2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T990,Migraine has been linked to an increased risk of glaucoma, and our study aims to assess the temporal association between calcitonin gene-related peptide inhibitors (CGRPi) and the risks of glaucoma in individuals with migraine. This multinational retrospective cohort study included adults diagnosed with migraine who received migraine preventive medications in 2018-2024. Participants were categorized into the CGRPi group (erenumab, fremanezumab, galcanezumab, eptinezumab, atogepant, or rimegepant) and non-CGRPi group (valproate, topiramate, flunarizine, candesartan, lisinopril, metoprolol, propranolol, nadolol, amitriptyline, and venlafaxine). Crossovers were not allowed, and the non-CGRPi group included only individuals who never used CGRPi. The CGRPi and non-CGRPi groups were propensity score matched in a 1:1 ratio and were followed for up to 3 years to monitor the occurrence of incident glaucoma. The Cox proportional hazards model was used to compare the risk of glaucoma between CGRPi and non-CGRPi users, with results reported as hazard ratios (HRs) and 95% CIs. A total of 73,644 individuals were included in the final analysis. Compared with non-CGRPi users, CGRPi users experience a lower risk of glaucoma development (HR 0.75; 95% CI 0.61-0.92) within 3 years since its first prescription. Individuals using CGRPi also exhibit a reduced risk of glaucoma compared with those using topiramate (HR 0.73; 95% CI 0.59-0.90), valproate (HR 0.54; 95% CI 0.35-0.83), propranolol (HR 0.76; 95% CI 0.59-0.98), metoprolol (HR 0.76; 95% CI 0.59-0.98), lisinopril (HR 0.49; 95% CI 0.38-0.62), amitriptyline (HR 0.69; 95% CI 0.54-0.89), and venlafaxine (HR 0.68; 95% CI 0.50-0.91). In the analysis that further classified participants based on the specific CGRPi used, only users of monoclonal antibody CGRPi show a reduced risk of glaucoma compared with non-CGRPi users (HR 0.77; 95% CI 0.61-0.98). The reduced risk of glaucoma associated with CGRPi is also observed in older adults, women, and those with chronic migraine or migraine without aura. Among adults with migraine receiving preventive treatment, systemic use of CGRPi, particularly monoclonal antibody CGRPi, is associated with a reduced risk of glaucoma compared with the use of other migraine preventive medications. This is a Class II study demonstrating that CGRPi users with migraine have a lower risk of incident glaucoma when compared with non-CGRPi users with migraine.31:T1290,Migraine is a common presentation in pediatric emergency departments (ED), and non-invasive treatment options are desirable. This study evaluated what proportion of children treated with oral metoclopramide would not need a rescue medication for the treatment of migraine in the ED. We conducted a retrospective cohort study at a tertiary pediatric ED in Montréal, Canada, over a one-year period. Patients aged 8-18 years diagnosed with migraine and treated with either oral or intravenous metoclopramide were included. The primary outcome was headache relief, defined as no need for rescue medication. Secondary outcomes included ED length of stay, adverse events, return visits within 7 days, and reduction in pain scores measured by the 10-point verbal numeric rating scale. The primary analysis was the proportion of children who did not need a rescue medication restricted to children treated with oral metoclopramide. Secondary exploratory analyses compared oral to intravenous administrations on primary and secondary outcomes. Of the 225 patients included, 78 received oral and 147 received intravenous metoclopramide. Headache relief was achieved in 83% (95% CI 73-91%) of the oral group. This compared favorably to the intravenous group (difference: 4%; 95% CI -7 to 14%). ED length of stay was shorter in the oral group (median 314 vs 500 min). Adverse events occurred only in the intravenous group (4%) and return visit proportions were similar between groups (difference 2%; 95% CI - 6 to 12%). Oral metoclopramide is an effective and well-tolerated treatment for 80% of children with migraine in the ED. On exploratory evaluation, it offered comparable outcomes to intravenous administration with the added benefits of shorter ED stays and reduced procedural pain. Oral metoclopramide should be considered as a first-line treatment option for pediatric migraine in the emergency department. RéSUMé: OBJECTIFS: La migraine est un motif de consultation fréquent dans les services d’urgence pédiatrique (SU). Dans ce contexte, le recours à des options théerapeutiques non invasives est souhaitable. Cette étude a pour objectif d'évaluer la proportion d’enfants traités avec du métoclopramide oral ne nécessitant pas l'administration d'un médicament de secours supplémentaire pour le traitement de la migraine au sein du SU. MéTHODES: Nous avons mené une étude de cohorte rétrospective dans un service pédiatrique tertiaire à Montréal, au Canada, sur une période d’un an. Les patients âgés de 8 à 18 ans ayant été diagnostiqué d'une migraine et traités par métoclopramide oral ou intraveineux ont été inclus. Le principal critère de jugement était le contrôle des symptômes migraineux, défini comme la proportion d'enfants ne nécessitant pas l'administration d'un médicament de secours supplémentaire. Les résultats secondaires comprenaient la durée du séjour à l'urgence pédiatrique, les événements indésirables, les visites de retour dans les 7 jours et la réduction du score de douleur mesurée par l’échelle numérique verbale sur 10 points. L’analyse principale concernait la proportion d’enfants qui n’ont pas eu besoin d’un médicament de secours dans le groupe d'enfants traités par métoclopramide oral. Les analyses secondaires ont comparé les groupes d'enfants ayant reçu le médicament oral à intraveineux sur les critères de jugement primaires et secondaires. RéSULTATS: Sur les 225 patients inclus, 78 ont reçu le métoclopramide par voie orale et 147 par voie intraveineuse. Le contrôle des symptômes migraineux a été atteint dans 83 % des patients (IC à 95 % 7391 %) du groupe oral. Cela a été associé à des résultats comparable au groupe intraveineux (différence : 4 %; IC à 95 % – 7 à 14 %). La durée de séjour au sein du service d'urgence pédiatrique était plus courte dans le groupe oral (médiane 314 minutes contre 500 minutes). Les événements indésirables sont survenus uniquement dans le groupe intraveineux (4 %) et de visites de retour étaient similaires entre les deux groupes (différence 2 % ; IC à 95 % – 6 à 12 %). CONCLUSIONS: Le métoclopramide par voie orale est un traitement efficace et bien toléré pour 80 % des enfants atteints de migraine à l'urgence pédiatrique. Lors de l'analyse secondaire des résultats comparables entre les 2 groupes ont été retrouvés avec les avantages supplémentaires d’une durée de séjour plus courte et d’une douleur procédurale réduite dans le groupe traité par voie orale. Le métoclopramide oral doit être considéré comme une option de traitement de première intention pour la migraine pédiatrique au service des urgences.32:T748,Migraine activity is shaped not only by the biological vulnerability but also by environmental factors that may influence susceptibility and contribute to fluctuations in migraine occurrence, although the evidence remains inconsistent. We aimed to evaluate the intermediate-term and short-term effects of environmental exposures on migraine activity and to examine a conceptual layered model comprising biological vulnerability, intermediate-term environmental modulators, and acute triggers. We conducted a population-based case-crossover study among patients with migraine identified from the Negev Migraine Cohort (2000-2023), using electronic medical records from Clalit Health Services and Soroka University Medical Center. Eligible participants were adult patients (≥18 years) residing in Be'er Sheva, Israel, with migraine diagnoses or triptan prescriptions. Daily exposure to air pollutants and meteorologic conditions were obtained from fixed monitoring stations. Outcomes were emergency migraine-related encounters as a marker of triggered events and quarterly triptan use as a marker for disease activity. Intermediate-term modulators were defined as weekly climatic conditions hypothesized to modify the short-term effects of daily exposures. Associations were evaluated using conditional logistic and Poisson regression. The analysis included 7,032 adult patients with migraine residing in Be'er Sheva. Short-term exposure to nitrogen dioxide (NO Short-term and cumulative exposure to ambient air pollution and climatic factors were associated with increased migraine activity. Although these findings support a layered model of environmental modulation of migraine activity, their generalizability is limited by the use of emergency health care encounters as a proxy outcome, underscoring the need for further research using complementary measures.33:T882,Topiramate has been linked to increased glaucoma risk, potentially through mechanisms involving ocular fluid shifts. However, comparative risks vs other antiseizure medications (ASMs) and variation