Journal of Headache and Pain最新文献

{"title":"Sex difference in TRPM3 channel functioning in nociceptive and vascular systems: an emerging target for migraine therapy in females?","authors":"Georgii Krivoshein, Eduardo Rivera-Mancilla, Antoinette MaassenVanDenBrink, Rashid Giniatullin, Arn M J M van den Maagdenberg","doi":"10.1186/s10194-025-01966-9","DOIUrl":"10.1186/s10194-025-01966-9","url":null,"abstract":"<p><p>Transient Receptor Potential Melastatin 3 (TRPM3) channels are Ca²⁺ permeable ion channels that act as polymodal sensors of mechanical, thermal, and various chemical stimuli. TRPM3 channels are highly expressed in the trigeminovascular system, including trigeminal neurons and the vasculature. Their presence in dural afferents suggests that they are potential triggers of migraine pain, which is originating from the meningeal area. This area is densely innervated by autonomous and trigeminal nerves that contain the major migraine mediator calcitonin gene-related peptide (CGRP) in peptidergic nerve fibers. Co-expression of TRPM3 channels and CGRP receptors in meningeal nerves suggests a potential interplay between both signalling systems. Compared to other members of the TRP family, TRPM3 channels have a high sensitivity to sex hormones and to the endogenous neurosteroid pregnenolone sulfate (PregS). The predominantly female sex hormones estrogen and progesterone, of which the levels drop during menses, act as natural inhibitors of TRPM3 channels, while PregS is a known endogenous agonist of these channels. A decrease in sex hormone levels has also been suggested as trigger for attacks of menstrually-related migraine. Notably, there is a remarkable sex difference in TRPM3-mediated effects in trigeminal nociceptive signalling and the vasculature. In line with this, the relaxation of human isolated meningeal arteries induced by the activation of TRPM3 channels is greater in females. Additionally, the sex-dependent vasodilatory responses to CGRP in meningeal arteries seem to be influenced by age-related hormonal changes, which could contribute to sex differences in migraine pathology. Consistent with these observations, activation of TRPM3 channels triggers nociceptive sensory firing much more prominently in female than male mouse meninges, suggesting that pain processing in female patients with migraine may differ. Overall, the combined TRPM3-related neuronal and vascular mechanisms could provide a possible explanation for the higher prevalence and even the more severe quality of migraine attacks in females. This narrative review summarizes recent data on the sex-dependent roles of TRPM3 channels in migraine pathophysiology, the potential interplay between TRPM3 and CGRP signalling, and highlights the prospects for translational therapies targeting TRPM3 channels, which may be of particular relevance for women with migraine.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"40"},"PeriodicalIF":7.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492213","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: Headache frequency and neck pain are associated with trapezius muscle T2 in tension‑type headache among young adults.","authors":"Nico Sollmann, Paul Schandelmaier, Dominik Weidlich, Jonathan Stelter, Gabby B Joseph, Corinna Börner, Severin Schramm, Meinrad Beer, Claus Zimmer, Mirjam N Landgraf, Florian Heinen, Dimitrios C Karampinos, Thomas Baum, Michaela V Bonfert","doi":"10.1186/s10194-025-01964-x","DOIUrl":"10.1186/s10194-025-01964-x","url":null,"abstract":"","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"38"},"PeriodicalIF":7.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468238","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 and stroke: correlation, coexistence, dependence - a modern perspective.","authors":"Michał Borończyk, Anna Zduńska, Julia Węgrzynek-Gallina, Olga Grodzka, Anetta Lasek-Bal, Izabela Domitrz","doi":"10.1186/s10194-025-01973-w","DOIUrl":"10.1186/s10194-025-01973-w","url":null,"abstract":"<p><strong>Background: </strong>Migraine is a chronic neurological condition that has a well-documented, yet not fully understood connection to stroke, particularly in patients who experience migraine with aura (MA). Although migraine can rarely be directly related to stroke, in the form of migrainous infarction, it serves as an independent risk factor, particularly when combined with other factors such as smoking or hypertension. This study will thoroughly review and summarize the existing literature regarding the relationship between migraine and stroke.