Prevalence Of Primary Headaches Research Articles

Prevalence of primary headaches in multiple sclerosis patients

BackgroundMultiple sclerosis (MS) is the most common immune-mediated inflammatory disease of the central nervous system. It is characterized by symptoms such as visual disturbances, paresis with spasticity, paresthesia, numbness, and fatigue. However, several studies have shown a high prevalence of headaches in individuals with MS. Migraine and tension-type headaches are the most frequent types of headaches experienced by those with MS. Additionally, the role of MS disease-modifying agents must be considered. These agents have different modes of action and side effect profiles, and their use may sometimes trigger headaches in patients with MS. ObjectivesThis study aimed to explore the prevalence and clinical characteristics of primary headaches in MS patients. The relationship between headache and clinical features of MS (Course of MS, duration, EDSS, brain imaging and DMD) are also investigated. Subjects and MethodsTwo hundred and eighty-one MS patients diagnosed according to according to the 2017 revisions to the McDonald Criteria were included in the study. Data was collected from the MS unit medical records and from the interview with the patients. Patients with reported headaches are asked to recall their headache characteristics and patterns using an interviewer administered Arabic language-structured validated questionnaire. ResultsThe median age of patients was 33 years old, with a range of 22–55. Tension-type headache (TTH) was more common in males, patients with more severe disability (EDSS ≥ 3), and those with SPMS and PPMS phenotypes. Additionally, patients on rituximab or cyclophosphamide therapy were more likely to have TTH. On the other hand, females, patients with milder disability (EDSS < 3), and those with RRMS phenotype were more likely to have migraine. This was also true for patients with MRI lesions involving the periaqueductal gray, and those receiving INF or fingolimod (P < 0.05). Periaqueductal gray matter lesions were found in the MRI of 48 patients (40 %) who experienced headaches on more than 10 days per month. Sensorimotor lesions in the brain were found in 55 patients (53.4 %) with severe headaches (p-value < 0.001). Interferons were associated with an increased risk of worsening preexisting headaches and the appearance of de novo headaches related to its intake (odds ratio: 2.84, 3.72; relative risk: 1.63, 2.04; p-value = 0.03, < 0.001, respectively). On the other hand, rituximab was associated with a decreased risk of worsening preexisting headaches and the appearance of de novo headaches related to its intake (odds ratio: 0.04, 0.09; relative risk: 0.11, 0.18; p-value = < 0.001, < 0.001, respectively). ConclusionPrimary headaches are a common occurrence in patients with MS. Migraines and tension-type headaches (TTH) are among the most prevalent types. It has been observed that interferon can exacerbate preexisting headaches and even cause new ones. Additionally, the location of MS plaques may play a role in the frequency and severity of headaches.

Unveiling the therapeutic potential of Dl-3-n-butylphthalide in NTG-induced migraine mouse: activating the Nrf2 pathway to alleviate oxidative stress and neuroinflammation

BackgroundMigraine stands as a prevalent primary headache disorder, with prior research highlighting the significant involvement of oxidative stress and inflammatory pathways in its pathogenesis and chronicity. Existing evidence indicates the capacity of Dl-3-n-butylphthalide (NBP) to mitigate oxidative stress and inflammation, thereby conferring neuroprotective benefits in many central nervous system diseases. However, the specific therapeutic implications of NBP in the context of migraine remain to be elucidated.MethodsWe established a C57BL/6 mouse model of chronic migraine (CM) using recurrent intraperitoneal injections of nitroglycerin (NTG, 10 mg/kg), and prophylactic treatment was simulated by administering NBP (30 mg/kg, 60 mg/kg, 120 mg/kg) by gavage prior to each NTG injection. Mechanical threshold was assessed using von Frey fibers, and photophobia and anxious behaviours were assessed using a light/dark box and elevated plus maze. Expression of c-Fos, calcitonin gene-related peptide (CGRP), Nucleus factor erythroid 2-related factor 2 (Nrf2) and related pathway proteins in the spinal trigeminal nucleus caudalis (SP5C) were detected by Western blotting (WB) or immunofluorescence (IF). The expression of IL-1β, IL-6, TNF-α, Superoxide dismutase (SOD) and malondialdehyde (MDA) in SP5C and CGRP in plasma were detected by ELISA. A reactive oxygen species (ROS) probe was used to detect the expression of ROS in the SP5C.ResultsAt the end of the modelling period, chronic migraine mice showed significantly reduced mechanical nociceptive thresholds, as well as photophobic and anxious behaviours. Pretreatment with NBP attenuated nociceptive sensitization, photophobia, and anxiety in the model mice, reduced expression levels of c-Fos and CGRP in the SP5C and activated Nrf2 and its downstream proteins HO-1 and NQO-1. By measuring the associated cytokines, we also found that NBP reduced levels of oxidative stress and inflammation. Most importantly, the therapeutic effect of NBP was significantly reduced after the administration of ML385 to inhibit Nrf2.ConclusionsOur data suggest that NBP may alleviate migraine by activating the Nrf2 pathway to reduce oxidative stress and inflammation in migraine mouse models, confirming that it may be a potential drug for the treatment of migraine.Graphical