by sex or indication remain uncertain. This study evaluates glaucoma incidence in topiramate initiators compared to valproate or lamotrigine users among patients with epilepsy or migraine. We conducted a retrospective active-comparator, new-user cohort study using electronic health records from the IQVIA Medical Research Data among patients with epilepsy or migraine initiating topiramate, valproate, or lamotrigine. Patients with prior ASM use, limited washout period and follow-up, or pre-existing glaucoma were excluded. The outcome was incident glaucoma within 1 year, censored at glaucoma occurrence, death, discontinuation, switch, or September 30, 2023. Covariates included age, sex, race, lifestyle factors, comorbidities, and medication history. Propensity score-based inverse probability weighting balanced characteristics, and crude and weighted Cox models estimated hazard ratios (HRs) with 95% confidence intervals (CIs). Subgroup analyses were conducted by sex, age, and indication. The cohort included 688 topiramate, 4490 valproate, and 4179 lamotrigine initiators. After weighting, the 1-year absolute risk increase was approximately 2.4% when comparing topiramate to valproate, and about 2.0% compared to lamotrigine. Topiramate was associated with higher glaucoma risk vs valproate (adjusted HR 2.66, 95% CI 1.12-6.32) and lamotrigine (adjusted HR 3.57, 95% CI 1.76-7.26). Risks were elevated in female (vs valproate: HR 5.31, 95% CI 1.48-19.08; vs lamotrigine: HR 5.73, 95% CI 2.38-13.79) or epilepsy patients (vs valproate: HR 2.23, 95% CI 1.04-4.76; vs lamotrigine: HR 5.08, 95% CI 2.32-11.14), but not in male or migraine patients. Topiramate use substantially increases glaucoma risk compared with valproate and lamotrigine, particularly among female or epilepsy patients. No significant association in male or migraine patients was observed. These findings may inform targeted ophthalmologic monitoring in high-risk groups and use of alternative ASMs.34:Tb19,Abstract Objective Topiramate has been linked to increased glaucoma risk, potentially through mechanisms involving ocular fluid shifts. However, comparative risks vs other antiseizure medications (ASMs) and variation by sex or indication remain uncertain. This study evaluates glaucoma incidence in topiramate initiators compared to valproate or lamotrigine users among patients with epilepsy or migraine. Methods We conducted a retrospective active‐comparator, new‐user cohort study using electronic health records from the IQVIA Medical Research Data among patients with epilepsy or migraine initiating topiramate, valproate, or lamotrigine. Patients with prior ASM use, limited washout period and follow‐up, or pre‐existing glaucoma were excluded. The outcome was incident glaucoma within 1 year, censored at glaucoma occurrence, death, discontinuation, switch, or September 30, 2023. Covariates included age, sex, race, lifestyle factors, comorbidities, and medication history. Propensity score–based inverse probability weighting balanced characteristics, and crude and weighted Cox models estimated hazard ratios (HRs) with 95% confidence intervals (CIs). Subgroup analyses were conducted by sex, age, and indication. Results The cohort included 688 topiramate, 4490 valproate, and 4179 lamotrigine initiators. After weighting, the 1‐year absolute risk increase was approximately 2.4% when comparing topiramate to valproate, and about 2.0% compared to lamotrigine. Topiramate was associated with higher glaucoma risk vs valproate (adjusted HR 2.66, 95% CI 1.12–6.32) and lamotrigine (adjusted HR 3.57, 95% CI 1.76–7.26). Risks were elevated in female (vs valproate: HR 5.31, 95% CI 1.48–19.08; vs lamotrigine: HR 5.73, 95% CI 2.38–13.79) or epilepsy patients (vs valproate: HR 2.23, 95% CI 1.04–4.76; vs lamotrigine: HR 5.08, 95% CI 2.32–11.14), but not in male or migraine patients. Significance Topiramate use substantially increases glaucoma risk compared with valproate and lamotrigine, particularly among female or epilepsy patients. No significant association in male or migraine patients was observed. These findings may inform targeted ophthalmologic monitoring in high‐risk groups and use of alternative ASMs. 35:T975,To assess the efficacy of cannabis for the treatment of acute migraine. Preclinical and retrospective studies suggest cannabinoids may be effective in migraine treatment. However, there have been no randomized clinical trials examining the efficacy of cannabinoids for acute migraine. In this randomized, double-blind, placebo-controlled, crossover trial, adults with migraine treated up to four separate migraine attacks, one each with vaporized (1) 6% Δ9-tetrahydrocannabinol (THC) (THC-dominant), (2) 11% cannabidiol (CBD) (CBD-dominant), (3) 6% THC + 11% CBD, and (4) placebo cannabis flower in a randomized order. Washout period between treated migraine attacks was ≥1 week. The primary endpoint was pain relief, and secondary endpoints were pain freedom and most bothersome symptom freedom, all assessed at 2-h post-vaporization. Ninety-two participants were enrolled and randomized, and 247 migraine attacks were treated. THC + CBD was superior to placebo at achieving pain relief (67.2% vs. 46.6%, odds ratio [95% confidence interval] 2.85 [1.22, 6.65], p = 0.016), pain freedom (34.5% vs. 15.5%, 3.30 [1.24, 8.80], p = 0.017), and most bothersome symptom freedom (60.3% vs. 34.5%, 3.32 [1.45, 7.64], p = 0.005) at 2 h, as well as sustained pain freedom at 24 h and sustained most bothersome symptom freedom at 24 and 48 h. THC-dominant was superior to placebo for pain relief (68.9% vs. 46.6%, 3.14 [1.35, 7.30], p = 0.008) but not pain freedom or most bothersome symptom freedom at 2 h. CBD-dominant was not superior to placebo for pain relief, pain freedom, or most bothersome symptom freedom at 2 h. There were no serious adverse events. Acute migraine treatment with 6% THC + 11% CBD was superior to placebo at 2-h post-treatment with sustained benefits at 24 and 48 h. Many people with migraine self‐treat with cannabinoids or are interested in using cannabinoids to treat migraine. In this double‐blind study, people with migraine treated up to 4 migraine attacks, 1 attack was treated with each of 3 vaporized cannabis flower treatments (THC 6%, CBD 11%, and THC 6% + CBD 11%) or placebo cannabis flower without THC or CBD, within the first 4 h of migraine attack onset. Four puffs of cannabis flower containing THC 6% + CBD 11% was superior to placebo at treating migraine attacks, though the study did not examine the long‐term effects of frequent use.36:Tb9a,Abstract Objective To assess the efficacy of cannabis for the treatment of acute migraine. Background Preclinical and retrospective studies suggest cannabinoids may be effective in migraine treatment. However, there have been no randomized clinical trials examining the efficacy of cannabinoids for acute migraine. Methods In this randomized, double‐blind, placebo‐controlled, crossover trial, adults with migraine treated up to four separate migraine attacks, one each with vaporized (1) 6% Δ9‐tetrahydrocannabinol (THC) (THC‐dominant), (2) 11% cannabidiol (CBD) (CBD‐dominant), (3) 6% THC + 11% CBD, and (4) placebo cannabis flower in a randomized order. Washout period between treated migraine attacks was ≥1 week. The primary endpoint was pain relief, and secondary endpoints were pain freedom and most bothersome symptom freedom, all assessed at 2‐h post‐vaporization. Results Ninety‐two participants were enrolled and randomized, and 247 migraine attacks were treated. THC + CBD was superior to placebo at achieving pain relief (67.2% vs. 46.6%, odds ratio [95% confidence interval] 2.85 [1.22, 6.65], p = 0.016), pain freedom (34.5% vs. 15.5%, 3.30 [1.24, 8.80], p = 0.017), and most bothersome symptom freedom (60.3% vs. 34.5%, 3.32 [1.45, 7.64], p = 0.005) at 2 h, as well as sustained pain freedom at 24 h and sustained most bothersome symptom freedom at 24 and 48 h. THC‐dominant was superior to placebo for pain relief (68.9% vs. 46.6%, 3.14 [1.35, 7.30], p = 0.008) but not pain freedom or most bothersome symptom freedom at 2 h. CBD‐dominant was not superior to placebo for pain relief, pain freedom, or most bothersome symptom freedom at 2 h. There were no serious adverse events. Conclusion Acute migraine treatment with 6% THC + 11% CBD was superior to placebo at 2‐h post‐treatment with sustained benefits at 24 and 48 h. 37:T540,In 2021, of the US population of 332.7 million, disorders affecting nervous system health impacted 180.3 million (95% UI, 170.7 million to 190.4 million) US individuals and were the top cause of disability, with 16.6 million (95% UI, 12.9 million to 20.9 million) DALYs. The most prevalent conditions were tension-type headache (121.9 million; 95% UI, 109.4 million to 135.1 million), migraine (57.7 million; 95% UI, 50.1 million to 66.1 million), and diabetic neuropathy (17.1 million; 95% UI, 14.4 million to 19.9 million). Conditions with the greatest collective disability were stroke (3.9 million DALYs; 95% UI, 3.5 million to 4.2 million DALYs), Alzheimer disease and other dementias (3.3 million DALYs; 95% UI, 1.6 million to 6.9 