebrovascular events. However, the biological underpinnings of this association remain poorly understood, particularly since they do not appear to be mediated through traditional or atherosclerotic pathways, and they are not associated with established cardiovascular risk factors. In this Correspondence, we build upon the findings of Marston et al. and contextualize them within the broader framework of migraine as a neurovascular disorder. Drawing from translational evidence, we propose a conceptual model that integrates findings regarding EC-PRS into the complex biological interplay linking migraine and cardiovascular disease, including coronary artery disease. In doing so, we aim to advance our understanding of migraine not only as a neurological disorder but as a marker of vascular vulnerability with implications for future research regarding personalized cardiovascular prevention, including statin therapy.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"113"},"PeriodicalIF":7.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008374","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}