Headache Conditions Research Articles

MetaCGRP is a high-precision meta-model for large-scale identification of CGRP inhibitors using multi-view information

Migraine is considered one of the debilitating primary headache conditions with an estimated worldwide occurrence of approximately 14–15%, contributing highly to factors responsible for global disability. Calcitonin gene-related peptide (CGRP) is a neuropeptide that plays a crucial role in the pathophysiology of migraines and thus, its inhibition can help relieve migraine symptoms. However, conventional process of CGRP drug development has been laborious and time-consuming with incurred costs exceeding one billion dollars. On the other hand, machine learning (ML)-based approaches that are capable of accurately identifying CGRP inhibitors could greatly facilitate in expediting the discovery of novel CGRP drugs. Therefore, this study proposes a novel and high-accuracy meta-model, namely MetaCGRP, that can precisely identify CGRP inhibitors. To the best of our knowledge, MetaCGRP is the first SMILES-based approach that has been developed to identify CGRP inhibitors without the use of 3D structural information. In brief, we initially employed different molecular representation methods coupled with popular ML algorithms to construct a pool of baseline models. Then, all baseline models were optimized and used to generate multi-view features. Finally, we employed the feature selection method to optimize the multi-view features and determine the best feature subset to enable the construction of the meta-model. Both cross-validation and independent tests indicated that MetaCGRP clearly outperforms several conventional ML classifiers, with accuracies of 0.898 and 0.799 on the training and independent test datasets, respectively. In addition, MetaCGRP in conjunction with molecular docking was utilized to identify five potential natural product candidates from Thai herbal pharmacopoeia and analyze their binding affinity and interactions to CGRP. To facilitate community-wide efforts in expediting the discovery of novel CGRP inhibitors, a user-friendly web server for MetaCGRP is freely available at https://pmlabqsar.pythonanywhere.com/MetaCGRP.

Pain from Internal Organs and Headache: The Challenge of Comorbidity.

Headache and visceral pain are common clinical painful conditions, which often co-exist in the same patients. Numbers relative to their co-occurrence suggest possible common pathophysiological mechanisms. The aim of the present narrative review is to describe the most frequent headache and visceral pain associations and to discuss the possible underlying mechanisms of the associations and their diagnostic and therapeutic implications based on the most recent evidence from the international literature. The conditions addressed are as follows: visceral pain from the cardiovascular, gastrointestinal, and urogenital areas and primary headache conditions such as migraine and tension-type headache. The most frequent comorbidities involve the following: cardiac ischemic pain and migraine (possible shared mechanism of endothelial dysfunction, oxidative stress, and genetic and hormonal factors), functional gastrointestinal disorders, particularly IBS and both migraine and tension-type headache, primary or secondary dysmenorrhea and migraine, and painful bladder syndrome and headache (possible shared mechanisms of peripheral and central sensitization processes). The data also show that the various visceral pain-headache associations are characterized by more than a simple sum of symptoms from each condition but often involve complex interactions with the frequent enhancement of symptoms from both, which is crucial for diagnostic and treatment purposes.

Headache Treatment Options.

Family medicine physicians often see headache as the chief complaint when meeting patients within their practice. The goal is to try different treatment modalities without having to send the patient to a specialist. Headaches affect different individuals during their lifetime. Before any treatment begins, it is best that one rules out possible causes of the headache, for example, drug interactions or structural cerebrum conditions. Nonpharmacological treatment is recommended first before attempting a stepwise approach to cost-effective pharmacological treatment options. Pharmacological treatment options should include preventive and on-demand options. A family physician has all the resources to assist patients with different types of headaches.