million DALYs), diabetic neuropathy (2.2 million DALYs; 95% UI, 1.5 million to 3.0 million DALYs), and migraine (2.1 million DALYs; 95% UI, 0.4 million to 4.6 million DALYs). Compared with age-standardized metrics in 1990, the prevalence of disorders affecting the nervous system was nearly identical (-0.2%; 95% UI, -1.5% to 1.9%), with decreased attributable deaths (-14.6%; 95% UI, -18.3% to -11.3%) but increased YLDs (9.8%; 95% UI, 4.6% to 16.6%). By state, Mississippi, Alabama, and Louisiana had the largest age-standardized DALY rates, while New York, Massachusetts, and New Jersey had the smallest.38:Ta77,Nervous system health is a major contributor to population health, which is directly affected by neurological conditions and other disorders where nervous system damage occurs. To quantify aggregated health loss from diseases affecting the nervous system, including neurological disorders; neurodevelopmental disorders; congenital, neonatal, and systemic illnesses; and infectious diseases in the United States. This is a cross-sectional study of the Global Burden of Disease 2021 study data for nervous system health loss confined to the United States from 1990 through 2021 among the entire US population. Data analysis was performed from December 2021 to January 2025. Thirty-six unique conditions that cause harm to the nervous system. Totals and age-standardized estimates with 95% uncertainty intervals (UIs) for disability-adjusted life-years (DALYs), years lived with disability (YLDs), years of life lost (YLLs), total attributable deaths (where applicable), and prevalence. In 2021, of the US population of 332.7 million, disorders affecting nervous system health impacted 180.3 million (95% UI, 170.7 million to 190.4 million) US individuals and were the top cause of disability, with 16.6 million (95% UI, 12.9 million to 20.9 million) DALYs. The most prevalent conditions were tension-type headache (121.9 million; 95% UI, 109.4 million to 135.1 million), migraine (57.7 million; 95% UI, 50.1 million to 66.1 million), and diabetic neuropathy (17.1 million; 95% UI, 14.4 million to 19.9 million). Conditions with the greatest collective disability were stroke (3.9 million DALYs; 95% UI, 3.5 million to 4.2 million DALYs), Alzheimer disease and other dementias (3.3 million DALYs; 95% UI, 1.6 million to 6.9 million DALYs), diabetic neuropathy (2.2 million DALYs; 95% UI, 1.5 million to 3.0 million DALYs), and migraine (2.1 million DALYs; 95% UI, 0.4 million to 4.6 million DALYs). Compared with age-standardized metrics in 1990, the prevalence of disorders affecting the nervous system was nearly identical (-0.2%; 95% UI, -1.5% to 1.9%), with decreased attributable deaths (-14.6%; 95% UI, -18.3% to -11.3%) but increased YLDs (9.8%; 95% UI, 4.6% to 16.6%). By state, Mississippi, Alabama, and Louisiana had the largest age-standardized DALY rates, while New York, Massachusetts, and New Jersey had the smallest. Disorders affecting the nervous system are highly prevalent and cause disability for millions of US individuals, with reduced mortality leading to more YLDS. The United States should prioritize efforts to combat these conditions with development and implementation of new and effective prevention strategies, therapeutics, and focused rehabilitation.39:Tf54, Importance Nervous system health is a major contributor to population health, which is directly affected by neurological conditions and other disorders where nervous system damage occurs. Objective To quantify aggregated health loss from diseases affecting the nervous system, including neurological disorders; neurodevelopmental disorders; congenital, neonatal, and systemic illnesses; and infectious diseases in the United States. Design, Setting, and Participants This is a cross-sectional study of the Global Burden of Disease 2021 study data for nervous system health loss confined to the United States from 1990 through 2021 among the entire US population. Data analysis was performed from December 2021 to January 2025. Exposure Thirty-six unique conditions that cause harm to the nervous system. Main Outcomes and Measures Totals and age-standardized estimates with 95% uncertainty intervals (UIs) for disability-adjusted life-years (DALYs), years lived with disability (YLDs), years of life lost (YLLs), total attributable deaths (where applicable), and prevalence. Results In 2021, of the US population of 332.7 million, disorders affecting nervous system health impacted 180.3 million (95% UI, 170.7 million to 190.4 million) US individuals and were the top cause of disability, with 16.6 million (95% UI, 12.9 million to 20.9 million) DALYs. The most prevalent conditions were tension-type headache (121.9 million; 95% UI, 109.4 million to 135.1 million), migraine (57.7 million; 95% UI, 50.1 million to 66.1 million), and diabetic neuropathy (17.1 million; 95% UI, 14.4 million to 19.9 million). Conditions with the greatest collective disability were stroke (3.9 million DALYs; 95% UI, 3.5 million to 4.2 million DALYs), Alzheimer disease and other dementias (3.3 million DALYs; 95% UI, 1.6 million to 6.9 million DALYs), diabetic neuropathy (2.2 million DALYs; 95% UI, 1.5 million to 3.0 million DALYs), and migraine (2.1 million DALYs; 95% UI, 0.4 million to 4.6 million DALYs). Compared with age-standardized metrics in 1990, the prevalence of disorders affecting the nervous system was nearly identical (−0.2%; 95% UI, −1.5% to 1.9%), with decreased attributable deaths (−14.6%; 95% UI, −18.3% to −11.3%) but increased YLDs (9.8%; 95% UI, 4.6% to 16.6%). By state, Mississippi, Alabama, and Louisiana had the largest age-standardized DALY rates, while New York, Massachusetts, and New Jersey had the smallest. Conclusions and Relevance Disorders affecting the nervous system are highly prevalent and cause disability for millions of US individuals, with reduced mortality leading to more YLDS. The United States should prioritize efforts to combat these conditions with development and implementation of new and effective prevention strategies, therapeutics, and focused rehabilitation. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Migraine: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Migraine (condition). Clinician-written summaries and actionable practice insights. Updated daily.\",\"url\":\"https://www.reachrx.ai/hub/tag/condition/Migraine\",\"breadcrumb\":{\"@type\":\"BreadcrumbList\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https://www.reachrx.ai\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Research Hub\",\"item\":\"https://www.reachrx.ai/hub\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Conditions\",\"item\":\"https://www.reachrx.ai/hub/tag/condition\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Migraine\",\"item\":\"https://www.reachrx.ai/hub/tag/condition/Migraine\"}]}}"}}]],["$","$L2f",null,{"title":"Migraine: Research & Clinical Takeaways","description":"Discover peer-reviewed research on Migraine with concise clinician summaries and next-step guidance.","papers":[{"doi":"10.1212/wnl.0000000000214881","pmid":"42673560","title":"Pharmacologic Treatment for Migraine Prevention in Adults Practice Guideline Recommendations","journal_title":"Neurology","journal_issn":"0028-3878","published_at":"2026-08-31T00:00:00.000Z","url":"https://doi.org/10.1212/wnl.0000000000214881","source_score":25,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-03T06:20:02.191Z","updated_at":"2026-09-03T06:20:02.191Z","tags":[{"paper_doi":"10.1212/wnl.0000000000214881","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214881","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214881","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214881","tag_type":"condition","value":"Medication Overuse Headache","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214881","tag_type":"condition","value":"Migraine","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214881","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214881","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214881","tag_type":"modality","value":"Migraine Preventive Pharmacotherapy","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214881","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214881","tag_type":"study_design","value":"Clinical Practice Guideline","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214881","tag_type":"warning","value":"Level of evidence assigned as '1' reflects the AAN guideline methodology (systematic review-backed CPG), not a single RCT; interpret accordingly.","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214881","tag_type":"warning","value":"Only the abstract was available; specific drug recommendations, recommendation grades (A/B/C), and numeric outcomes cannot be extracted without the full text.","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214881","tag_type":"warning","value":"The companion systematic review publication is referenced but not provided — individual drug-level evidence ratings are not assessable here.","value_numeric":null}],"summaries":{"what_studied":"A multidisciplinary panel conducted a systematic review (studies through June 6, 2024) and developed updated AAN practice guideline recommendations on pharmacologic migraine prevention in adults, covering when to start preventive therapy, which agents to choose, and special populations (e.g., pregnancy, lactation, obesity, hypertension, fibromyalgia, older adults, medication overuse).","key_result":"Evidence-based recommendations were issued covering: initiation criteria for preventive therapy, agent selection by comorbidity and population, assessment of efficacy and adverse effects, and criteria for discontinuation — though specific numeric thresholds or effect sizes are not reported in the abstract.","limitations":"Abstract-only source; specific recommendation grades, evidence levels for individual drugs, and full supporting data are not available here. The full systematic review is in a companion publication, limiting direct appraisal of the underlying evidence quality.","practice_takeaway":"Clinicians should use this AAN guideline to guide decisions on when to start migraine prevention and which agent to select, with particular attention to patient comorbidities (e.g., obesity, hypertension, fibromyalgia) and special situations (pregnancy, lactation, medication overuse, older adults). Review the companion systematic review for the underlying evidence supporting each recommendation."