The correlation between the frequent intake of dietary migraine triggers and increased clinical features of migraine (analytical cross-sectional study from Egypt)

Despite the high prevalence of primary headaches, the role of food in modifying clinical characteristics among migraine patients is often overlooked. The aim is to detect the correlation between adopting unhealthy dietary habits and migraine severity and identify foods that have a greater chance of triggering specific subtypes of migraine. The present study was a cross-sectional analytical study that was conducted at Kasralainy Hospital, Cairo University, headache clinic at Alexandria University Hospital, and Al-Azhar University Hospitals from January to June 2020. We included 124 patients fulfilling the ICHD-3 criteria for migraine. A full clinical profile for migraine headaches was reported using a headache sheet applied to the Al-Azhar University headache unit. A nutritionist obtained data collected about dietary habits using many reliable scales and questionnaires such as food frequently sheets questionnaire. Logistic regression and Pearson correlation coefficients have been used to identify foods that are more likely to be associated with increased clinical features of migraine. Our participants reported that the fried meat, fried chicken, processed meats, fava beans, falafel, aged cheese “Pottery salted cheese” and “Rummy cheese”, salted-full fatty cheese “Damietta cheese”, citrus fruits, tea, coffee, soft drinks, nuts, pickles, chocolate, canned foods, sauces, ice cream, smoked herring, in addition to the stored food in the refrigerator for many days were significantly associated with the diagnosis of chronic migraine CM compared to episodic migraine (EM). Margarine, pickles, and smoked herring were significantly associated with the diagnosis of migraine with aura (MA) compared to migraine without aura (MO). Adopting unhealthy eating habits was a more prevalent dietary consumption pattern among people with chronic migraines compared to those with episodic migraine.

Primary Headache Is Related to Reduced Health-Related Quality of Life in Children with Epilepsy.

Headache is a frequent comorbidity in patients with epilepsy. Data are sparse regarding the distribution of headache types in children with epilepsy (CWE). We aimed to assess the prevalence of primary headache types and their influence on health-related quality of life (QoL) in CWE. CWE filled out a validated headache questionnaire to assess migraine (MIG), tension-type headache (TTH), trigeminal-autonomic cephalalgia (TAC), or, if the criteria were not fulfilled, non-classifiable headache (NCH). QoL was measured using both patient and parent versions of a validated questionnaire. Of 119 CWE (59 female; 11.5 ± 3.1 y), headache was found in 46 (38.7%). Sixteen (34.8%) patients showed MIG, 9 (19.6%) patients TTH, and 21 (45.7%) patients described NCH. More girls reported headache (χ2 = 5.4, p = 0.02) when compared to boys. Overall, QoL was reduced in patients with headache from both the patients' and parents' points of view (70.8% [39.6; 87.5] vs. 77.0% [46.9; 95.8], p = 0.002; 71,9% [33.3; 87.5] vs. 78,1% [54.2; 95.8], p = 0.003). Headache is common among CWE with MIG as the most prevalent primary headache type and higher rates in female patients. Importantly, patients and their parents perceive a reduced overall QoL when suffering from headache.

