Journal of Headache and Pain最新文献

{"title":"Impact of migraine on productivity and efficiency among adult population in India: a scoping review.","authors":"S Saha, D Chowdhury, M Wadhwa, R Sarkar, D Raval, I Patel, A Bondia, V Madaan","doi":"10.1186/s10194-025-02112-1","DOIUrl":"10.1186/s10194-025-02112-1","url":null,"abstract":"<p><strong>Background: </strong>Migraine is a common neurological disorder that has a major negative influence on productivity loss and quality of life. Significant socioeconomic consequences are associated with the condition, such as decreased productivity at work and increased medical expenses. The frequency is higher in women, especially in reproductive age, and the burden varies globally. In India, the prevalence of migraine is 25%; this is higher than the global prevalence of 14.7%. The scoping review is undertaken with an aim to synthesize existing literature that summarizes the impact of migraine on productivity among working professionals, with a focus on its determinants in India.</p><p><strong>Methods: </strong>A systematic scoping review, with a comprehensive search strategy, was conducted across major databases. Eligibility criteria for studies to be included focused on prevalence, economic and observational studies involving adults aged 18 and older diagnosed with migraines. Studies conducted from January 2014 to October 2024 in Low- and Middle-Income Countries (LMICs) were included. Data extraction was standardized, capturing key study characteristics. The methodological quality of included studies was assessed using the JBI score checklist for the assessment of cross-sectional and prevalence studies. The pooled estimates for productivity loss were collated from individual studies and adjusted per capita national income. This pooled productivity loss was used to estimate the per day economic loss based on per capita income.</p><p><strong>Results: </strong>The systematic search identified 11 relevant articles for LMICs that provided insights into the impact of migraines on productivity and economic outcomes. The evidence highlighted that migraine-related productivity losses ranged from 3% to 4.3% of productive time, translating to significant financial implications. Evidence from India suggests one-year prevalence of migraines is approximately 14.12% to 28.99%, affecting around 213 million cases annually. The pooled analysis obtained from two studies shows that productivity loss due to migraine is 17.3 days per year. This was found to be INR 8731/- annually based on daily per capita income. Taking the prevalence of migraine in India, it leads to a total economic loss of about INR 18,674.35 crore (approximately USD 22.21 billion). This significant burden emphasizes the urgent need for effective healthcare interventions to address and manage migraine disorders in the population.</p><p><strong>Conclusion: </strong>Migraines impose a significant threat to the economy and productivity in India, especially for working professionals and women in their prime working years. Addressing migraine as a public health priority through awareness, early diagnosis, and effective management will not only improve quality of life but also enhance national productivity and economic growth of the country.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"180"},"PeriodicalIF":7.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794612","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":"Small-molecule CGRP antagonist atogepant does not affect cortical spreading depression susceptibility in rats.","authors":"Xuyan Jin, Andreia Morais, Yuichi Sasaki, Qingling Zhai, Pradeep Banerjee, Andrea Harriott, Cenk Ayata","doi":"10.1186/s10194-025-02127-8","DOIUrl":"10.1186/s10194-025-02127-8","url":null,"abstract":"<p><strong>Background: </strong>Atogepant is a small-molecule non-competitive calcitonin gene-related peptide (CGRP) receptor antagonist efficacious in preventing episodic migraine. Cortical spreading depolarization (CSD) is a slowly propagating depolarization wave underlying migraine aura. We investigated whether the efficacy of atogepant in migraine is mediated by CSD suppression.</p><p><strong>Method: </strong>We used Sprague-Dawley rats (n = 28 males, 28 females) to determine the electrical stimulation intensity threshold for CSD induction and the frequency of CSDs induced by continuous topical 1 M KCl application sequentially in the same animal, using intracortical glass microelectrodes under isoflurane anesthesia and full systemic physiological monitoring, including arterial blood pressure and blood gases. In a separate cohort, we disrupted the BBB by inducing three CSDs in the contralateral hemisphere using 1 M KCl daily for 2 days before CSD susceptibility testing. Both cohorts received atogepant (30 mg/kg, once daily oral gavage) or vehicle for four days. CSD susceptibility was examined 1 h after the last atogepant dose.