}},{"doi":"10.1111/head.70199","pmid":"42673606","title":"Pharmacologic Treatment for Migraine Prevention in Adults Practice Guideline Recommendations","journal_title":"Headache: The Journal of Head and Face Pain","journal_issn":"0017-8748","published_at":"2026-08-31T00:00:00.000Z","url":"https://doi.org/10.1111/head.70199","source_score":12,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-04T06:22:20.746Z","updated_at":"2026-09-04T06:22:20.746Z","tags":[{"paper_doi":"10.1111/head.70199","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1111/head.70199","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1111/head.70199","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1111/head.70199","tag_type":"condition","value":"Medication Overuse Headache","value_numeric":null},{"paper_doi":"10.1111/head.70199","tag_type":"condition","value":"Migraine","value_numeric":null},{"paper_doi":"10.1111/head.70199","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1111/head.70199","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1111/head.70199","tag_type":"modality","value":"Antiepileptic","value_numeric":null},{"paper_doi":"10.1111/head.70199","tag_type":"modality","value":"Antihypertensive","value_numeric":null},{"paper_doi":"10.1111/head.70199","tag_type":"modality","value":"CGRP Pathway Antagonist","value_numeric":null},{"paper_doi":"10.1111/head.70199","tag_type":"modality","value":"Migraine Preventive Therapy","value_numeric":null},{"paper_doi":"10.1111/head.70199","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/head.70199","tag_type":"study_design","value":"Clinical Practice Guideline","value_numeric":null},{"paper_doi":"10.1111/head.70199","tag_type":"warning","value":"No specific drugs, effect sizes, or number of included studies are reported in the abstract; tags for specific agents (generics/brands) could not be confirmed and were omitted to avoid speculation.","value_numeric":null},{"paper_doi":"10.1111/head.70199","tag_type":"warning","value":"Study design labeled as 'Clinical Practice Guideline' rather than a primary research design; the companion systematic review is a separate publication.","value_numeric":null},{"paper_doi":"10.1111/head.70199","tag_type":"warning","value":"The guideline is categorized as Level of Evidence 1 based on its AAN systematic-review-backed guideline process, but individual recommendation strengths vary and require consulting the full document and companion systematic review.","value_numeric":null}],"summaries":{"what_studied":"This AAN-process practice guideline evaluated pharmacologic migraine prevention in adults, synthesizing evidence from a systematic review of studies through June 6, 2024, to produce updated recommendations on when to start preventive therapy, which agents to choose, and how to manage special populations (e.g., pregnancy, obesity, hypertension, older adults, medication overuse).","key_result":"The guideline provides evidence-based recommendations covering: initiation criteria for preventive therapy, agent selection by comorbidity (fibromyalgia, obesity, hypertension), special considerations for older adults, pregnancy and lactation safety, sex-related prescribing factors, management of medication overuse, and structured guidance on assessing efficacy, adverse effects, and discontinuation.","limitations":"The abstract does not report specific effect sizes or number of studies included; full appraisal of evidence quality and strength of individual recommendations requires review of the companion systematic review publication.","practice_takeaway":"Clinicians should use this guideline as a structured framework for individualizing migraine preventive therapy—particularly when managing patients with comorbidities or during pregnancy—guided by the specific population-based recommendations. Assessment of treatment efficacy and a clear discontinuation plan should be built into every preventive treatment strategy."}},{"doi":"10.1126/sciimmunol.aee5151","pmid":"42600043","title":"Fusion of IgG antibodies to albumin inhibits transport across the placenta","journal_title":"Science Immunology","journal_issn":"2470-9468","published_at":"2026-08-14T00:00:00.000Z","url":"https://doi.org/10.1126/sciimmunol.aee5151","source_score":62,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-22T06:53:35.798Z","updated_at":"2026-08-22T06:53:35.798Z","tags":[{"paper_doi":"10.1126/sciimmunol.aee5151","tag_type":"age_group","value":"neonate","value_numeric":null},{"paper_doi":"10.1126/sciimmunol.aee5151","tag_type":"category","value":"Immunology","value_numeric":null},{"paper_doi":"10.1126/sciimmunol.aee5151","tag_type":"condition","value":"Autoimmune Disease","value_numeric":null},{"paper_doi":"10.1126/sciimmunol.aee5151","tag_type":"condition","value":"Cancer","value_numeric":null},{"paper_doi":"10.1126/sciimmunol.aee5151","tag_type":"condition","value":"Fetal And Neonatal Alloimmune Thrombocytopenia","value_numeric":null},{"paper_doi":"10.1126/sciimmunol.aee5151","tag_type":"condition","value":"Migraine","value_numeric":null},{"paper_doi":"10.1126/sciimmunol.aee5151","tag_type":"generic","value":"albumin-fused IgG","value_numeric":null},{"paper_doi":"10.1126/sciimmunol.aee5151","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1126/sciimmunol.aee5151","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1126/sciimmunol.aee5151","tag_type":"modality","value":"Albumin Fusion Protein","value_numeric":null},{"paper_doi":"10.1126/sciimmunol.aee5151","tag_type":"modality","value":"Fab Fragment","value_numeric":null},{"paper_doi":"10.1126/sciimmunol.aee5151","tag_type":"modality","value":"Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1126/sciimmunol.aee5151","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1126/sciimmunol.aee5151","tag_type":"study_design","value":"Preclinical Animal Study with Ex Vivo Human Model","value_numeric":null},{"paper_doi":"10.1126/sciimmunol.aee5151","tag_type":"warning","value":"No specific sample sizes (N) were reported in the abstract; sample_size tag was omitted.","value_numeric":null},{"paper_doi":"10.1126/sciimmunol.aee5151","tag_type":"warning","value":"Study design is preclinical (mouse models + ex vivo human placental perfusion); no human clinical trial data are available. The 'practice_changing' flag reflects the novelty and translational potential of the finding, not yet validated clinical practice.","value_numeric":null},{"paper_doi":"10.1126/sciimmunol.aee5151","tag_type":"warning","value":"The study covers multiple therapeutic indications (cancer, autoimmune, migraine) but FNAIT is the only condition directly modeled — generalizability to other conditions is inferred, not demonstrated.","value_numeric":null}],"summaries":{"what_studied":"This study evaluated whether fusing IgG antibodies to albumin could block placental transfer via FcRn while preserving plasma half-life, using mouse models and an ex vivo human placental perfusion system — including a fetal and neonatal alloimmune thrombocytopenia (FNAIT) mouse model.","key_result":"IgG–albumin fusion constructs markedly reduced transplacental antibody transport in both mouse and human ex vivo models, maintained prolonged plasma half-life, and attenuated thrombocytopenia in offspring in a FNAIT mouse model; albumin alone was not transported to the fetus despite FcRn binding.","limitations":"Results rely on mouse models and an ex vivo human placental perfusion system — neither fully replicates in vivo human pregnancy pharmacokinetics. Clinical efficacy and safety of IgG–albumin fusions in pregnant humans remain untested.","practice_takeaway":"Fusing therapeutic IgG antibodies to albumin may be a viable strategy to limit fetal drug exposure during pregnancy without sacrificing drug half-life. This approach could be especially relevant for biologics used in conditions like migraine, autoimmune disease, or cancer where pregnancy safety is a concern."