Medication overuse headache: awareness and risk assessment among patients attending health care settings in Jouf Region, Saudi Arabia

Objective: This study aimed to assess the community awareness towards medication overuse headache (MOH), estimate people at risk of developing MOH and to identify the potential factors that affect awareness towards MOH. Methods: A retrospective cross-sectional study was conducted in health care settings in Jouf region. The data were collected by interviewing patients using a structured questionnaire. Results: A substantial proportion of participants (89%) had not heard about MOH before. Tension-type headache was the most prevalent primary headache diagnosis (58%), the majority of participants experienced headaches 3-7 days per month (40.7%). Acetaminophen was the most common chronically used analgesic among primary headache patients. Conclusion: Migraine headache patients were considered at high risk to develop medication overuse headache. A significant association was observed between primary headache diagnosis and the perceived safest longest duration to use analgesics.

Clinical Features, Socio-cultural Characteristics, Sleep Patterns, and Depression in Fibromyalgia Patients from India: A Cross-Sectional Study

Introduction: Fibromyalgia (FM) is a complex and chronic disease with significant regional variation. There is a lack of studies on Fibromyalgia (FM) in Indian population. Objective: The aim of this study is to investigate the clinical features of FM patients in India, including the prevalence and distribution of comorbidities, sleep patterns, and depression. Methods: Cross-sectional analysis of patients attending outpatient rheumatology clinic from 2019-2020 fell in the ACR2016 criteria for FM. Results: Of the 121 patients enrolled in the study, the majority (93.4%) were female, with a female-to-male ratio of 14:1. The mean age of the patients was 45 ±11 years. The socio-cultural profile of the patients revealed that the majority were married (88%) and homemakers (68.8%), lived in nuclear families (56%) and were middle to upper middle class (68.6%). Contrary to the existing literature, a higher prevalence of FM has been observed in people with a higher educational status. Common clinical symptoms were extensive body aches (100%), fatigue (88%), difficulty concentrating (69.4%), irritability and gastrointestinal complaints (58.5%). We observed a high prevalence of primary headache (76%), mainly migraine (42%) and obsessive-compulsive (OCB) (71%). Sleep disturbances and depression were found in the significant number of patients with FM. The patients reported various sleep problems, such as snoring, waking up at night, daytime sleepiness, and taking daytime naps. Most of the patients had mild (50.8%) to moderate (29%) depression, while a smaller proportion experienced severe (6.6%) symptoms. Most of the patients had low serum vitamin D (91%). The presence of moderate to severe depression was associated with the severity of FM. Conclusion: The demographic profile of Indian patients was similar to that reported in the literature but had varied socio-cultural profiles needing further community-based studies. The high prevalence of psychological comorbidities and sleep disturbances highlights their importance in managing FM patients.

Who cares about migraine? Pathways and hurdles in the European region - access to care III

BackgroundMigraine is a highly prevalent primary headache disorder and a leading cause of disability. Difficulties in access to care during diagnostic and therapeutic journey contribute to the disease burden. Several target-specific drugs have reached the market in the past four years and have modified the treatment paradigm in migraine. The aim of this study is to provide an updated snapshot of the pathways and hurdles to care for migraine in different European countries by directly asking patients.MethodsIn 2021 the European Migraine and Headache Alliance proposed a 39-item questionnaire that was administered online to an adult migraine population in European countries. Questions were focused on socio-demographic and migraine data, access to diagnosis and treatment, disease-related burden and the main channel for disease information.ResultsA total of 3169 questionnaires were returned from 10 European countries. Responders were predominantly females, age range 25–59 years, with a migraine history longer than 10 years in 82% of cases, and with at least 8 headache days per month in 57% of cases. Respondents reported limitations in social, working and personal life during both the ictal and interictal phase. The activities mostly impaired during the attacks were driving (55%), cooking or eating (42%), taking care of family/childcare (40%) and getting medicines at the pharmacy (40%). The most frequently reported unmet need was the long delay between the first visit and migraine diagnosis: 34% of respondents had to see ≥ 4 specialists before being correctly diagnosed, and between the diagnosis and treatment prescription: > 5 years in 40% of cases. The most relevant needs in terms of quality of life were the desire for a lower migraine frequency, an effective treatment and a greater involvement in society.ConclusionsData from the present survey point to the existence and persistence of multiple hurdles that result in significant limitations to access to care and to the patients’ social life. A close cooperation between decision makers, healthcare workers and patients is needed to overcome these barriers.Graphical