</p><p><strong>Results: </strong>Atogepant did not affect the CSD threshold, frequency, propagation speed, amplitude, or duration compared with vehicle, either without or with preceding CSDs. Systemic physiological parameters did not differ between groups.</p><p><strong>Conclusions: </strong>These data suggest that atogepant efficacy in migraine is not mediated via CSD suppression, even when BBB permeability is increased.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"177"},"PeriodicalIF":7.9,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789313","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":"Pretreatment with an anti-CGRP monoclonal antibody attenuates mild TBI-induced tactile hypersensitivity in mice.","authors":"Anne-Sophie Wattiez, Adisa Kuburas, William C Castonguay, Kim Fejgin, Ib V Klewe, Andrew F Russo","doi":"10.1186/s10194-025-02108-x","DOIUrl":"10.1186/s10194-025-02108-x","url":null,"abstract":"","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"175"},"PeriodicalIF":7.9,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784466","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":"Volume of the hypothalamus and its subunits in patients with episodic migraine without aura during interictal periods.","authors":"Irene Giardina, Antonio Di Renzo, Davide Chiffi, Francesca Giovannini, Giada Giuliani, Gabriele Sebastianelli, Francesco Casillo, Chiara Abagnale, Marta Altieri, Vittorio Di Piero, Gianluca Coppola, Francesca Caramia","doi":"10.1186/s10194-025-02118-9","DOIUrl":"10.1186/s10194-025-02118-9","url":null,"abstract":"<p><strong>Background: </strong>The hypothalamus is thought to play a crucial role in the recurrence of migraine attacks, exhibiting activity prior to the onset of a migraine attack. Nonetheless, our comprehension of the roles of its subunits, especially during the interictal phase, remains limited. This study investigated hypothalamic volumetric differences between individuals with episodic migraine and healthy controls, with scans conducted during the interictal phase, free from the effects of preventative medications.</p><p><strong>Methods: </strong>We analyzed hypothalamic volumes in 30 patients with episodic migraine without aura (MO), scanned during interictal periods and not on preventative medication, and in 30 healthy controls (HCs) matched for age and sex. Volumetric segmentation was performed of both hypothalamic subunits (anterior-inferior, anterior-superior, posterior, tubular inferior, and tubular superior) and the entire hypothalamus using magnetic resonance imaging (MRI) with T1-weighted sequences. General linear models were employed to evaluate volumetric differences after controlling for age, sex, and total brain volume.</p><p><strong>Results: </strong>The volumes of hypothalamic subunits and overall hypothalamus volumes exhibited no statistically significant differences between HCs and MO patients (p > 0.05). No associations were found between the clinical characteristics of MO and the total hypothalamic volume or its subunits.</p><p><strong>Conclusions: </strong>These findings suggest that the hypothalamus and its subregions do not exhibit detectable volumetric alterations during the interictal phase in patients with migraine without aura.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"176"},"PeriodicalIF":7.9,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784467","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":"Network control theory uncovers aberrant connectome controllability in trigeminal neuralgia.","authors":"Tiantian Chu, Juan Peng, Feng Gao, Fei Xiong, Ye Tu","doi":"10.1186/s10194-025-02122-z","DOIUrl":"10.1186/s10194-025-02122-z","url":null,"abstract":"<p><strong>Background: </strong>Trigeminal neuralgia (TN) involves complex neural network alterations beyond the trigeminal system. Network Control Theory (NCT) offers a novel framework to quantify how brain network architecture constrains neural dynamics. This study investigated structural network controllability in TN to elucidate disease-specific alterations in brain network control properties.