Gnashing of Teeth

Life is filled with objects, things, strategies, devices, ploys that may be complex or simple. A common condition impacting not only the teeth but gumjawbone complex, temporal mandibular joint, muscles, tendons, ligaments and softtissues of the oral cavity is that of “gnashing of teeth.” We in the honorable art and science of dentistry call this condition bruxism, tapping, jiggling or extra-oral movements (parafunctional habits) that may impede breathing, influence headache, or other super-pectoral painful conditions such as neuropathies. After 55 years of practice I have observed a huge rise in these condition in the past ten to fifteen years. Oral Bruxism condition is associated with snoring, clapping of teeth, airway compromise, and their attending effects—loss of sleep, quality of sleep as well as emotional implications. Upper Airway Resistance Syndrome (UARS) is the condition identified from a medical view and, related to snoring, grinding of teeth, tapping, jiggling and has led many to devices such as an electrical stimulator called “Inspire” (figure 2.) which is alleged as an alternative to Continuous Positive Airway Pressure (CPAP—see figure 1.) that works inside your body while you sleep. It’s a small electrical device placed during a same-day, outpatient procedure below the collar bone that monitors breathing and stimulates the tongue to reposition for better breathing, hopefully. Obstructive sleep apnea is the most common form of sleep apnea and occurs when the throat muscles relax and block the airway during sleep. Of course, this is theory with some facts in logic, in my humble opinion. About 18 million American adults have moderate to severe obstructive sleep apnea.Another approach in resolution of these condition are oral positioners as shown below, Figure 3 below. All of these devices are made of hard plastics that may cause more harm than good in my experience and estimation. They are often of novel colors to encourage acceptance of their many designs. Constructed to fit the upper arch and lower and work together they are complex and ill-fitting mostly.

Evaluation and Treatment of Patients with Small Posterior Cranial Fossa and Chiari Malformation, Types 0 and 1.

The diagnosis of Chiari I malformation is straightforward in patients with typical signs and symptoms of Chiari I malformation and magnetic resonance imaging (MRI) confirming ≥5 mm of cerebellar tonsillar ectopia, with or without a syrinx. However, in many cases, Chiari I malformation is discovered incidentally on MRI to evaluate global headache, cervical radiculopathy, or other conditions. In those cases, the clinician must consider if cerebellar tonsillar ectopia is related to the presenting symptoms. Surgical decompression of the cerebellar tonsils and foramen magnum in patients with symptomatic Chiari I malformation effectively relieves suboccipital headache, reduces syrinx distension, and arrests syringomyelia progression. Neurosurgeons must avoid operative treatments decompressing incidental tonsillar ectopia, not causing symptoms. Such procedures unnecessarily place patients at risk of operative complications and tissue injuries related to surgical exploration. This chapter reviews the typical signs and symptoms of Chiari I malformation and its variant, Chiari 0 malformation, which has <5 mm of cerebellar tonsillar ectopia and is often associated with syringomyelia. Chiari I and Chiari 0 malformations are associated with incomplete occipital bone development, reduced volume and height of the posterior fossa, tonsillar ectopia, and compression of the neural elements and cerebrospinal fluid (CSF) pathways at the foramen magnum. Linear, angular, cross-sectional area, and volume measurements of the posterior fossa, craniocervical junction, and upper cervical spine identify morphometric abnormalities in Chiari I and Chiari 0 malformation patients. Chiari 0 patients respond like Chiari I patients to foramen magnum decompression and should not be excluded from surgical treatment because their tonsillar ectopia is <5 mm. The authors recommend the adoption of diagnostic criteria for Chiari 0 malformation without syringomyelia. This chapter provides updated information and guidance to the physicians managing Chiari I and Chiari 0 malformation patients and neuroscientists interested in Chiari malformations.

Discharge pain management from the emergency department; practices and perspectives

Objective: This study aimed to investigate pain management practices and perspectives among emergency department&amp;apos;s (ED) discharged patients. Methods: A prospective observational study using an electronic questionnaire was conducted at King Fahad Hospital of the University between November 2023 and February 2024. Patients discharged from the ED who received pain medications were included. Pain presentations were categorized into headache, chest pain, abdominal pain, back pain, musculoskeletal pain, renal colic, or other unspecified conditions. Results: A total of 331 patients were included, with 56.8% males, 84.9% Saudi national, and 29.0% completed high school. The mean age was 35.7 ±11.0 years, and the most common presentation was musculoskeletal pain (48.6%). Regarding acetaminophen use, 65.6% of patients knew the recommended dose (1g), while only 42.0% were aware of the 6-hour interval between doses. A minority (15.3%) correctly identified the maximum daily dose (4g). Additionally, 43.8% of patients were discharged on acetaminophen. Fevadol had the highest level of dose-reduction awareness (56.8%), while 73.4% were unsure about dose reductions for Solpadeine. Non-steroidal anti-inflammatory drugs (NSAIDs) were prescribed to all chest pain cases and the majority of headache cases (88.9%). Conclusion: Suboptimal escalation of pain medications was seen in more than half of the patients. Also, the use of other pain medications after discharge and unawareness about acetaminophen content in common pain medications was greatly noted.