PREVALENCE, PREDICTORS TRIGGERS AND COPING STRATEGIES OF TENSION HEADACHE AMONG MEDICAL STUDENTS AND IN KSAU-HS RIYADH, SAUDI ARABIA

This study aimed to investigate the prevalence of primary headaches, specifically tension-type headaches (TTH), among medical students at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Riyadh, Saudi Arabia, and to identify the factors that contribute to the occurrence and relief of headaches. A cross-sectional study was conducted among second to sixth-year medical students at KSAU-HS from October 2022 to February 2023. Participants with chronic headaches who volunteered to participate were included. The International Classification of Headache Disorders, third edition (ICHD-3), was used to classify and differentiate between different types of headaches. Additional questions were included to assess factors that exacerbate or alleviate headaches, headache management strategies, and the impact of headaches on academic performance. Data were collected using electronic self-administered questionnaires and analyzed using SPSS version 21. A total of 303 participants were included in the study, with a mean age of 22 ± 1.7 years. The majority of participants were male (59.4%), and most were in clinical years (61.1%) with a GPA of 4.5 to 5 (57.1%). Nearly all participants reported experiencing at least one episode of headache in the past year, and 60.7% met the criteria for TTH. The most commonly reported headache characteristics were bilateral location (71.3%), frequent occurrence (53.8%), duration of more than one hour (84.5%), and frontal site (61.7%). Lack of sleep (62.4%) was identified as the most common trigger, while taking simple analgesics like Paracetamol (72.3%) and sleep (50.5%) were the most commonly used therapies to manage headaches. The majority of participants (75.9%) reported that their headaches did not significantly affect their academic performance. A significant association was found between gender and tension-type headaches, with male students being at a higher risk (p-value &lt; 0.001). In conclusion, primary headaches, particularly tension-type headaches, are prevalent among medical students at KSAU-HS, potentially impacting their academic performance. Further research is warranted to raise awareness among students regarding effective headache management strategies.

Quality assessment of pharmaceutical care to patients with headaches using the simulated patient method: interaction practice

Relevance. WHO assesses headaches as a global world problem. Russia occupies a leading position in the prevalence of primary headaches. Headaches are one of the most common reasons for visiting a pharmacy for self-medication. The interaction of the pharmacist and the visitor with the headache problem in general determines the quality of pharmaceutical care.Aim. To assess the practice of the interaction between a patient with a headache and a pharmacist using the simulated patient method.Materials and methods. Trained simulated patients (women aged 20, 40 and 58 years) visited a total of 101 pharmacies. The dialogue was recorded on a voice recorder, all the features of the interaction were additionally recorded aſter the visit. Special forms were filled out based on the information received. The data was processed using Microsoſt Excel 2010 and STATISTIKA 10.0.Results. The average interaction time was 98.2±3.8 seconds. There was a high frequency of spontaneous recommendations without preliminary questions (66.3%), a small number of questions asked (0.84±0.1). These indicators practically did not depend on various factors (type of pharmacy organization, age of the pharmacist, age of the simulated patient, the presence of a queue, and others).Conclusion. The results of the study demonstrate a low level of interaction between pharmacists and visitors with a headache, as well as a practical absence of involvement in the process of providing pharmaceutical care, which negatively affects its quality: frequent spontaneous recommendations, short consultations and rare questions. The approach to the interaction of pharmacists with visitors with headaches is formal and requires standardization.