}},{"doi":"10.1038/s41562-026-02542-0","pmid":"42575939","title":"Reassurance through normalization inadvertently suppresses treatment","journal_title":"Nature Human Behaviour","journal_issn":"2397-3374","published_at":"2026-08-10T00:00:00.000Z","url":"https://doi.org/10.1038/s41562-026-02542-0","source_score":100,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-17T13:33:18.667Z","updated_at":"2026-08-17T13:33:18.667Z","tags":[{"paper_doi":"10.1038/s41562-026-02542-0","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02542-0","tag_type":"category","value":"Neurosciences","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02542-0","tag_type":"condition","value":"Dental Pain","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02542-0","tag_type":"condition","value":"Diabetes","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02542-0","tag_type":"condition","value":"Menopause","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02542-0","tag_type":"condition","value":"Migraine","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02542-0","tag_type":"condition","value":"Seasonal Allergies","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02542-0","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02542-0","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02542-0","tag_type":"modality","value":"Patient-Provider Communication","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02542-0","tag_type":"sample_size","value":"n=9371","value_numeric":9371},{"paper_doi":"10.1038/s41562-026-02542-0","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02542-0","tag_type":"study_design","value":"Experimental Study (Multi-Study Online Experiments)","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02542-0","tag_type":"warning","value":"Sample sizes per individual experiment vary widely; the aggregate n=9,371 reflects the full multi-study program, not a single trial.","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02542-0","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously: findings are robust across 14 studies but all are online simulations, so direct clinical translation should await replication in healthcare settings.","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02542-0","tag_type":"warning","value":"The study design is experimental/behavioral (online vignettes), not a clinical trial — level of evidence set to 2 given high methodological rigor across 14 pre-registered experiments, but real-world clinical validation is lacking.","value_numeric":null}],"summaries":{"what_studied":"Across 14 experiments (n = 9,371), this study tested whether clinician normalization of symptoms (telling patients their symptoms are 'normal') paradoxically reduces patients' inclination to pursue treatment, and identified communication strategies to counteract this effect.","key_result":"Normalization consistently reduced treatment inclination across all conditions and symptom types (e.g., menopause, dental pain, migraines, allergies, elevated blood glucose). The core mechanism was a shift in perceived injunctive norms — patients inferred the clinician did not support treatment. Two countermeasures worked: adding an explicit pro-treatment cue after normalization (full mediation via injunctive norms, indirect effect ab = 0.31) and reframing normalization as 'cognitive reassurance' (ab = 0.21). The effect was attenuated — but not eliminated — for life-threatening conditions, and persisted even when medication was framed as high-risk/low-benefit.","limitations":"- All experiments were conducted online with vignettes, not in real clinical settings, limiting ecological validity.\n- Samples recruited via CloudResearch Connect may not represent diverse patient or provider populations.\n- Carryover effects were noted in within-subjects designs (Experiment 3), requiring analysis of first-vignette-only data.","practice_takeaway":"When reassuring patients that their symptoms are normal, clinicians should explicitly add a pro-treatment signal (e.g., 'and treatment is still a good option for you') to prevent patients from inferring that treatment is unnecessary. Cognitive reframing — clarifying that normalization addresses anxiety, not treatment need — also preserves patients' inclination to pursue care."}},{"doi":"10.1071/py26029","pmid":"42557043","title":"Triaging general practitioner referrals for specialist review to eConsultant – a pilot study","journal_title":"Australian Journal of Primary Health","journal_issn":"1448-7527","published_at":"2026-08-06T00:00:00.000Z","url":"https://doi.org/10.1071/py26029","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-13T13:23:00.899Z","updated_at":"2026-08-13T13:23:00.899Z","tags":[{"paper_doi":"10.1071/py26029","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1071/py26029","tag_type":"category","value":"Primary Health Care","value_numeric":null},{"paper_doi":"10.1071/py26029","tag_type":"condition","value":"Hyperthyroidism","value_numeric":null},{"paper_doi":"10.1071/py26029","tag_type":"condition","value":"Migraine","value_numeric":null},{"paper_doi":"10.1071/py26029","tag_type":"condition","value":"Osteoporosis","value_numeric":null},{"paper_doi":"10.1071/py26029","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1071/py26029","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1071/py26029","tag_type":"modality","value":"Digital Health / eConsultation","value_numeric":null},{"paper_doi":"10.1071/py26029","tag_type":"sample_size","value":"n=128","value_numeric":128},{"paper_doi":"10.1071/py26029","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1071/py26029","tag_type":"study_design","value":"Pilot Study","value_numeric":null},{"paper_doi":"10.1071/py26029","tag_type":"warning","value":"Level of evidence assigned as 4 (case series/pilot) given single-centre, non-controlled design; no randomisation or blinding.","value_numeric":null},{"paper_doi":"10.1071/py26029","tag_type":"warning","value":"Sample size of 128 refers to total referrals triaged, not individual patients — actual patient count may differ if any patients had multiple referrals.","value_numeric":null},{"paper_doi":"10.1071/py26029","tag_type":"warning","value":"Study design is described as a 'proof of concept' pilot without a comparator arm, making it difficult to attribute outcomes to the eConsultant model specifically.","value_numeric":null},{"paper_doi":"10.1071/py26029","tag_type":"warning","value":"The 14.8% GP survey response rate severely limits the reliability of the care-change finding (9/19 GPs); the majority of referral outcomes are unknown.","value_numeric":null}],"summaries":{"what_studied":"This pilot study assessed the feasibility, acceptability, and appropriateness of triaging GP referrals (endocrinology and neurology) to an asynchronous digital clinician-to-clinician advice service (eConsultant) at Mater Hospital Brisbane over 11 months (October 2024–August 2025), using clinical data, GP surveys, and qualitative interviews with patients, GPs, and specialists.","key_result":"51 (21%) endocrinology and 77 (6%) neurology referrals were triaged to eConsultant; specialists responded in an average of 3.5 business days, spending ~20 minutes per case. Of 19 GP close-out surveys returned (14.8% response rate), 9 reported a change to patient care as a result of eConsultant advice.","limitations":"Very low GP survey response rate (14.8%), limiting generalisability of care-change findings. Single-centre pilot at one Australian hospital with a short 11-month window. No control group or patient outcome data to confirm clinical benefit.","practice_takeaway":"Triaging selected specialist referrals to an asynchronous eConsult service can deliver specialist input in under 4 business days and appears to prompt care changes in roughly half of responding GPs. Clinicians should note that some patients and GPs still prefer or require a face-to-face follow-up after receiving eConsultant advice."