The journal of headache and pain
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Observational Study
Analysis of free-living daytime movement in patients with migraine with access to acute treatment.
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. ⋯ 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.
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Review Meta Analysis
Prediction models for treatment response in migraine: a systematic review and meta-analysis.
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. ⋯ 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.
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Randomized Controlled Trial
Effects of neck-exercise and health promotion on headache outcomes in office workers: secondary analysis of the NEXpro stepped wedge cluster randomised controlled trial.
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. ⋯ 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.
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To assess the effect of modeling free water (FW) on the identification of white matter (WM) microstructure alterations using diffusion Magnetic Resonance Imaging (dMRI) in episodic migraine without aura patients compared with healthy controls. ⋯ These findings suggest WM alterations in these migraine patients in comparison with control subjects, in accordance with other migraine studies. Differences in the diffusion parameters might point to inflammatory processes in migraine related to cellular swelling.
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Changes in large-scale brain networks have been reported in migraine patients, but it remains unclear how these manifest in the various phases of the migraine cycle. Case-control fMRI studies spanning the entire migraine cycle are lacking, precluding a complete assessment of brain functional connectivity in migraine. Such studies are essential for understanding the inherent changes in the brain of migraine patients as well as transient changes along the cycle. Here, we leverage the concept of functional connectome (FC) fingerprinting, whereby individual subjects may be identified based on their FC, to investigate changes in FC and its stability across different phases of the migraine cycle. ⋯ Our novel multilevel clinical connectome fingerprinting approach captured FC variations along the migraine cycle in a case-control longitudinal study, bringing new insights into the cyclic nature of the disorder.