Upsurge of Powassan virus disease in northeastern United States: a public health concern—a short communication

Powassan virus (POWV) is a tick-borne Flavivirus primarily transmitted through ticks in North America which is a significant public health threat in the northeastern United States. POWV infection spans from Ontario to the Mid-Atlantic, Northeast, and Midwest regions in the USA. Climate change, ecological factors, and human-related changes, including shifts in migration and agriculture, contribute to the dissemination of POWV. Symptoms include sore throat, fatigue, headache, and severe neuroinvasive conditions. Specialized attention is required for diagnosing and managing. MRI scans detect central nervous system abnormalities, while neuromonitoring identifies metabolic distress. Severe cases may necessitate ICU hospitalisation with continuous monitoring. Prevention measures, such as awareness, controlling mammals, and protecting pets, reduce POWV infection risk. The recent outbreak of POWV in Maine, USA, highlights the importance of worldwide collaboration for prevention. With the global prevalence of POWV increasing due to climate and socioeconomic changes, implementing preventative measures and promoting awareness are crucial in reducing infection risk.

The Effect Of Integrated Neuromuscular Inhibition Technique On Improving Neck Functional Ability In Tension-Type Headache

Tension-type headache is one of the most common complaints of musculoskeletal pain due to myofascial trigger points. The presence of pain and soreness in the neck and head, tightness, stiffness, spasms, and limitation of motion is a complaint that is often experienced by patients. Methods: This study aims to determine the effect of the Integrated Neuromuscular Inhibition Technique exercise on increasing the functional ability of the neck in Tension-Type Headache conditions. This research is a pre-experimental study with a pre-test and post-test one-group design using an accidental sampling technique with a total sample of 30 people. The place of research was conducted at the Telkomedika Makassar Clinic. A tool to measure the functional ability of the neck using the Neck Disability Index (NDI). Result: The results of the study were an increase in the functional ability of the neck based on measurements of the Neck Disability Index (NDI), namely a pre-test value of 48.80 to a post-test of 41.13 in the condition of Tension-Type Headache at the Telkomedika Clinic Makassar because after being given Integrated Neuromuscular Inhibition Technique therapy (INIT) decreased neck pain, decreased spasm of the neck muscles, and increased functional ability of the neck. Conclusion: Integrated Neuromuscular Inhibition Technique exercises can improve the functional ability of the neck in Tension-Type Headache conditions at the Telkomedika Clinic in Makassar.

Insights on the terminology and on some pathophysiological aspects of cluster headache and related conditions

IntroductionCluster headache and the more recently reported “related conditions”, namelyChronic Paroxysmal Hemicrania, Short-lasting, unilateral, Neuralgiform Headachewith Conjunctival Injection and Tearing (SUNCT) Syndrome and (possibly also)Hemicrania Continua, are one of the fascinating groups of conditions in Neurologywhose cardinal features are the almost absolute unilaterality of pain, its excruciatingseverity, besides the prominent mainly facial autonomic disturbances and overall theintriguing biorhythmicity.Beyond any doubt, the progress of our knowledge about themechanisms of these conditions has been considerable, but there is always room forreflection on where we are and where we can go.ObjectiveThe objectives of the present study are to analyze the metrics of publications onthe pathophysiology of these conditions, to explore in detail how proper the term”Trigeminal Autonomic Cephalgia” is, and to comment on their numerous synonyms.CommentMuch is needed to know the exact structures and circuitry involved in the pathophysiology of these conditions; accordingly, a non-compromising and just descriptive termmight be useful. Along this line of reasoning and bearing in mind the cardinal pointsof such conditions, namely, pain in the trigeminal territory, prominent autonomicsymptoms, prominent chronobiological features, and the excruciating character ofthe pain, a terminological possibility would be: Unilateral with Prominent Rhythmicityand Autonomic Symptoms Excrutiating Cephalgia (UPRASEC).

Bruxism and oro-facial pain not related to temporomandibular disorder conditions: Comorbidities or risk factors?