</p><p><strong>Methods: </strong>Eighty-two TN patients and 42 healthy controls (HCs) underwent diffusion tensor imaging. Structural connectomes were constructed using deterministic tractography and parcellated with the Brainnetome atlas. Average controllability (AC), reflecting the ease of driving networks toward accessible states, and modal controllability (MC), indicating the capacity for difficult state transitions, were calculated at whole-brain, network, and regional levels. Age-related effects on controllability were examined.</p><p><strong>Results: </strong>TN patients demonstrated significantly reduced whole-brain AC (P = 0.009) and increased MC (P = 0.009) compared to HCs. Network-level analyses revealed decreased AC and increased MC in the dorsal attention network (P = 0.018) and default mode network (P = 0.009), with reduced AC in subcortical regions (P = 0.041). No regional differences survived False Discovery Rate correction. Notably, controllability metrics correlated significantly with age in TN patients across multiple networks, whereas HCs showed no age-related correlations. Neither pain laterality nor neurovascular compression influenced controllability patterns.</p><p><strong>Conclusions: </strong>TN is characterized by aberrant network controllability, manifesting as reduced efficiency in routine state transitions and increased energy requirements for network control. The unique age-controllability relationship in TN suggests disease-specific alterations in network dynamics distinct from normal aging. These findings establish NCT as a valuable framework for understanding TN pathophysiology and highlight the disorder's network-level rather than focal nature.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"174"},"PeriodicalIF":7.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764931","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":"Migraine in men - differences in phenotype and treatment patterns: results from the Migraine in Poland cross-sectional national survey.","authors":"Marta Waliszewska-Prosół, Karol Marschollek, Sławomir Budrewicz, Mieszko Więckiewicz, Magdalena Nowaczewska, Marcin Straburzyński","doi":"10.1186/s10194-025-02117-w","DOIUrl":"10.1186/s10194-025-02117-w","url":null,"abstract":"<p><strong>Background: </strong>The 'Migraine in Poland' study is a large-scale nationwide cross-sectional online survey that assessed symptomatology, consulting, diagnosis, treatment, and burden of migraine in Poland, conducted from August 2021 to June 2022. The purpose of this paper is to define migraine phenotype and patterns of care for Polish men.</p><p><strong>Methods: </strong>Participants were recruited through various channels, primarily targeting individuals experiencing headaches. The questionnaire evaluated healthcare system utilization, headache features, history of diagnosis, comorbidities, burden, as well as the use of acute or preventive treatment. The survey included questions that allowed for diagnosis according to the International Classification of Headache Disorders-3.</p><p><strong>Results: </strong>3225 individuals aged 13 to 80 (mean age 38.9) responded to the survey (87.1% were women). Migraine without aura diagnosis was confirmed in 1679 (52.7%) of subjects, and this group was included in further analysis. The current study group consisted of 244 men (14.6%) and 1431 women (85.4%). Men tended to experience fewer types of headaches compared to women (p < 0.001) and were significantly less likely to report visual and sensory symptoms accompanying the worst headache than women (p < 0.001). Premonitory symptoms preceding the onset of headache were more likely, and the time required to return to normal functioning was longer in men than in women (median 24 and 10 h, respectively; p < 0.001). The use of acute treatment was significantly higher in men, regarding both physician-prescribed medications (80.3% vs. 69.3%; p < 0.001) and over-the-counter medications (77% vs. 52.2%; p < 0.001), as well as natural-based or alternative remedies (43% vs. 15.4%; p < 0.001). Men were more likely to use combination drugs (66% vs. 57.9%; p = 0.017) and often fulfilled the criteria for medication overuse (29.5% vs. 22%; p = 0.01). Prophylactic treatment was less frequently used in men (21.7% vs. 38%; p < 0.001). Men reported spending more money on medications monthly than women (p < 0.001). Both on the MIDAS (p < 0.001) and PHQ-9 (p = 0.002) scales, men scored lower than women.</p><p><strong>Conclusions: </strong>Our study confirms the existence of significant gender differences in the course of migraine, both in terms of clinical characteristics of the disease and patterns related to health behaviors and access to medical care.