Headache frequency and neck pain are associated with trapezius muscle T2 in tension-type headache among young adults

BackgroundTension-type headache (TTH) is the most prevalent primary headache disorder. Neck pain is commonly associated with primary headaches and the trigemino-cervical complex (TCC) refers to the convergence of trigeminal and cervical afferents onto neurons of the brainstem, thus conceptualizes the emergence of headache in relation to neck pain. However, no objective biomarkers exist for the myofascial involvement in primary headaches. This study aimed to investigate the involvement of the trapezius muscles in primary headache disorders by quantitative magnetic resonance imaging (MRI), and to explore associations between muscle T2 values and headache frequency and neck pain.MethodsThis cohort study prospectively enrolled fifty participants (41 females, age range 20–31 years): 16 subjects with TTH only (TTH-), 12 with mixed-type TTH plus migraine (TTH+), and 22 healthy controls (HC). The participants completed fat-suppressed T2‐prepared three-dimensional turbo spin-echo MRI, a headache diary (over 30 days prior to MRI), manual palpation (two weeks before MRI), and evaluation of neck pain (on the day of MRI). The bilateral trapezius muscles were manually segmented, followed by muscle T2 extraction. Associations between muscle T2 and the presence of neck pain as well as the number of days with headache (considering the 30 days prior to imaging using the headache calendar) were analyzed using regression models (adjusting for age, sex, and body mass index).ResultsThe TTH+ group demonstrated the highest muscle T2 values (right side: 31.4 ± 1.2 ms, left side: 31.4 ± 0.8 ms) as compared to the TTH- group or HC group (p < 0.001). Muscle T2 was significantly associated with the number of headache days (β-coefficient: 2.04, p = 0.04) and the presence of neck pain (odds ratio: 2.26, p = 0.04). With muscle T2 as the predictor, the area under the curve for differentiating between HC and the TTH+ group was 0.82.ConclusionsIncreased T2 of trapezius muscles may represent an objective imaging biomarker for myofascial involvement in primary headache disorders, which could help to improve patient phenotyping and therapy evaluation. Pathophysiologically, the increased muscle T2 values could be interpreted as a surrogate of neurogenic inflammation and peripheral sensitization within myofascial tissues.

Epidemiology of Primary Headache and Its Associated Psychosocial Factors Amongst Undergraduate Medical Students: A Cross-Sectional Study From the Vidarbha Region.

Introduction The present study was carried out to investigate the epidemiology of primary headaches amongst undergraduate medical students by determining the prevalence of primary headaches and their associated psychosocial factors. Methods A cross‑sectional study was conducted at a medical collegein the Vidarbha region of India from January 2023 to February 2023 amongst 471 medical students. Diagnosis of tension-type headache (TTH) was made according to the International Classification of Headache Disorders (ICHD-3) criteria. Data were collected by interview technique using a pre-designed and pre-tested questionnaire.that consisted of socio-demographic variables and psychosocial factors. Statistical analysis was done using SPSS 24.0 (IBM Corp., Armonk, NY, USA). Results Prevalence of headache was 80% and was higher in females (87%) than in males (71%). TTH is the most common type with a prevalence of 76% in females followed by 64% in males. Psychosocial factors associated with presence of headache in study subjects were disappointment in relation to academic performance (OR 3.85, CI 1.68-2.71),poor socio-economic status (OR 2.69, CI 1.58-4.57),work overload (OR 0.41, CI 0.24-0.68), irritability (OR 0.33, CI 0.19-0.57) and frequent conflicts (OR 1.45, CI 0.78-2.70). Stress (OR 0.27, CI 0.11-0.71) and anxiety (OR 3.45, CI 1.31-9.08) were associated with headaches only in females and depression (OR 0.50, CI 0.25-1.01) was found to be associated with headaches only in males. Conclusions Psychosocial factors from the personal sphere like stress, overwork, and anxiety were highly prevalent amongst students and these factors need to be addressed meticulouslyin order to mitigate the problem of primary headache disorders amongst medical undergraduates.