Bruxism has historically been of particular interest to the field of dentistry, primarily due to the inferred damage it may cause to the dentition and supporting periodontal structures. The definition of bruxism itself has undergone multiple changes over time. In addition, the effects of bruxism as it relates to oro-facial pain conditions has remained a debatable topic. To review the available literature relating to bruxism and non-temporomandibular disorder (TMD) pain conditions. A literature search was conducted with the assistance of an expert librarian. The following databases were reviewed: PubMed, MEDLINE, EMBASE and Google Scholar. For additional references, articles were also retrieved by hand search from the selected papers. Any articles that were not published in English, or the focus were related to temporomandibular disorders were excluded. While bruxism and certain headache conditions do tend to occur together frequently, evidence relating to any clear common pathophysiological mechanism has yet to be fully elucidated. Robust evidence as it relates to the relationship between bruxism and other non-TMD oro-facial pains is also lacking.

A single infusion of intravenous lidocaine for primary headaches and trigeminal neuralgia: a retrospective analysis.

Intravenous (IV) lidocaine has been used as a transitional treatment in headache and facial pain conditions, typically as an inpatient infusion over several days, which is costly and may increase the risk of adverse effects. Here we report on our experience using a single one-hour IV lidocaine infusion in an outpatient day-case setting for the management of refractory primary headache disorders with facial pain and trigeminal neuralgia. This is a retrospective, single-center analysis on patients with medically refractory headache with facial pain and trigeminal neuralgia who were treated with IV lidocaine between March 2018 and July 2022. Lidocaine 5 mg.kg-1 in 60 mL saline was administered over 1 h, followed by an observation period of 30 min. Patients were considered responders if they reported reduction in pain intensity and/or headache frequency of 50% or greater. Duration of response was defined as short-term (< 2 weeks), medium-term (2-4 weeks) and long-term (> 4 weeks). Forty infusions were administered to 15 patients with trigeminal autonomic cephalalgias (n = 9), chronic migraine (n = 3) and trigeminal neuralgia (n = 3). Twelve patients were considered responders (80%), eight of whom were complete responders (100% pain freedom). The average duration of the treatment effect for each participant was 9.5 weeks (range 1-22 weeks). Six out of 15 patients reported mild and self-limiting side effects (40%). A single infusion of IV lidocaine might be an effective and safe transitional treatment in refractory headache conditions with facial pain and trigeminal neuralgia. The sustained effect of repeated treatment cycles in some patients may suggest a role as long-term preventive therapy in some patients.

Cognitive Behavioral Therapy for the Management of Episodic Migraine.

This article provides an overview of the application of CBT in the management of episodic migraine while also providing context and insight into the underlying neurophysiological mechanisms of therapeutic change. It discusses the theoretical foundations of CBT and highlights key components including education, cognitive restructuring, behavioral interventions, relaxation techniques, and lifestyle changes. Cognitive behavioral therapy (CBT) is an empirically based treatment that is well suited for the management of episodic migraine. Although first-line treatments of migraine are typically pharmacological, a review of empirical literature suggests growing evidence for the use of CBT as a standard non-pharmacological treatment of headache conditions. In summary, this article explores evidence supporting the efficacy of CBT in reducing the frequency, intensity, and duration of migraine attacks as well as improving the quality of life and psychological well-being of those with episodic migraine.

Cervical musculoskeletal impairments and pressure pain sensitivity in office workers with headache

BackgroundOffice workers are specifically vulnerable to headache conditions. Neck pain is reported by almost 80% of patients with headaches. Associations between currently recommended tests to examine cervical musculoskeletal impairments, pressure pain sensitivity and self-reported variables in headache, are unknown. The aim of this study is to evaluate whether cervical musculoskeletal impairments and pressure pain sensitivity are associated with self-reported headache variables in office workers. MethodsThis study reports a cross-sectional analysis using baseline data of a randomized controlled trial. Office workers with headache were included in this analysis. Multivariate associations, controlled for age, sex and neck pain, between cervical musculoskeletal variables (strength, endurance, range of motion, movement control) and pressure pain threshold (PPT) over the neck and self-reported headache variables, such as frequency, intensity, and the Headache-Impact-Test-6, were examined. ResultsEighty-eight office workers with a 4-week headache frequency of 4.8 (±5.1) days, a moderate average headache intensity (4.5 ± 2.1 on the NRS), and “some impact” (mean score: 53.7 ± 7.9) on the headache-impact-test-6, were included. Range of motion and PPT tested over the upper cervical spine were found to be most consistently associated with any headache variable. An adjusted R2 of 0.26 was found to explain headache intensity and the score on the Headache-Impact-Test-6 by several cervical musculoskeletal and PPT variables. DiscussionCervical musculoskeletal impairments can explain, irrespective of coexisting neck pain, only little variability of the presence of headache in office workers. Neck pain is likely a symptom of the headache condition, and not a separate entity.