</p><p><strong>Main text: </strong>Several key processes are common to both stroke and migraine. These include cortical spreading depression, particularly in MA, endothelial dysfunction, which activates local inflammatory responses, and vasculopathy, which often appears as white matter hyperintensities on neuroimaging. Furthermore, microRNAs also play a significant role in the pathogenesis of both migraine and stroke by targeting genes such as CALCA, which regulates calcitonin gene-related peptide, a factor involved in the pathophysiology of both conditions. There are also several genetic links between migraine and stroke, including both monogenic diseases and common risk loci. Moreover, various conditions are linked to both migraine and stroke, including patent foramen ovale (PFO), atrial fibrillation, carotid artery dissection, platelet dysfunction, dyslipidemia, obesity, hyperhomocysteinemia, and elevated estrogen levels, such as in combined hormonal contraceptives. Notably, PFO is often found in patients who have experienced a cryptogenic stroke, as well as in those with MA. While microemboli associated with PFO may provoke ischemic events and migraine attacks, the effectiveness of PFO closure in alleviating migraine symptoms has produced varying results. Migraine is linked to worse outcomes after ischemic stroke, including larger stroke volumes and poorer functional outcomes, while the connection between migraines and hemorrhagic stroke is less understood. Furthermore, migraine may serve as a stroke mimic (condition presenting with symptoms similar to ischemic stroke) or a stroke chameleon (unrecognized stroke misdiagnosed as migraine), leading to significant diagnostic and treatment errors.</p><p><strong>Conclusions: </strong>The interplay between migraine and stroke is complex, involving shared pathophysiology and overlapping risk factors. While migraine can serve as both a cause and a risk factor for stroke, the precise mechanisms remain unclear, warranting further research to clarify their connection and enhance clinical management.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"39"},"PeriodicalIF":7.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468151","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":"Stroke etiology and white matter burden in women with and without migraine.","authors":"Anne E Wilms, Nelleke van der Weerd, Thijs W van Harten, Katie M Linstra, Hendrikus J A van Os, Irene de Boer, Mark C Kruit, Antoinette Maassen van den Brink, Marieke J H Wermer, Gisela M Terwindt","doi":"10.1186/s10194-025-01975-8","DOIUrl":"10.1186/s10194-025-01975-8","url":null,"abstract":"<p><strong>Background: </strong>Women with migraine, especially with aura (MA), have a higher risk of white matter hyperintensities (WMH) and ischemic stroke. We aimed to assess differences in stroke etiology between women with and without migraine and the impact of migraine on WMH volume in women with stroke.</p><p><strong>Methods: </strong>We included women aged 40-60 years with a history of ischemic stroke, migraine or both. Stroke etiology was categorized using the TOAST criteria. WMH volume was measured using 3D-FLAIR images. Presence or absence of cerebellar WMH was scored. We used regression analysis to assess differences between groups, with adjustments for age, BMI, hypertension and smoking status.</p><p><strong>Results: </strong>We included 55 women with stroke, 55 with stroke and migraine, and 38 with MA. Women with stroke more often had a history of smoking than those with stroke and migraine (74% vs. 46%, p = 0.004). Stroke of undetermined origin was more common in women with both conditions than with stroke alone (49% vs. 27%, p = 0.019). Periventricular WMH volumes were higher in women with stroke with migraine than in those with MA alone (0.55mL vs. 0.42mL, B = 0.21, 95%CI = 0.01-0.41, p = 0.040). There were no differences in deep WMH volume and cerebellar WMH between groups. Importantly, the addition of migraine did not affect WMH volume in women who had experienced stroke.</p><p><strong>Conclusion: </strong>Women with both stroke and migraine more often had undetermined etiology of stroke compared to women with stroke alone, and in women with stroke alone smoking was a more prevalent risk factor. Migraine did not contribute to increased WMH volume in women with stroke.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"37"},"PeriodicalIF":7.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458207","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 effect of calcitonin gene-related peptide monoclonal antibodies on restless legs syndrome in patients with migraine.","authors":"Keisuke Suzuki, Shiho Suzuki, Hiroaki Fujita, Saro Kobayashi, Mukuto Shioda, Ryotaro Hida, Koichi Hirata","doi":"10.1186/s10194-025-01976-7","DOIUrl":"10.1186/s10194-025-01976-7","url":null,"abstract":"<p><strong>Background: </strong>Calcitonin gene-related peptide monoclonal antibody (CGRP mAb) effects on restless legs syndrome (RLS) are unclear.</p><p><strong>Methods: </strong>Fifteen migraine patients (aged 49.1 ± 5.8 years; 14 women) with concomitant RLS who received CGRP mAbs (2 erenumab, 3 galcanezumab, and 10 fremanezumab) were retrospectively studied. Number of monthly migraine days (MMDs) was obtained from headache diaries. The primary outcome is changes in RLS severity as assessed by the International RLS Group Rating Scale (IRLS). Headache-related disability was assessed using the Migraine Disability Assessment (MIDAS). The severity of headache and RLS was rated using the Patient Global Impression of Change (PGIC) scale. Central sensitization was evaluated with the Central Sensitization Inventory (CSI).