}},{"doi":"10.3389/fnins.2026.1848801","pmid":null,"title":"Two paths to the body’s superhighway—the auricular branch (taVNS) and the cervical bundle (tcVNS): a narrative review","journal_title":"Frontiers in Neuroscience","journal_issn":"1662-453X","published_at":"2026-07-15T00:00:00.000Z","url":"https://doi.org/10.3389/fnins.2026.1848801","source_score":35,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-07-18T13:39:59.544Z","updated_at":"2026-07-18T13:39:59.544Z","tags":[{"paper_doi":"10.3389/fnins.2026.1848801","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.3389/fnins.2026.1848801","tag_type":"category","value":"Neurosciences","value_numeric":null},{"paper_doi":"10.3389/fnins.2026.1848801","tag_type":"condition","value":"Chronic Pain","value_numeric":null},{"paper_doi":"10.3389/fnins.2026.1848801","tag_type":"condition","value":"Depression","value_numeric":null},{"paper_doi":"10.3389/fnins.2026.1848801","tag_type":"condition","value":"Inflammatory Disorders","value_numeric":null},{"paper_doi":"10.3389/fnins.2026.1848801","tag_type":"condition","value":"Migraine","value_numeric":null},{"paper_doi":"10.3389/fnins.2026.1848801","tag_type":"condition","value":"Post-Traumatic Stress Disorder","value_numeric":null},{"paper_doi":"10.3389/fnins.2026.1848801","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.3389/fnins.2026.1848801","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.3389/fnins.2026.1848801","tag_type":"modality","value":"Transcutaneous Vagus Nerve Stimulation","value_numeric":null},{"paper_doi":"10.3389/fnins.2026.1848801","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.3389/fnins.2026.1848801","tag_type":"warning","value":"No sample size is applicable to this narrative review; the tag was omitted accordingly.","value_numeric":null},{"paper_doi":"10.3389/fnins.2026.1848801","tag_type":"warning","value":"Sex of study populations is not reported at the review level; sex tag was omitted.","value_numeric":null},{"paper_doi":"10.3389/fnins.2026.1848801","tag_type":"warning","value":"The full text body was not rendered in the provided source (only abstract, metadata, and image placeholders were available), so summary content is based primarily on the abstract. Specific study counts, cited trial data, and detailed conclusions from the review body could not be verified.","value_numeric":null}],"summaries":{"what_studied":"This narrative review compares two transcutaneous vagus nerve stimulation (tVNS) approaches — the auricular branch (taVNS) and the cervical bundle (tcVNS) — examining their anatomical access points, methodological differences, and clinical applications across conditions including depression, PTSD, migraine, chronic pain, and inflammatory disorders.","key_result":"Both taVNS and tcVNS target the vagus nerve but differ substantially in their anatomical access and stimulation methods; the review characterizes each pathway's distinct profile without reporting pooled outcome data or head-to-head effect sizes.","limitations":"Full text body was not accessible (only abstract and metadata were extractable), preventing detailed appraisal of individual studies cited, quality assessment, or specific efficacy data. As a narrative review, it is subject to selection bias and does not perform a systematic or meta-analytic synthesis.","practice_takeaway":"Clinicians considering non-invasive vagus nerve stimulation should understand that taVNS (ear-based) and tcVNS (neck-based) engage the same cranial nerve via distinct anatomical routes, which may influence tolerability, target specificity, and suitability for different conditions. Choosing between the two approaches should account for these methodological and anatomical differences until direct comparative trials are available."}},{"doi":"10.1111/head.70115","pmid":"42312391","title":"Child abuse and migraine in adulthood: A prospective cohort study spanning 20 years","journal_title":"Headache: The Journal of Head and Face Pain","journal_issn":"0017-8748","published_at":"2026-06-18T00:00:00.000Z","url":"https://doi.org/10.1111/head.70115","source_score":12,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-26T13:25:30.862Z","updated_at":"2026-06-26T13:25:30.862Z","tags":[{"paper_doi":"10.1111/head.70115","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/head.70115","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1111/head.70115","tag_type":"condition","value":"Anxiety","value_numeric":null},{"paper_doi":"10.1111/head.70115","tag_type":"condition","value":"Child Abuse","value_numeric":null},{"paper_doi":"10.1111/head.70115","tag_type":"condition","value":"Depression","value_numeric":null},{"paper_doi":"10.1111/head.70115","tag_type":"condition","value":"Migraine","value_numeric":null},{"paper_doi":"10.1111/head.70115","tag_type":"condition","value":"Post-Traumatic Stress Disorder","value_numeric":null},{"paper_doi":"10.1111/head.70115","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1111/head.70115","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1111/head.70115","tag_type":"sample_size","value":"n=305","value_numeric":305},{"paper_doi":"10.1111/head.70115","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/head.70115","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1111/head.70115","tag_type":"warning","value":"Level of evidence assigned as 2 (prospective cohort); however, the study relies on self-reported, physician-diagnosed migraine rather than validated clinical criteria, which may inflate or misclassify the outcome.","value_numeric":null},{"paper_doi":"10.1111/head.70115","tag_type":"warning","value":"The sample is predominantly Black and from a single region of upstate New York, which may limit external validity to other racial/ethnic and geographic populations.","value_numeric":null},{"paper_doi":"10.1111/head.70115","tag_type":"warning","value":"The sex-moderated findings (child abuse predicting migraine in males but not females) are exploratory and based on subgroup analyses in a relatively small sample — results should not be over-interpreted without replication in larger cohorts.","value_numeric":null}],"summaries":{"what_studied":"A 20-year prospective cohort study (N=305, upstate New York) examined whether CPS-documented child abuse predicts physician-diagnosed migraine in adulthood, testing sex as a moderator and depression, anxiety, and PTSD as mediators.","key_result":"CPS-documented child abuse was associated with adult migraine in males (aOR 1.77; 95% CI 1.09–2.86) but not females (aOR 0.68; 95% CI 0.40–1.16); depression mediated this link in males. Females had higher overall migraine rates (26.3% vs. 15.5% past-year).","limitations":"- Sample is modest (N=305), predominantly Black, and from a single U.S. region, limiting generalizability.\n- Migraine was self-reported as physician-diagnosed, not clinically verified with standardized criteria.\n- The sex-specific finding is exploratory and should be interpreted cautiously given limited power for subgroup analyses.","practice_takeaway":"Male patients with a documented history of childhood abuse may carry elevated long-term migraine risk — screening for both migraine and depression in this group is warranted. Addressing depression in abused male patients could be a key intervention point to reduce downstream migraine burden."}},{"doi":"10.1038/s41562-026-02476-7","pmid":"42265330","title":"Genome-wide meta-analysis of quantitatively measured generalized anxiety symptoms in individuals of European ancestry","journal_title":"Nature Human Behaviour","journal_issn":"2397-3374","published_at":"2026-06-09T00:00:00.000Z","url":"https://doi.org/10.1038/s41562-026-02476-7","source_score":184,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-15T13:21:58.989Z","updated_at":"2026-06-15T13:21:58.989Z","tags":[{"paper_doi":"10.1038/s41562-026-02476-7","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02476-7","tag_type":"category","value":"Neurosciences","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02476-7","tag_type":"condition","value":"Anxiety","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02476-7","tag_type":"condition","value":"Coronary Artery Disease","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02476-7","tag_type":"condition","value":"Depression","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02476-7","tag_type":"condition","value":"Endometriosis","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02476-7","tag_type":"condition","value":"Generalized Anxiety Disorder","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02476-7","tag_type":"condition","value":"Irritable Bowel Syndrome","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02476-7","tag_type":"condition","value":"Migraine","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02476-7","tag_type":"condition","value":"Neuroticism","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02476-7","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02476-7","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02476-7","tag_type":"modality","value":"Polygenic Score","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02476-7","tag_type":"sample_size","value":"n=693869","value_numeric":693869},{"paper_doi":"10.1038/s41562-026-02476-7","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02476-7","tag_type":"study_design","value":"Genome-Wide Association Meta-Analysis","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02476-7","tag_type":"warning","value":"Full text body was not accessible — only the abstract and metadata were available; all extracted details are drawn from the abstract alone.","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02476-7","tag_type":"warning","value":"The impact_flag 'practice_changing' is applied cautiously — the genetic findings have translational implications but direct clinical implementation of polygenic scores for anxiety is not yet standard of care.","value_numeric":null},{"paper_doi":"10.1038/s41562-026-02476-7","tag_type":"warning","value":"The level of evidence rating of '2' reflects a large, well-powered meta-analysis but is based on observational/genetic design rather than an interventional study.","value_numeric":null}],"summaries":{"what_studied":"A genome-wide association meta-analysis (GWAMA) of quantitatively measured generalized anxiety symptom severity in 693,869 individuals of European ancestry across 14 cohorts, comparing the discovery power of a continuous trait approach versus traditional case-control design.","key_result":"80 independent genome-wide significant variants within 74 loci were identified (39 novel). SNP-based heritability was 5.9%. Polygenic scores explained R² = 1.2–2.9% of variance in anxiety across European, African, and South Asian ancestry samples. Strong genetic correlations were found with depression and neuroticism (rg = 0.71–0.85), irritable bowel syndrome (rg = 0.57), and coronary artery disease, endometriosis, and migraine (rg = 0.20–0.27). Brain-expressed synaptic and axonal pathways were implicated.","limitations":"- Sample restricted to individuals of European ancestry for discovery, limiting direct generalizability to other populations.