Behavioral Health, Telemedicine, and Opportunities for Improving Access.

The purpose of this review is to summarize advances in behavioral treatments for pain and headache disorders, as well as recent innovations in telemedicine for behavioral treatments. Research for behavioral treatments continues to support their use as part of a multidisciplinary approach to comprehensive management for pain and headache conditions. Behavioral treatments incorporate both behavioral change and cognitive interventions and have been shown to improve outcomes beyond that of medical management alone. The onset of the COVID-19 public health emergency necessitated the rapid uptake of nontraditional modalities for behavioral treatments, particularly telemedicine. Telemedicine has long been considered the answer to several barriers to accessing behavioral treatments, and as a result of COVID-19 significant progress has been made evaluating a variety of telemedicine modalities including synchronous, asynchronous, and mobile health applications. Researchers are encouraged to continue investigating how best to leverage these modalities to improve access to behavioral treatments and to continue evaluating the efficacy of telemedicine compared to traditional in-person care. Comprehensive pain and headache management should include behavioral treatments to address a variety of behavior change and cognitive targets. Policy changes and advances in telemedicine for behavioral treatments provide the opportunity to address historical barriers limiting access.

Inter-rater reliability, discriminatory and predictive validity of neck movement control tests in office workers with headache and/or neck pain

BackgroundMovement control tests (MCTs) are clinical tests to evaluate impairment of movement and associated neuromuscular control and are commonly used to evaluate people with neck pain or headache conditions. The aim of this study was to establish inter-rater reliability as well as discriminatory and predictive validity for seven MCTs of the upper (UCS) and lower cervical spine (LCS) in office workers with headache or neck pain. MethodsSeven MCTs of the UCS (3) and LCS (4) were performed at baseline on 140 office workers which were included in a cluster randomized controlled trial. The occurrences of headache and neck pain were established at baseline (discriminatory validity) and at a 15-month follow-up (predictive validity). Inter-rater-reliability was established in a separate cross-sectional study. ResultsMCTs showed slight to almost perfect inter-rater reliability but limited discriminatory (baseline) and limited to small predictive validity (15-month follow up) for different subgroups of office workers with headache and/or neck pain. MCTs of the UCS showed limited discriminatory validity, especially for rotation in participants with headache and neck pain compared to those with headache only (Negative Likelihood-ratio: 0.82, 95% CI: 0.69–0.98). Participants with neck pain only and ≥1/4 positive MCTs for the sagittal plane had an increased risk for future neck pain (Relative risk: 3.33, 95% CI: 1.05-10.56). DiscussionMCTs of the UCS and LCS are reliable but have only limited to small validity to predict future headache events in office workers. Insufficient sagittal plane movement control may predict neck pain relapses in the future.

Prevalence of Self- Medication Practice and Associated Factors Among Kabarak University Students

Background: Self-medication is a common practice in the world and it is greatly encouraged by the World Health Organization. Rational practice of self-medication confers beneficial effects to the user although the reverse is equally true. Benefits include self-reliance in managing minor illnesses and reduction in medical costs. Untoward effects associated with the practice include emergence of antibiotic resistance, toxicities in cases of overdose and development of tolerance. While self-medication practice has some positive side, the negative effects requires that the extent of its practice is established and where necessary, regulatory interventions considered. Currently, these data are either limited or completely lacking. We therefore assessed the prevalence of self-medication practice and associated factors among students in Kabarak university. &#x0D; Method: Survey-descriptive research design was employed to study students in Kabarak University. Questionnaires were used to collect data from a sample size of 369 participants. Multistage stratified convenient sampling technique was used to select study participants. Ethical and study approval were obtained prior to data collection. &#x0D; Results: Out of the 368 respondents, 82% practiced self-medication with majority being females (195). School of pharmacy reported the highest prevalence rate (22%) among the seven schools in Kabarak University. The main symptom prompting self-medication was reported to be headache (37%) and respiratory associated conditions. Friends and family members were the most common source of information and drug use for self-medication. Majority of participants stated that long delays in the process of seeking for conventional medical attention exacerbated the practice of self-medication. Paracetamol and antibiotics were the most common drugs used for self-medication. &#x0D; Conclusion: Majority of students sampled practice self-medication. Considering the associated negative effects, targeted sensitization programs should be designed and implemented to scale down the practice.