Prevalence and risk factors of primary headache disorders among Healthcare professionals in México, results of a multicenter survey (P11-12.010)

<h3>Objective:</h3> The objectives of this study were (1) to assess the prevalence of primary headaches among medical staff and nurses in México; (2) to describe risk factors for Tensional Headache and Migraine; (3) to examine the frequency of Medication-overuse headache (MOH). <h3>Background:</h3> The global prevalence of current headache disorders among adults is nearly 47%. A Mexican cohort in teachers reported a lifetime prevalence of 19% of migraine. Nevertheless, there is lack of epidemiology reports of other primary headache types in México. <h3>Design/Methods:</h3> An online survey was conducted randomly, including staff from 7 hospital centers, in the period from August 16 to 22, 2022. <h3>Results:</h3> Of a total of 387 surveys (attending physicians=63; residents=211; last year medical students=44; nursing staff=69), 324 (83.7%) stated they had headache, of which 239 (73.8%) had migraine and 253 (78.1%) tension headache. Headache was significantly more prevalent in nursing staff and last year medical students vs. residents and attendings (95.2%, 93.2% vs. 77.7%, 84.1%; P= 0.001), however, this difference was not observed in migraine-specific prevalence (77.3%, 78% VS 75.6%, 60.4; P=0.090) nor for tension headache (69.6%, 68.3% VS 82.3%, 83.0%; P=0.058). Medication abuse was found in 5.1%, being more frequent in nursing staff and last year medical students VS residents and assigned (7.6%, 14.6% VS 4.9%, 0.0%; P=0.022). No relationship was found for the onset or worsening of headache with the COVID-19 pandemic. <h3>Conclusions:</h3> In this first Mexican study of headache in healthcare professionals, it is confirmed that primary headaches are more prevalent than in the general population. <b>Disclosure:</b> Dr. Roman Guzman has nothing to disclose. Dr. Rodriguez-Leyva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Rodriguez-Leyva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva . Dr. Rodriguez-Leyva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pfizer. Dr. Rodriguez-Leyva has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Lilly Eli and Company. Dr. Rodriguez-Leyva has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Torrent Pharmaceuticals Mexico. Dr. Rodriguez-Leyva has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for abbvie allergan. Dr. Aguilera Barragán Pickens has nothing to disclose. Ms. Badial has nothing to disclose. Dr. Vega has nothing to disclose.

Primary headache disorders in Latin America and the Caribbean: A meta-analysis of population-based studies

In this manuscript, we aim to systematically estimate the pooled prevalence and incidence of primary headaches and its subtypes (migraine, tension-type headache, and chronic headaches) in Latin America and the Caribbean, describing its epidemiological profile and associated factors. We systematically searched PubMed/MEDLINE, Scopus, and LILACS (From conception to March 2021), for populational studies reporting the epidemiology of primary headaches and their associated factors in Latin America and the Caribbean. The data extraction was conducted independently. We performed random-effect model meta-analysis of prevalence (overall primary headaches and by subtypes) and associated factors, assessed potential sources of heterogeneity, the risk of bias, publication bias, and the evidence certainty (GRADE methodology). We included 32 populational studies (38 subpopulations, n = 63,813). The prevalence of primary headaches was 41.4% (95% CI 31.1-52.2%; n = 54,357), 15% for migraine (95% CI 12.0-18.3; n = 53,658 individuals), 20.6% for tension-type headache (95% CI 12.4-30.2; n = 25,840), and 6% for chronic headaches (95% CI 3.3-9.6; n = 21,720), with high between-study heterogeneity. No incidence data was found. Female sex, white ethnicity, high BMI, comorbid mental health disorders, and low-back pain were associated with higher prevalence of primary headaches. The prevalence was less in rural areas. In Latin America and the Caribbean, primary headaches are highly prevalent affecting young females disproportionally. The prevalence of chronic headaches is higher than in other systematic global and regional estimations. The presence of comorbidities as modifiable risk factors should encourage their integration as targets for community-based preventive and therapeutic interventions. CRD42018105116.

Estimating the prevalence of primary headache disorders in university students: Application of the Croatian version of the HARDSHIP questionnaire

Background: Studies reporting the prevalence of headaches in Croatia have methodological differences that make it difficult to consolidate their results. This study aimed to assess the prevalence of the most common primary headaches in a student population using the standardized HARDSHIP questionnaire (in Croatian). Methods: This cross-sectional epidemiological study collected data regarding the 1-year prevalence of headaches in a student population using the diagnostic algorithm of the HARDSHIP questionnaire. The chi-squared test was used to analyze gender differences, and Cramer’s V was used for effect size interpretation. Results: The questionnaire was administered to 1350 university students enrolled in health profession programs (81.3% female; 18.7% male; average age: 23 years). The 1-year prevalence of migraine was 38.9% (male: female ratio, 1:1.5), and that of tension-type headache was 35.6% (male: female ratio, 1:0.9). Overall, 91.0% of participants responded positively to the question regarding the incidence of headache in the past 12 months. Conclusions: We report a high prevalence of primary headaches among students of health professions in Croatia. The differences in prevalence may be attributed to various sociocultural, geographical, genetic, and methodological differences. Population-specific studies may facilitate a more accurate assessment of headache prevalence and enable more effective targeting of public health activities.