\n- Polygenic scores showed lower R² in African and South Asian ancestry samples, reflecting known transferability gaps.\n- SNP-based heritability (5.9%) captures only a fraction of likely genetic architecture, and the continuous symptom measures may vary in definition across the 14 cohorts.","practice_takeaway":"Anxiety shares substantial genetic overlap with depression, neuroticism, and several physical conditions (IBS, coronary artery disease, migraine), supporting integrated screening approaches. Polygenic scores for anxiety now show meaningful cross-ancestry portability, though performance remains lower in non-European groups."}},{"doi":"10.1016/j.chest.2025.12.032","pmid":"42264575","title":"Pulmonary Arterial Hypertension Associated With Calcitonin Gene-Related Peptide Antagonist Therapy for Migraine","journal_title":"CHEST","journal_issn":"0012-3692","published_at":"2026-06-09T00:00:00.000Z","url":"https://doi.org/10.1016/j.chest.2025.12.032","source_score":3,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-19T13:23:22.408Z","updated_at":"2026-06-19T13:23:22.408Z","tags":[{"paper_doi":"10.1016/j.chest.2025.12.032","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.chest.2025.12.032","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1016/j.chest.2025.12.032","tag_type":"condition","value":"Migraine","value_numeric":null},{"paper_doi":"10.1016/j.chest.2025.12.032","tag_type":"condition","value":"Pulmonary Arterial Hypertension","value_numeric":null},{"paper_doi":"10.1016/j.chest.2025.12.032","tag_type":"generic","value":"gepant","value_numeric":null},{"paper_doi":"10.1016/j.chest.2025.12.032","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1016/j.chest.2025.12.032","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1016/j.chest.2025.12.032","tag_type":"modality","value":"CGRP Antagonist","value_numeric":null},{"paper_doi":"10.1016/j.chest.2025.12.032","tag_type":"modality","value":"Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1016/j.chest.2025.12.032","tag_type":"sample_size","value":"n=3","value_numeric":3},{"paper_doi":"10.1016/j.chest.2025.12.032","tag_type":"study_design","value":"Case Series","value_numeric":null},{"paper_doi":"10.1016/j.chest.2025.12.032","tag_type":"warning","value":"One patient had suspected portal hypertension, a known PAH risk factor, which confounds interpretation for that case.","value_numeric":null},{"paper_doi":"10.1016/j.chest.2025.12.032","tag_type":"warning","value":"Only 3 cases reported — causality is not established and findings may reflect coincidence or detection bias.","value_numeric":null},{"paper_doi":"10.1016/j.chest.2025.12.032","tag_type":"warning","value":"Sex of patients is not reported in the abstract, so the sex tag was omitted.","value_numeric":null},{"paper_doi":"10.1016/j.chest.2025.12.032","tag_type":"warning","value":"Specific CGRP-targeted agents used are not named in the abstract; 'gepant' tag is a class-level generic approximation.","value_numeric":null}],"summaries":{"what_studied":"Three patients who developed hemodynamically confirmed pulmonary arterial hypertension (PAH) while receiving CGRP-targeted therapies (monoclonal antibodies or gepants) for migraine, examining a potential cardiopulmonary safety signal.","key_result":"All 3 patients presented with markedly elevated pulmonary vascular resistance; 2 of 3 improved after CGRP-targeted therapy was discontinued and PAH-specific treatment was started. Two patients had no traditional PAH risk factors.","limitations":"Causality cannot be established from 3 cases; no systematic population-level data; one patient had a potential confounding risk factor (suspected portal hypertension).","practice_takeaway":"Monitor patients on CGRP-targeted migraine therapies for new cardiopulmonary symptoms such as dyspnea or exercise intolerance. Consider early evaluation for PAH if symptoms arise, given CGRP's role as a potent pulmonary vasodilator."}},{"doi":"10.1212/wnl.0000000000218035","pmid":"42090640","title":"Glaucoma Risk Associated With Calcitonin Gene–Related Peptide Inhibitor Use in Migraine","journal_title":"Neurology","journal_issn":"0028-3878","published_at":"2026-05-06T00:00:00.000Z","url":"https://doi.org/10.1212/wnl.0000000000218035","source_score":90,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-05-07","doi":"10.1212/wnl.0000000000218035","days":"14","issn":"0028-3878","rank":"3","field":"Clinical Medicine","score":"90","category":"Clinical Neurology","categories":["Clinical Neurology"],"_categories":["Clinical Neurology"]},"pubmed":{"doi":"10.1212/WNL.0000000000218035","title":"Glaucoma Risk Associated With Calcitonin Gene-Related Peptide Inhibitor Use in Migraine: A Multinational Cohort Study.","journal":"Neurology","methods":"","results":"A total of 73,644 individuals were included in the final analysis. Compared with non-CGRPi users, CGRPi users experience a lower risk of glaucoma development (HR 0.75; 95% CI 0.61-0.92) within 3 years since its first prescription. Individuals using CGRPi also exhibit a reduced risk of glaucoma compared with those using topiramate (HR 0.73; 95% CI 0.59-0.90), valproate (HR 0.54; 95% CI 0.35-0.83), propranolol (HR 0.76; 95% CI 0.59-0.98), metoprolol (HR 0.76; 95% CI 0.59-0.98), lisinopril (HR 0.49; 95% CI 0.38-0.62), amitriptyline (HR 0.69; 95% CI 0.54-0.89), and venlafaxine (HR 0.68; 95% CI 0.50-0.91). In the analysis that further classified participants based on the specific CGRPi used, only users of monoclonal antibody CGRPi show a reduced risk of glaucoma compared with non-CGRPi users (HR 0.77; 95% CI 0.61-0.98). The reduced risk of glaucoma associated with CGRPi is also observed in older adults, women, and those with chronic migraine or migraine without aura.","abstract":"$30","keywords":[],"pubmed_id":"42090640","conclusions":"","publication_date":"2026-05-06T00:00:00"},"crossref":{"DOI":"10.1212/wnl.0000000000218035","URL":"https://doi.org/10.1212/wnl.0000000000218035","ISSN":["0028-3878","1526-632X"],"link":[{"URL":"https://www.neurology.org/doi/pdfdirect/10.1212/WNL.0000000000218035","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":"11","score":1,"title":["Glaucoma Risk Associated With Calcitonin Gene–Related Peptide Inhibitor Use in Migraine"],"author":[{"given":"Chien-Chih","family":"Chou","sequence":"first","affiliation":[{"name":"School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;"},{"name":"Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan;"},{"name":"Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan;"},{"name":"Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan;"}]},{"given":"Jr-Wei","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;"},{"name":"Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan;"}]},{"given":"Hui-Ju","family":"Lin","sequence":"additional","affiliation":[{"name":"Eye Center, China Medical University Hospital, Taichung, Taiwan;"},{"name":"School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan;"}]},{"given":"I-Jong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan;"},{"name":"Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan;"}]},{"given":"Ssu-Yu","family":"Pan","sequence":"additional","affiliation":[{"name":"School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;"},{"name":"Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan;"}]},{"given":"Chien-Hsiang","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Brown University Warren Alpert Medical School, Providence, RI; and"},{"name":"Brown Health Medical Group, Brown University Health, Providence, RI."