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"173"},"PeriodicalIF":7.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760304","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":"In patients' words: natural language processing of reports from patients experiencing orofacial pain and dysfunction.","authors":"Dominik A Ettlin, Markus Wolf, Nikola Biller-Andorno, Gerold Schneider","doi":"10.1186/s10194-025-02095-z","DOIUrl":"10.1186/s10194-025-02095-z","url":null,"abstract":"","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"172"},"PeriodicalIF":7.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753568","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":"One-month atogepant treatment induces rapid changes in delta-band functional connectivity in migraine: an HD-EEG study.","authors":"Matteo Conti, Silvio Bagetta, Federico Carparelli, Valerio Ferrari, Vittoria Carla D'Agostino, Fabio Placidi, Alessandro Stefani, Nicola Biagio Mercuri, Maria Albanese","doi":"10.1186/s10194-025-02115-y","DOIUrl":"10.1186/s10194-025-02115-y","url":null,"abstract":"<p><strong>Background: </strong>Atogepant is a novel oral calcitonin gene-related peptide (CGRP) receptor antagonist approved for the preventive treatment of migraine. While its peripheral mechanisms are well characterized, little is known about its potential effects on central functional brain networks. This study aims to investigate changes in resting-state functional connectivity (FC) using high-density EEG (HD-EEG) after one month of atogepant treatment in patients with migraine, and to assess the relationship between these changes and clinical response.</p><p><strong>Methods: </strong>Twelve patients with high-frequency episodic migraine (HFEM; n = 7) or chronic migraine (CM; n = 5) underwent HD-EEG recordings at two time points: before starting Atogepant administration (T0) and after one month of treatment (T1). Fifteen healthy controls (HC) were also enrolled. Clinical evaluations included: monthly migraine days (MMD), monthly symptomatic drugs intake (MSI), modified Migraine Disability Assessment (mMIDAS), the headache impact test (HIT-6), the Migraine-Specific Quality of Life Questionnaire (MSQ), the 12-item Allodynia Symptom Checklist (ASC-12), and the Migraine Interictal Burden Scale (MIBS-4). EEG-based FC was analyzed in source space using the weighted Phase Lag Index (wPLI) across δ, θ, α, β, low-γ, and high-γ bands. To identify changes related to treatment, we applied Network-Based Statistics (NBS), while Spearman correlation was used to explore the relationship between clinical improvements and functional changes.</p><p><strong>Results: </strong>Compared to HCs, HFEM + CM patients exhibited increased δ band functional connectivity (FC) in temporo-parietal, orbitofrontal, insular, and limbic regions. After one month of atogepant treatment, a significant reduction in this aberrant FC was observed, particularly in bilateral temporo-parietal, cingulate, insular, and prefrontal cortices. Baseline δ-band FC correlated with greater clinical disability (mMIDAS, MSQ), while treatment-induced FC changes (ΔmNC) were associated with improvements in mMIDAS, HIT-6, and ASC-12 scores, highlighting the clinical relevance of δ band network modulation.</p><p><strong>Conclusions: </strong>This pilot study provides preliminary evidence that atogepant modulates δ band functional brain connectivity after one month of treatment in patients with episodic and chronic migraine. These changes in central brain networks are associated with clinical improvement and may serve as a neurophysiological marker of CGRP receptor antagonist efficacy. Larger-scale studies are needed to confirm and extend these findings.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"171"},"PeriodicalIF":7.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753569","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":"Headache diagnosis in children and adolescents: validation of the Italian version of the HARDSHIP questionnaire.","authors":"Agnese Onofri, Raffaele Ornello, Chiara Rosignoli, Vittorio Trozzi, Michela Teresa Adipietro, Benedetta Germani, Martina D'Ambrosio, Caterina Cascione, Maria Elena Russo, Simone Fanì, Roberta Ciuffini, Simona Sacco","doi":"10.1186/s10194-025-02113-0","DOIUrl":"10.1186/s10194-025-02113-0","url":null,"abstract":"<p><strong>Background: </strong>Headache disorders are common in children and adolescents, significantly affecting quality of life and academic performance. Despite their high prevalence, they remain underdiagnosed and undertreated. The Child and Adolescents HARDSHIP questionnaire, developed by the Global Campaign Against Headache, has been widely used in adult epidemiological studies but lacks validation in the Italian pediatric population.