Journal of Headache and Pain最新文献

{"title":"Forecasting migraine with time-series machine learning from mobile health data.","authors":"Fahim Faisal, Amalie C Poole, Antonios Danelakis, Tore Wergeland, Marte Bjørk, Andrej N Khanevski, Espen Saxhaug Kristoffersen, Tjaša Kumelj, Iben C K Larsen, Oda V Lunder, Manjit Matharu, Parashkev Nachev, Melanie R Simpson, Erling Tronvik, Kjersti G Vetvik, Bendik S Winsvold, Lise R Øie, Ane B Øvrevik, Anker Stubberud","doi":"10.1186/s10194-026-02346-7","DOIUrl":"10.1186/s10194-026-02346-7","url":null,"abstract":"<p><strong>Background: </strong>Machine learning provides a powerful framework to model the complex patterns underlying migraine attack onset from real-world high dimensional datasets. In this study, we used machine learning to forecast headache days using mobile health (mHealth) data from a migraine biofeedback treatment app.</p><p><strong>Method: </strong>This was a machine learning analysis of data from the BioCer clinical trial (NCT05616741) evaluating app-based biofeedback for preventive treatment of episodic migraine. Participants completed three months of daily biofeedback sessions with wearables measuring trapezius muscle tension, heart rate variability, and peripheral skin temperature. Input data for the models included summary metrics from the biofeedback sessions and daily headache diary entries. The outcome of interest was the presence of a moderate-to-severe headache (defined as an intensity of 4 or higher on an 11-point scale of 0-10) on the next calendar day and the next three calendar days. The dataset was randomly split into training, validation, and test sets. Multiple standard machine learning architectures, foundation models, and time-series models were trained and optimized using the area under the receiver operating characteristics curve (AUC) as the primary scoring metric. Among these three classes of machine learning models, the best optimized model in each class identified during training was applied on the unseen test set. Permutation feature importance (PFI) was created for model explainability.</p><p><strong>Results: </strong>146 individuals, with a total of 21,550 headache days, were included in the forecasting models. For the next calendar day predictions, the top performing standard machine learning approach (decision tree) and foundation model achieved a test set AUC of 0.59 (95% CI 0.56 to 0.61) and 0.55 (95% CI 0.55 to 0.56), respectively. The best time-series model achieved a test set AUC of 0.84 (95% CI 0.82 to 0.85). For the three-calendar day forecasting window, the test set performances were 0.55 (95% CI 0.53 to 0.56), 0.55 (95% CI 0.54 to 0.57), and 0.76 (95% CI 0.74 to 0.77), respectively. The most important features were headache intensity, duration of the headache, and heart rate scores.</p><p><strong>Conclusion: </strong>Time-series machine learning models using a relatively large dataset could forecast moderate-to-severe headaches with good accuracy in patients with episodic migraine.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581470","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":"A GABAergic neural circuit from the suprachiasmatic nucleus to DG drives cognitive impairment in migraine mice.","authors":"Qingfang Xie, Yu Zhang, Ying Huang, Wen Yan, Yanjie Zhou, Zheman Xiao","doi":"10.1186/s10194-026-02341-y","DOIUrl":"10.1186/s10194-026-02341-y","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment and circadian rhythm disturbances are prevalent comorbidities of migraine, yet their underlying neural circuit mechanisms remain poorly understood. The suprachiasmatic nucleus (SCN), as the master circadian pacemaker, and the hippocampus, essential for memory, are key regions involved in these symptoms. The dentate gyrus (DG) in the hippocampus acts as the main entry point for information and is essential for pattern separation, a key memory process. We hypothesized that a direct neural pathway from the SCN to the DG might link circadian dysfunction to cognitive deficits in migraine.</p><p><strong>Methods: </strong>Using a nitroglycerin (NTG)-induced chronic migraine mouse model, we combined behavioral assays, immunofluorescence, chemogenetics, monosynaptic retrograde tracing, and projection-specific optogenetics to investigate the role of the SCN and its potential connection to the DG in migraine-related cognitive impairment.