</p><p><strong>Results: </strong>At 1, 2, and 3 months, the percentages of patients with ≥ 50% improvement in number of MMDs were 53.3%, 66.6%, and 60.0%, respectively. From baseline to 3 months, there were significant reductions in the MIDAS (25.1 ± 23.2 vs. 19.7 ± 22.8, p = 0.005) and CSI scores (36.3 ± 12.9 vs. 29.1 ± 12.3, p = 0.001). IRLS scores decreased significantly from baseline to 1 month (-8.8 ± 2.1 points) and 3 months (-11.6 ± 2.3 points) after CGRP mAb treatment. On the PGIC scale, 86.7% and 73.3% of patients reported at least \"minimal improvement\" in migraine and RLS severity, respectively, with 46.7% and 26.7% reporting \"very much improvement\". Among those with a < 50% reduction in number of MMDs at 3 months, 66.6% reported at least \"minimal improvement\", with 33.3% reporting \"very much improvement\".</p><p><strong>Conclusion: </strong>Our study revealed that 3-month CGRP mAb treatment significantly alleviated RLS symptoms, central sensitization and headache-related disability in patients with comorbid migraine and RLS.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"36"},"PeriodicalIF":7.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458208","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":"Safety and feasibility of deep brain stimulation of the anterior cingulate and thalamus in chronic refractory neuropathic pain: a pilot and randomized study.","authors":"Denys Fontaine, Aurélie Leplus, Anne Donnet, Nelly Darmon, Anne Balossier, Bruno Giordana, Benoit Simonet, Petru Isan, Jean Regis, Michel Lanteri-Minet","doi":"10.1186/s10194-025-01967-8","DOIUrl":"10.1186/s10194-025-01967-8","url":null,"abstract":"<p><strong>Background: </strong>Deep Brain Stimulation (DBS) of the anterior cingulum has been recently proposed to treat refractory chronic pain but its safety and its efficacy have not been evaluated in controlled conditions. Our objective was to evaluate the respective feasibility and safety of sensory thalamus (Thal-DBS) combined with anterior cingulate (ACC-DBS) DBS in patients suffering from chronic neuropathic pain.</p><p><strong>Methods: </strong>We conducted a bicentric study (clinicaltrials.gov NCT03399942) in patients suffering from medically-refractory chronic unilateral neuropathic pain surgically implanted with both unilateral Thal-DBS and bilateral ACC-DBS, to evaluate successively: Thal-DBS only; combined Thal-DBS and ACC-DBS; ACC-DBS \"on\" and \"off\" stimulation periods in randomized cross-over double-blinded conditions; and a 1-year open phase. Safety and efficacy were evaluated by repeated neurological examination, psychiatric assessment, comprehensive assessment of cognitive and affective functioning. Changes on pain intensity (Visual Analogic Scale) and quality of life (EQ-5D scale) were used to evaluate DBS efficacy.</p><p><strong>Results: </strong>All the patients (2 women, 6 men, mean age 52,1) completed the study. Adverse events were: epileptic seizure (2), transient motor or attention (2), persistent gait disturbances (1), sleep disturbances (1). No patient displayed significant cognitive or affective change. Compared to baseline, the quality of life (EQ-5D utility score) was significantly improved during the ACC-DBS \"On\" stimulation period (p = 0,039) and at the end of the study (p = 0,034).</p><p><strong>Conclusion: </strong>This pilot study confirmed the safety of anterior cingulate DBS alone or in combination with thalamic stimulation and suggested that it might improve quality of life of patients with chronic refractory neuropathic pain.</p><p><strong>Trial registration: </strong>The study has been registered on 20,180,117 (clinicaltrials.gov NCT03399942).</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"35"},"PeriodicalIF":7.3,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441054","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":"Physical activity as a predictor of fremanezumab response in chronic migraine - the Phy-Fre-Mig study.","authors":"Álvaro Sierra-Mencía, Andrea Recio-García, David García-Azorín, Antonio José Molina de la Torre, Isabel Ros González, Ángel Luis Guerrero-Peral","doi":"10.1186/s10194-025-01965-w","DOIUrl":"10.1186/s10194-025-01965-w","url":null,"abstract":"<p><strong>Background: </strong>The relationship between physical activity (PA) and migraine is insufficiently understood. Studies have not analysed levels of PA or Time Sitting (TS) during preventive treatment, nor the role these might play in the response to preventive treatment.</p><p><strong>Methods: </strong>An observational, longitudinal prospective study in a headache clinic was conducted. All consecutive chronic migraine patients initiating fremanezumab were invited to participate and were followed for three visits. The International Physical Activity Questionnaire (IPAQ) - long version was used.