</p><p><strong>Methods: </strong>The study was conducted within the Epidemiologic Registry of Child and Adolescents Headaches - Registro Epidemiologico delle Cefalee in età evolutiva (REPICEF), a population-based registry on pediatric headache epidemiology in L'Aquila, Italy. The Italian version of the HARDSHIP questionnaire was adapted using the TRAPD method, ensuring linguistic and conceptual accuracy. Validation was performed by comparing questionnaire-based diagnoses with clinical diagnoses attributed by expert neurologists assumed as gold standard. We computed the sensitivity, specificity, positive and negative predictive values.</p><p><strong>Results: </strong>Out of 858 screened children and adolescents, the first 535 (62.4%) were selected for the validation questionnaire. Based on the HARDSHIP questionnaire, the most common diagnoses were probable Migraine (pMig) in 175 (20.7%), probable Tension-Type Headache (pTTH) in 144 (16.7%), Undifferentiated Headache (UDH) in 105 (12.2%), Tension-Type Headache (TTH) in 86 (10.0%), migraine in 68 (7.9%) children and adolescents. The agreement between questionnaire-based and clinical diagnoses was for migraine k = 0.432, for TTH k = 0.327, for pMOH k = 0.214.</p><p><strong>Conclusions: </strong>The validated Italian version of the HARDSHIP questionnaire provides a useful instrument for epidemiological research and for the improvement in diagnosis of pediatric headache disorders.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"169"},"PeriodicalIF":7.9,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731748","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":"Calcitonin gene-related peptide monoclonal antibody treatment for new daily persistent headache.","authors":"Sanjay Cheema, Khadija Rerhou Rantell, Rachel Pickering, Susie Lagrata, Salwa Kamourieh, Manjit Matharu","doi":"10.1186/s10194-025-02111-2","DOIUrl":"10.1186/s10194-025-02111-2","url":null,"abstract":"<p><strong>Background: </strong>New daily persistent headache (NDPH) is a rare headache disorder that often resembles chronic migraine (CM) phenotypically, but unlike CM is daily from onset. Several calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) have been proven to be effective in CM. It is not known whether CGRP mAbs are effective in NDPH. We sought to assess the efficacy, tolerability, and safety of CGRP mAbs in NDPH and compare their effect in NDPH to CM.</p><p><strong>Methods: </strong>We performed an observational study using prospectively collected data in consecutive patients treated with CGRP mAbs in three groups: Group 1 included patients with NDPH with migraine features; Group 2 included patients with CM with daily headache; and Group 3 patients with non-daily CM. Given the observational nature of the study, propensity score matching was used in an attempt to balance the three groups on baseline factors to make them comparable. The majority of patients were treated with erenumab while the remainder received galcanezumab. Patients completed a headache diary and disability questionnaires at baseline and 12-week follow-up, with the primary endpoint being the proportion who achieved a reduction of at least 30% in monthly moderate-to-severe headache days (MSHD) compared between the three groups.</p><p><strong>Results: </strong>A total of 48 patients with NDPH, 101 with daily-CM, and 68 with non-daily-CM were included. From baseline to week 12, 11/47 (23%) of patients with NDPH had a ≥ 30% improvement in MSHD, compared to 46/99 (46%) in daily CM (OR 2.02, 95% CI 0.82-4.97, p = 0.125), and 51/61 (84%) in non-daily-CM (OR 4.41, 95% CI 1.17-16.6, p = 0.028). Only 5/47 (11%) of patients with NDPH had a ≥ 30% improvement in monthly headache days, and 24/44 (54%) reported an overall subjective improvement of ≥ 30%. Almost 50% of patients experienced at least one side effect, which were mild in almost all cases, and similar between groups.</p><p><strong>Conclusions: </strong>CGRP mAbs were effective in approximately 1/4 patients with treatment-refractory NDPH,but less likely to be effective in NDPH than CM. This suggests that NDPH cannot be seen as equivalent to CM and that new treatment options are required for this highly disabling disorder.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"170"},"PeriodicalIF":7.9,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731747","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}