</p><p><strong>Results: </strong>NTG-treated mice exhibited not only pain hypersensitivity but also significant circadian rhythm disruption and deficits in recognition and spatial working memory. Our immunofluorescence analysis revealed a marked increase in c-Fos expression within the SCN of NTG-induced migraine mice. Notably, despite increased total c-Fos expression in the SCN, the density and proportion of c-Fos⁺/GAD67⁺ cells were reduced, whereas c-Fos⁺/CaMKII⁺ cells showed no significant change. These findings indicate an altered recruitment of neuronal subpopulations rather than uniform changes in SCN neuronal activity. This interpretation was further supported by chemogenetic manipulation of SCN neurons, in which inhibition exacerbated, whereas activation rescued, cognitive deficits without affecting pain sensitivity. Immunostaining revealed increased c-Fos recruitment of GABAergic interneurons in the DG. Using convergent anterograde and retrograde tracing approaches, we obtained anatomical evidence supporting the presence of a direct SCN→DG projection with preferential association to DG inhibitory interneuron populations. Projection-specific optogenetic activation of SCN terminals in the DG was sufficient to reverse cognitive impairments in migraine mice.</p><p><strong>Conclusions: </strong>Our research reveals a previously underappreciated GABAergic pathway from the SCN to the DG that is functionally implicated in cognitive deficits associated with migraine. The findings suggest that migraine is associated with altered recruitment of neuronal subpopulations and network-level coordination within the SCN and along the SCN-DG pathway. This is accompanied by increased recruitment of GABAergic interneurons in the DG and impaired DG information processing. Together, these results identify the SCN-DG circuit as a potential neuromodulatory target for future investigation of cognitive symptoms associated with migraine.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574220","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":"Epimutations in migraine and in medication overuse headache: a longitudinal study after acute medication withdrawal.","authors":"Francesca Ferraresi, Valentina Favoni, Davide Mascarella, Chiara Pirazzini, Katarzyna Malgorzata Kwiatkowska, Francesco Ravaioli, Maria Giulia Bacalini, Daniele Dall'olio, Gastone Castellani, Claudia Sala, Giulia Pierangeli, Pietro Cortelli, Davide Gentilini, Luciano Calzari, Rossana Terlizzi, Paolo Garagnani, Sabina Cevoli","doi":"10.1186/s10194-026-02343-w","DOIUrl":"10.1186/s10194-026-02343-w","url":null,"abstract":"","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147529835","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":"Epidemiology, pharmacological treatment and invasive management of idiopathic intracranial hypertension in Austria: a nationwide, hospital-based, controlled analysis of insurance data.","authors":"Nina Müller, Nik Krajnc, Sina Zaic, Stefan Macher, Wolfgang Marik, Klaus Novak, Martin Bertich, Berthold Pemp, Christian Wöber, Berthold Reichardt, Gabriel Bsteh","doi":"10.1186/s10194-026-02336-9","DOIUrl":"10.1186/s10194-026-02336-9","url":null,"abstract":"<p><strong>Question/objective: </strong>Idiopathic intracranial hypertension (IIH) is a rare disorder characterized by headaches and papilledema. In this nationwide, hospital-based, controlled analysis of insurance data, we aimed at investigating IIH prevalence and treatment patterns.</p><p><strong>Methods: </strong>The Austrian health insurance register was queried for patients discharged between 2016 and 2021 with an ICD-10 diagnosis of G93.2 and/or prescription of acetazolamide (AZM). Study inclusion required both ≥ 2 assignments of G93.2 and ≥ 1 dispensation of AZM. For each IIH patient, age- and sex-matched obese controls (OBC, ICD-10: E65/66/68) and general population controls (GPC) were drawn. We then extracted all medication collected and procedures performed during the study period.</p><p><strong>Results: </strong>Of 5,969 patients identified, 114 met the inclusion criteria, yielding an estimated hospital-based IIH prevalence of 4.77 per 100,000 discharges in total and 7.88 per 100,000 female discharges. IIH patients had the highest rates of AZM (100% vs. 0% vs. 0%), topiramate (39.5% vs. 2.6% vs. 0.9%), furosemide (18.4% vs. 5.3% vs. 0.9%), lumbar puncture (11.4% vs. 0% vs. 0%), and ventriculoperitoneal shunting (18.4% vs. 0% vs. 0%) compared with OBC and GPC. In contrast, bariatric surgery was less common in IIH than in OBC (4.4% vs. 31.6%; 0% in GPC).</p><p><strong>Conclusions: </strong>The estimated prevalence falls within reported ranges for Central Europe while likely underestimating the prevalence due to reliance on hospital discharge data. Treatment patterns generally reflect guideline-based management, although invasive procedures appear overrepresented because hospital data skew towards severe cases. Bariatric surgery is underutilized in patients with IIH compared to those with obesity alone.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147529783","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 erenumab on migraine aura frequency: a REFORM study.","authors":"Jonas T Jakobsen, William K Karlsson, Rune H Christensen, Haidar M Al-Khazali, Messoud Ashina, Håkan Ashina","doi":"10.1186/s10194-026-02338-7","DOIUrl":"10.1186/s10194-026-02338-7","url":null,"abstract":"<p><strong>Background: </strong>Anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies effectively prevent migraine headache, but their impact on aura is unclear. The aim of this study was to characterize longitudinal changes in migraine aura frequency during and after preventive treatment with erenumab in adults with frequent, prospectively confirmed migraine aura.