</p><p><strong>Results: </strong>Seventy-six patients with a median of 46 years old, 84.2% female were enrolled. One month after fremanezumab administration, there was a significant increase of most PA variables and a significant decrease in TS levels compared with baseline; headache days and walking, TS and migraine days showed a moderate correlation. Three months after initiation, all PA variables statistically increased and TS levels statistically decreased, and variables such as headache/migraine days showed a moderate correlation with all PA variables analysed. In the multivariate analysis, higher levels of walking at baseline were independently associated with response to fremanezumab (OR_a: 1.194; CI: 1.018-1.401, p = 0.029).</p><p><strong>Conclusion: </strong>Patients who spent more time walking before starting treatment, were more likely to have a response to fremanezumab. PA and TS levels changed since the first month and correlated with clinical variables.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"34"},"PeriodicalIF":7.3,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425454","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":"Analysis of free-living daytime movement in patients with migraine with access to acute treatment.","authors":"Jonas Van Der Donckt, Nicolas Vandenbussche, Mathias De Brouwer, Bram Steenwinckel, Marija Stojchevska, Femke Ongenae, Koen Paemeleire, Sofie Van Hoecke","doi":"10.1186/s10194-025-01971-y","DOIUrl":"10.1186/s10194-025-01971-y","url":null,"abstract":"<p><strong>Background: </strong>Motion can exacerbate headache during a migraine attack, potentially leading to avoidance of routine physical activity. Advances in wrist-worn actigraphy facilitate objectively analyzing how headache episodes affect physical activity in everyday settings. The primary hypothesis was hypoactivity during daytime headache events. Secondary hypotheses are hypoactivity during the prodromal and postdromal hours closest to the headache event.</p><p><strong>Methods: </strong>During a 90-day prospective observational study, participants diagnosed with migraine wore an actigraphy device on their non-dominant wrist during daily life and work, while also logging migraine-related data in a dedicated smartphone application. There were no restrictions on use of acute and preventive headache treatments. Data from the wrist-worn accelerometer were used to (i) calculate activity energy expenditure, and (ii) predict types of human activities. These metrics were used to compare daytime prodromal, ictal, and postdromal phases of headache events with time-matched intervals during non-headache periods.</p><p><strong>Results: </strong>A significant reduction in daytime physical activity was observed during the ictal phase of headache attacks, as evidenced by decreases in both activity energy expenditure and human activity recognition prediction metrics. A reduction in movement was also observed during evening hours (18:00-24:00) on headache days. However, no significant physical activity changes were noted in the prodromal and postdromal phases. Reduced physical activity was more pronounced during the ictal phase when acute treatments were ineffective.</p><p><strong>Conclusions: </strong>This study is the first to examine the impact of headache on physical activity levels during daytime headache events by assessing changes in daily activities and activity energy expenditure in individuals with migraine, within their habitual environments and without restrictions on acute medication use. Our findings confirm reduced movement during the ictal phase of migraine attacks, supporting the primary hypothesis. Wrist-worn actigraphy further indicated that this reduction is more pronounced when patients experience movement sensitivity. Evening hypoactivity is also observed on headache days. Furthermore, attacks with ineffective acute treatment or moderate-to-high intensity were associated with more pronounced reductions in movement. In contrast, our data did not support the secondary hypothesis that physical activity would decrease during daytime prodromal and postdromal periods.</p><p><strong>Trial registration: </strong>NCT04983186 ( www.</p><p><strong>Clinicaltrials: </strong>gov ).</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"33"},"PeriodicalIF":7.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414407","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 neck-exercise and health promotion on headache outcomes in office workers: secondary analysis of the NEXpro stepped wedge cluster randomised controlled trial.","authors":"Markus J Ernst, André Meichtry, Kerstin Luedtke, Deborah Falla","doi":"10.1186/s10194-025-01963-y","DOIUrl":"10.1186/s10194-025-01963-y","url":null,"abstract":"<p><strong>Background: </strong>Headache conditions have a high prevalence worldwide. Office workers with high and demanding workload, but low physical activity levels are considered vulnerable for suffering from headache. This analysis examines whether exercise combined with health promotion at the workplace is effective for headache relief in office workers.