Alterations in the structure and function of the brain in adolescents with new daily persistent headache: A pilot MRI study.

The purpose of this study was to explore brain morphological and functional connectivity alterations in adolescents with new daily persistent headache (NDPH) compared to pain-free, healthy controls. NDPH is one of the most disabling and least understood primary headache conditions. To date, no studies have considered the role of brain function and structure in pediatric patients with NDPH. In this cross-sectional study, resting-state functional and structural images were acquired for 13 patients with NDPH (M age=15.9, standard deviation [SD] ± 1.4) and 13 age- and sex-matched controls (M age=16.2, SD ± 1.8) using magnetic resonance imaging. Participants were recruited from the Pediatric Headache Program at Boston Children's Hospital and from the Greater Boston area. In patients, clinical features of NDPH, including disease duration, pain intensity ratings, pain sensitivity, and functional disability were also assessed, and their associations with functional and structural brain alterations were explored. Compared to controls, patients with NDPH demonstrated reduced cortical thickness in the bilateral superior temporal gyrus, left superior, and middle frontal gyrus areas (p < 0.05, Monte Carlo corrected for multiple comparisons). Furthermore, reduced cortical thickness of the left superior frontal gyrus was related to elevated pain sensitivity in NDPH (r=-0.79, p=0.006). Patients showed altered functional connectivity between regions involved in emotional and cognitive networks of pain, including the amygdala, insula, frontal regions, and cerebellar subregions. The present study provides the first preliminary evidence of functional and structural brain differences in pediatric patients with NDPH compared to controls. Identifying alterations in cortical thickness and resting-state connectivity between specific brain regions could provide characteristics of NDPH and probable mechanisms that may guide personalized therapeutic interventions.

Review on primary headache among college students

Introduction: The most common sort of headache problem on the planet is primary headache disorders yet underappreciated, misunderstood, and inadequately treated, and they seem to be the third leading cause of disability in the world, because of the unpredictability of headache attacks and the existence of associated symptoms including dizziness, vomiting, nausea, and visual and/or hearing problems, persistent primary headaches can even have a massive effect on peoples’ health. Migraine, the most common cause of headache in the world, is characterized by headache bouts that last anywhere from 4 to 72 hours if left untreated. Students are more likely to experience exhaustion, stress, and worry, being the most prevalent triggers of TTH as well as migraine. Cluster Headache is amongst the most debilitating headache conditions, with a significant level of severity. CH has a lesser incidence than migraines. It hits about one out of every thousand people. Methodology: Database searches including PubMed Central, Google Scholar and Cochrane library were performed. Studies that investigated Impact of primary headache, prevalence of primary headache among students, health related quality of life in students with primary headache disorders were included and reviewed. Articles that evaluate any form of secondary headache were excluded.

Is calcitonin gene-related peptide a reliable biochemical marker of migraine?

The aim of this study was to provide an overview of clinical studies on calcitonin gene-related peptide (CGRP) measurements in body fluids of migraine patients and to discuss the validity of CGRP measurement as a clinical biomarker of migraine. Several studies have reported increased CGRP levels in venous blood, saliva and tear fluid of migraine patients compared with healthy controls and in migraine patients during attacks compared with the interictal state, suggesting that CGRP may be a feasible biomarker of migraine. However, the findings of studies investigating CGRP levels in migraine patients are generally conflicting and measurements of CGRP levels are challenged by several methodological issues. Reported differences in CGRP levels between patients with chronic migraine relative to episodic migraine have also been inconsistent. There is also a well documented involvement of CGRP in several nonmigraine pain disorders, including cluster headache and common pain conditions such as osteoarthritis. Current evidence does not justify the usage of CGRP levels as a biomarker for diagnosing migraine or for determining the severity of the disease in individual patients. However, CGRP measurements could prove useful in the future as clinically relevant biomarkers for predicting the response to therapy, including anti-CGRP migraine drugs.

The Meaning of Words Related to Orofacial Pain and Headache Conditions: The Need for a Single and Unified Classification Scheme in a People-Centered Language

The Meaning of Words Related to Orofacial Pain and Headache Conditions: The Need for a Single and Unified Classification Scheme in a People-Centered Language