Prevalence of Primary Headache in Nurses in Japan: A Cross-sectional Single-center Study.

Objective This study examined the prevalence of migraine in nurses in Japan, which, to our knowledge, has not been documented in English. Methods From April to May 2021, we administered a questionnaire to 229 nurses working at Keio University Hospital to investigate the prevalence and characteristics of headache among nurses in Japan. Headaches were classified as migraine or tension-type headache (TTH) based on the International Classification of Headache Disorders-3 (ICHD-3). Results In total, 80 patients (34.9%) had primary headaches, including 47 (20.5%) with migraine and probable migraine and 33 (14.4%) with TTH and probable TTH. We found a significant difference in the Numerical Rating Scale score, nausea and vomiting, photophobia, phonophobia, and aggravation by routine physical activity between migraine and TTH. The specificities for a migraine diagnosis were 100% and 93.9% for nausea/vomiting and photophobia, respectively. Only 8.8% of patients had their headaches diagnosed by a physician. Conclusion Migraines have a high prevalence (>20%) among nurses and are often under-diagnosed. In many cases, headache-associated symptoms are more important than laterality or other characteristics for the diagnosis. Many nurses are treated for headaches without a correct diagnosis. Further education regarding primary headaches may be necessary for health practitioners as well as society.

Eptinezumab-jjmr, a humanized monoclonal specific to Calcitonin Gene Related Peptide, for the preventive treatment of migraine in adults.

Migraines are prevalent and cause significant morbidity, decline in quality of life and healthcare costs universally. Treatment options are varied, but efficacy is limited. This review centers on Eptinezumab-jjmr, a humanized monoclonal specific to CGRP for the prevention of migraines in adults. Herein presented are the science and mechanism of action, indication and clinical evidence for use. Migraines are severe, recurrent headaches, which are either episodic or chronic in nature. The pain is severe, often accompanied by co-morbid symptoms, such as photophobia, phonophobia, nausea and emesis, and is limiting in nature. It is a prevalent disorder that causes significant, worldwide disability, morbidity, suffering, and costs.The pathophysiology of migraines is actively studied, though recent research points to an initiating event causing migraine generation, that is then propagated by other brain regions, a significant one being the trigeminocervical complex. This is driven by biochemical transmitters, chiefly CGRP. This discovery led to the development of CGRP-targeting drugs, including gepants (small molecular antagonists) and anti-CGRP antibodies, such as Eptinezumab-jjmr.Traditional therapy includes preventative and abortive treatment; however, adherence with preventative treatment has been historically poor, and certain types of abortive therapy carry risks and side effects that preclude them from a large patient population. Moreover, traditional therapy often falls short in migraine therapy. CGRP antagonist, including Eptinezumab, aims to cover the gaps in migraine therapy. We present here evidence to support the safe and effective use of Eptinezumab for the prevention of migraines. Migraines are a prevalent primary headache disorder causing significant morbidity worldwide. Traditional abortive and preventative treatments fall short for many patients. Eptinezumab is part of new generation of CGRP-targeting medications and has shown significant evidence to support its use for the prevention of migraines. Further research is required to properly compare eptinezumab with existing pharmacotherapy and update guidelines on the appropriate combinations of therapies that are not available and the correct patient selection for each.

CGRP and CGRP-Receptor as Targets of Migraine Therapy: Brain Prize-2021.