</p><p><strong>Methods: </strong>This study reports the results of secondary outcomes of a stepped wedge cluster randomized controlled trial. Office workers (n = 120) were randomly assigned to a twelve-week supervised intervention period, consisting of neck and shoulder girdle exercises with health promotion interventions performed at the workplace. Secondary outcomes were analysed and modelled for headache occurrence, frequency, and the Headache Impact Test-6 (HIT-6), accounting for possible effects for the intervention, the period it had been introduced, and interactional and nested effects.</p><p><strong>Results: </strong>At baseline, 88 of the 120 participants reported ≥ one headache episode in the past four weeks, with a mean headache frequency of 3.58 days for that period. The mean HIT-6 score for the entire cohort amounted to 53.6 points. For headache occurrence and HIT-6, the simplest model with the intervention only, showed the best statistical fit with an odds ratio for headache occurrence of 0.46 (95% confidence interval: 0.25 to 0.84), and - 2.23 (95% confidence interval: -3.35 to -1.12) points on the HIT-6 questionnaire. For headache frequency, the model accounting for interaction effects (intervention x period) had the best statistical fit and showed an incidence rate ratio of 0.57 (95% confidence interval: 0.44 to 0.74) for the first period, but not for later ones.</p><p><strong>Conclusions: </strong>Neck exercises and health promotion had a positive impact on headache occurrence, headache frequency and HIT-6, with the latter not reaching clinical importance. Although only statistically significant for headache frequency, larger effects were found during earlier periods or shorter interventional exposure for all outcomes, necessitating refresher sessions at later periods.</p><p><strong>Trial registration: </strong>NCT04169646.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"30"},"PeriodicalIF":7.3,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11817237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408727","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":"Prediction models for treatment response in migraine: a systematic review and meta-analysis.","authors":"Qiuyi Chen, Jiarun Zhang, Baicheng Cao, Yihan Hu, Yazhuo Kong, Bin Li, Lu Liu","doi":"10.1186/s10194-025-01972-x","DOIUrl":"10.1186/s10194-025-01972-x","url":null,"abstract":"<p><strong>Background: </strong>Migraine is a complex neurological disorder with significant clinical variability, posing challenges for effective management. Multiple treatments are available for migraine, but individual responses vary widely, making accurate prediction crucial for personalized care. This study aims to examine the use of statistical and machine learning models to predict treatment response in migraine patients.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted to assess the performance and quality of predictive models for migraine treatment response. Relevant studies were identified from databases such as PubMed, Cochrane Register of Controlled Trials, Embase, and Web of Science, up to 30th of November 2024. The risk of bias was evaluated using the PROBAST tool, and adherence to reporting standards was assessed with the TRIPOD + AI checklist.</p><p><strong>Results: </strong>After screening 1,927 documents, ten studies met the inclusion criteria, and six were included in a quantitative synthesis. Key data extracted included sample characteristics, intervention types, response outcomes, modeling methods, and predictive performance metrics. A pooled analysis of the area under the curve (AUC) yielded a value of 0.86 (95% CI: 0.67-0.95), indicating good predictive performance. However, the included studies generally had a high risk of bias, particularly in the analysis domain, as assessed by the PROBAST tool.</p><p><strong>Conclusion: </strong>This review highlights the potential of statistical and machine learning models in predicting treatment response in migraine patients. However, the high risk of bias and significant heterogeneity emphasize the need for caution in interpretation. Future research should focus on developing models using high-quality, comprehensive, and multicenter datasets, rigorous external validation, and adherence to standardized guidelines like TRIPOD + AI. Incorporating multimodal magnetic resonance imaging (MRI) data, exploring migraine symptom-treatment interactions, and establishing uniform methodologies for outcome measures, sample size calculations, and missing data handling will enhance model reliability and clinical applicability, ultimately improving patient outcomes and reducing healthcare burdens.</p><p><strong>Trial registration: </strong>PROSPERO, CRD42024621366.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"26 1","pages":"32"},"PeriodicalIF":7.3,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11817351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408739","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}