</p><p><strong>Methods: </strong>This prospective, longitudinal, single-center investigation enrolled adults diagnosed with migraine with aura who reported ≥ 4 monthly migraine days and ≥ 2 monthly aura days during a 4-week baseline period. Erenumab was administered subcutaneously at a dose of 140 mg every 4 weeks for 24 weeks, followed by a 12-week post-treatment follow-up period. Headache and aura outcomes were recorded prospectively using standardized headache diaries completed throughout baseline, treatment, and follow-up. The primary outcome consisted of the mean absolute change in monthly aura days from baseline, evaluated at four-week intervals across the study period.</p><p><strong>Results: </strong>Eighty participants with migraine with aura provided outcome data eligible for analysis. The mean (SD) age was 43.1 (11.9) years, and 74 participants (93%) were female. At baseline, participants reported a mean of 8.0 (SD, 5.1) monthly aura days. After 24 weeks of treatment, the mean change in monthly aura days was - 4.9 (95% CI, - 5.8 to - 4.0) compared to baseline (p < 0.001). This improvement was partially sustained during the subsequent 12-week post-treatment follow-up, with a mean change of - 3.2 days (95% CI, - 4.2 to - 2.2) relative to baseline (p < 0.001). Exploratory analyses identified that greater reductions in monthly aura days were independently associated with a higher baseline number of monthly aura days (β = -0.60; 95% CI, - 0.72 to - 0.47; p < 0.001) and a greater reduction in monthly migraine days (β = -0.36; 95% CI, - 0.49 to - 0.23; p < 0.001).</p><p><strong>Conclusions: </strong>Preventive treatment with erenumab was associated with substantial and sustained reductions in aura frequency in adults with frequent migraine aura. These findings underscore the relevance of incorporating aura-specific outcomes into future controlled trials evaluating preventive migraine treatments.</p><p><strong>Trial registration: </strong>The study was registered on ClinicalTrials.gov (NCT04603976).</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521197","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":"Cellular senescence in migraine - a hypothesis-driven narrative review.","authors":"Michal Fila, Jan Krekora, Elzbieta Pawlowska, Jaroslaw Dróżdż, Mikolaj Ogrodnik, Janusz Blasiak","doi":"10.1186/s10194-026-02347-6","DOIUrl":"10.1186/s10194-026-02347-6","url":null,"abstract":"","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521194","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":"TREM2 contributes to central sensitization through PI3K/Akt/mTOR-mediated autophagic dysfunction in a rat model of vestibular migraine.","authors":"Changman Zhang, Yanan Huang, Ning Zhang, Jiarong Ban, Qijun Yu, Qingling Zhai, Qihui Chen, Changchang Ying, Yonghui Pan","doi":"10.1186/s10194-026-02337-8","DOIUrl":"https://doi.org/10.1186/s10194-026-02337-8","url":null,"abstract":"","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mesocorticolimbic circuitry in episodic migraine: reward- and punishment-related responses and resting-state connectivity.","authors":"Stefania Ferraro, Menghan Li, Dan Liu, Yali Zhou, Yiqi Mi, Shengkun Peng, Longlin Yin, Bin Huang, Luca Giani, Keith M Kendrick, Michael Maes, Benjamin Becker","doi":"10.1186/s10194-026-02342-x","DOIUrl":"10.1186/s10194-026-02342-x","url":null,"abstract":"","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521149","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":"Impact of fertility treatments on headache disorders: a systematic review with an overview of treatment modalities.","authors":"Carolin Luisa Hoehne, Alina Lohner, Yones Salim, Maria Terhart, Wiebke Andersen, Cornelius Angerhöfer, Rüdiger Moltrecht, Florian Scheuerecker, Antoinette Maassen van den Brink, Bianca Raffaelli","doi":"10.1186/s10194-026-02325-y","DOIUrl":"10.1186/s10194-026-02325-y","url":null,"abstract":"","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"27 1","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13011522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512587","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":"Posterior insular cortex hyperactivation drives vestibular migraine and comorbid anxiety.","authors":"Tianyu Zhang, Yifei Xiang, Bin Huang, Xiaoping Wang, Ping Yang, Baoming He, Nengwei Yu, Jie Liu","doi":"10.1186/s10194-026-02340-z","DOIUrl":"10.1186/s10194-026-02340-z","url":null,"abstract":"","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512643","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}