Migraine is a highly prevalent primary headache with an unclear pathomechanism. During the last 40 years, numerous hypotheses have arisen; among them, the theory of the trigeminovascular system is the primary one. It serves as a skeleton in successful preclinical studies and in the development of effective therapeutic options for migraine headache. The brain prize (awarded annually by the Lundbeck Foundation) is the most prestigious tribute in neuroscience. The winners in 2021 were Lars Edvinsson, Peter Goadsby, Michael Moskowitz and Jes Olesen. They are the fathers of migraine pathomechanism, which led to revolutionary new treatments. This review summarizes their landmark findings. Data related to this topic were reviewed from PubMed records published between 1979 and May 2021. Searches were based on preclinical and clinical studies in the covered field. The findings were listed in chronological order. From a therapeutic perspective, only randomized controlled trials and meta-analysis were discussed. The calcitonin gene-related peptide-related pathogenesis of migraine is based on the activation of the trigeminovascular system. The therapeutic triad for migraine is triptans, gepants, and calcitonin gene-related peptide-targeted monoclonal antibodies. In the past 40 years, the systematic work of leading headache scientists has resulted in robust theoretical and therapeutic knowledge in the preclinical and clinical study of migraine.

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.

The prevalence and impact of primary headaches in orphaned children: a cross-sectional, observational study in a boarding school

ABSTRACT The relationship between headache and stressful life events experienced in childhood has been found mostly associated with recurrent primary headaches and headache chronicity. We aimed to investigate the prevalence, clinical characteristics, daily life impact of migraine and tension-type headache in orphaned children with low income in a boarding school. Four hundred and fifteen permanent boarders aged 12–17 years were evaluated using the Structured Headache Questionnaire, the Pediatric Migraine Disability Assessment Scale (PedMIDAS), the Strength and Difficulties Questionnaire and Visual Analogue Scale (VAS). Prevalence of primary headache was 59.8%; 24.1% for migraine; 35.7% for tension-type headache; 4.1% for chronic migraine; and 2.4% for chronic tension-type headache. Prevalence of probable diagnoses was found to be higher in early ages; however, definite diagnoses became more common with age. Sex distribution was affected by age in migraineurs. The most distinctive features separating migraine were high frequency, pain severity, throbbing/pounding nature, photophobia, phonophobia, nausea, vomiting, and aggravated by physical activity. Prodromal symptoms and triggering factors were more closely associated with migraine. Sleep was the most common method to relieve of headache, taking medicines was preferred more commonly in migraineurs with a higher mean number of analgesics. Mean VAS, PedMIDAS, and total difficulty scores were higher in migraineurs, emotional problems were found increased in migraine. Headache is underestimated in pediatric population when probable diagnoses are not evaluated. The prevalence of primary headaches and the risk of chronic headaches are high in orphaned students, especially in older adolescent girls, and the effect of headache on daily life is evident.

Prevalence and Characteristics of Primary Headache as well as Coping Strategies among Medical Students of Taibah University

Background: Primary headaches are more prevalent than secondary headache, accounted for about 90% of cases. Prevalence of headache among university students was high. Moreover, medical students have higher prevalence of all headache types than other university students. Aims of our study were to investigate the prevalence and character of primary headache as well as coping strategies among medical students. Subjects and Methods: A cross sectional observational study was conducted among a sample of medical students (from 2nd to 6th academic years) at Taibah University in Al-Madinah, Kingdom of Saudi Arabia (KSA). A self-administrated valid English questionnaire was applied, which contains demographics of students, 23 questions about the primary headache character and coping strategies used with headache. Results: The study included 488 medical students. Their age ranged between 18 to 26 years with a mean (±) SD of 21.78±1.41. Females represented 58% of them. The prevalence of primary headache among the participants was 94.9%. Regarding the usual site of the primary headache, frontal ranked first (41.5%), followed by generalized (34.8%), temporal (32.8%) and orbital (22.7%). The commonest reported quality of primary headache was pressing/tightening (60.9%). The commonest reported therapy/medication was paracetamol (69.8%), followed by sleeping (54%), and caffeine (26.1%). Academic level was not affected by 54.5% of male students compared to 42.8% of females. This difference was statistically significant, p=0.041. Conclusion: Primary headache is very prevalent among medical students at Taibah University, with no difference between them according to age, gender and academic level. It impacts the academic performance of a considerable proportion of the students, particularly males.