}]}],"issued":{"date-parts":[[2026,6,9]]},"member":"276","prefix":"10.1212","source":"Crossref","volume":"106","created":{"date-time":"2026-05-06T20:00:20Z","timestamp":1778097620000,"date-parts":[[2026,5,6]]},"indexed":{"date-time":"2026-05-11T20:16:35Z","timestamp":1778530595640,"date-parts":[[2026,5,11]]},"subject":[],"abstract":null,"language":"en","relation":{},"resource":{"primary":{"URL":"https://www.neurology.org/doi/10.1212/WNL.0000000000218035"}},"subtitle":["A Multinational Cohort Study"],"assertion":[{"name":"received","group":{"name":"publication_history","label":"Publication History"},"label":"Received","order":0,"value":"2025-07-09"},{"name":"accepted","group":{"name":"publication_history","label":"Publication History"},"label":"Accepted","order":2,"value":"2026-03-02"},{"name":"published","group":{"name":"publication_history","label":"Publication History"},"label":"Published","order":3,"value":"2026-05-06"}],"deposited":{"date-time":"2026-05-11T20:00:15Z","timestamp":1778529615000,"date-parts":[[2026,5,11]]},"issn-type":[{"type":"print","value":"0028-3878"},{"type":"electronic","value":"1526-632X"}],"published":{"date-parts":[[2026,6,9]]},"publisher":"Ovid Technologies (Wolters Kluwer Health)","reference":[{"DOI":"10.1016/j.ophtha.2014.05.013","key":"e_1_3_7_2_2","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/j.ogla.2019.09.002","key":"e_1_3_7_3_2","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1167/iovs.15-17274","key":"e_1_3_7_4_2","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1186/s12886-019-1062-9","key":"e_1_3_7_5_2","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/0014-4835(88)90013-9","key":"e_1_3_7_6_2","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1089/jop.1993.9.77","key":"e_1_3_7_7_2","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/S0140-6736(25)00109-6","key":"e_1_3_7_8_2","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1056/NEJMoa1705848","key":"e_1_3_7_9_2","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/0143-4179(92)90155-p","key":"e_1_3_7_10_2","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/j.exer.2017.06.002","key":"e_1_3_7_11_2","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":null,"key":"e_1_3_7_12_2","year":"1994","issue":"8","author":"Wiencke AK","volume":"35","first-page":"3268","unstructured":"Wiencke AK, Nilsson H, Nielsen PJ, Nyborg NC. 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The 'practice_changing' flag is applied cautiously given this design.","value_numeric":null}],"summaries":{"what_studied":"This multinational retrospective cohort study evaluated whether CGRP inhibitors (CGRPi: erenumab, fremanezumab, galcanezumab, eptinezumab, atogepant, rimegepant) reduce incident glaucoma risk in adults with migraine, compared with other preventive medications (e.g., topiramate, valproate, beta-blockers, antidepressants), using 1:1 propensity score matching and up to 3 years of follow-up (2018–2024).","key_result":"Among 73,644 adults, CGRPi users had a 25% lower risk of developing glaucoma vs. non-CGRPi users (HR 0.75; 95% CI 0.61–0.92). Monoclonal antibody CGRPi specifically showed reduced risk (HR 0.77; 95% CI 0.61–0.98), while gepants did not reach significance in subgroup analysis. The largest risk reduction was vs. lisinopril (HR 0.49; 95% CI 0.38–0.62).","limitations":"- Retrospective observational design (Class II) limits causal inference; residual confounding cannot be excluded.\n- Crossover was not allowed and CGRPi use was treated as a fixed exposure, which may not reflect real-world adherence or switching.\n- Gepants (atogepant, rimegepant) did not show a statistically significant reduction individually, but subgroup power was not reported.","practice_takeaway":"For adults with migraine who need preventive therapy, systemic CGRPi — especially monoclonal antibodies — may offer a secondary benefit of reducing incident glaucoma risk over 3 years. Clinicians managing patients with migraine and elevated glaucoma risk may consider this association when choosing a preventive agent."}},{"doi":"10.1007/s43678-026-01169-4","pmid":"42047987","title":"Oral metoclopramide for pediatric migraine management in the ED: health records review","journal_title":"Canadian Journal of Emergency Medicine","journal_issn":"1481-8035","published_at":"2026-04-28T00:00:00.000Z","url":"https://doi.org/10.1007/s43678-026-01169-4","source_score":3,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-05-04","doi":"10.1007/s43678-026-01169-4","days":"14","issn":"1481-8035","rank":"5","field":"Clinical Medicine","score":"3","category":"Emergency Medicine","categories":["Emergency Medicine"],"_categories":["Emergency Medicine"]},"pubmed":{"doi":"10.1007/s43678-026-01169-4","title":"Oral metoclopramide for pediatric migraine management in the ED: health records review.","journal":"CJEM","methods":"","results":"Of the 225 patients included, 78 received oral and 147 received intravenous metoclopramide. Headache relief was achieved in 83% (95% CI 73-91%) of the oral group. This compared favorably to the intravenous group (difference: 4%; 95% CI -7 to 14%). ED length of stay was shorter in the oral group (median 314 vs 500 min). Adverse events occurred only in the intravenous group (4%) and return visit proportions were similar between groups (difference 2%; 95% CI - 6 to 12%).","abstract":"$31","keywords":["Children","Metoclopramide","Migraine","Pediatric emergency department"],"pubmed_id":"42047987","conclusions":"","publication_date":"2026-04-28T00:00:00"},"crossref":{"DOI":"10.1007/s43678-026-01169-4","URL":"https://doi.org/10.1007/s43678-026-01169-4","ISSN":["1481-8035","1481-8043"],"link":[{"URL":"https://link.springer.com/content/pdf/10.1007/s43678-026-01169-4.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://link.springer.com/article/10.1007/s43678-026-01169-4","content-type":"text/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https://link.springer.com/content/pdf/10.1007/s43678-026-01169-4.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Oral metoclopramide for pediatric migraine management in the ED: health records review"],"author":[{"given":"Paola Andrea","family":"Rouge Elton","sequence":"first","affiliation":[]},{"given":"Nathalie","family":"Lucas","sequence":"additional","affiliation":[]},{"given":"Evelyne","family":"D. 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Environmental Triggers and Intermediate-Term Modulators of Emergency Migraine-Related Health Care Encounters","updated":"2026-04-20T08:06:07+00:00","published_date":"2026-04-15","best_oa_location":{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13089202/","pmh_id":"oai:pubmedcentral.nih.gov:13089202","url_for_pdf":null,"url_for_landing_page":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13089202/"}}},"created_at":"2026-05-07T22:51:22.404Z","updated_at":"2026-05-14T15:13:26.918Z","tags":[{"paper_doi":"10.1212/wnl.0000000000214936","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214936","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214936","tag_type":"condition","value":"Migraine","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214936","tag_type":"generic","value":"sumatriptan","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214936","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214936","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214936","tag_type":"modality","value":"Environmental Exposure / Air Pollution","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214936","tag_type":"modality","value":"Triptan","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214936","tag_type":"sample_size","value":"n=7,032","value_numeric":7032},{"paper_doi":"10.1212/wnl.0000000000214936","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214936","tag_type":"study_design","value":"Case-Crossover Study","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214936","tag_type":"warning","value":"Effect estimates use an individual-level 0–1 rescaling (min-to-max), not standard per-unit increments; ORs represent full within-person exposure range effects and are not directly comparable to per-unit estimates in other studies.","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214936","tag_type":"warning","value":"Study population is ~97.9% Jewish, predominantly female (77.4%), from a single arid-climate Israeli city; generalizability to other ethnic or climatic populations is uncertain.","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214936","tag_type":"warning","value":"The protective associations for SO₂ and CO with triptan use are interpreted by the authors as confounded by meteorologic conditions, not biological protection—clinicians should not interpret these as therapeutic signals.","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000214936","tag_type":"warning","value":"Triptan class was used as the modality/generic proxy; specific triptans were not identified in the text—'sumatriptan' is used as a canonical representative but individual agents were not distinguished.","value_numeric":null}],"summaries":{"what_studied":"A population-based case-crossover study (Be'er Sheva, Israel; 2000–2023) evaluated short-term (daily) and intermediate-term (weekly/quarterly) effects of air pollutants (NO₂, PM2.5, SO₂, CO, O₃, PM10) and meteorologic factors (temperature, humidity, solar radiation) on emergency migraine-related health care encounters and quarterly triptan use in 7,032 adults with migraine.","key_result":"Short-term NO₂ exposure 1 day prior was associated with increased emergency migraine encounters (OR 1.41; 95% CI 1.13–1.77), as was solar radiation (OR 1.23; 95% CI 1.07–1.42). Cumulative NO₂ raised triptan use (IRR 1.10; 95% CI 1.00–1.21), and cumulative PM2.5 similarly (IRR 1.09; 95% CI 1.00–1.19). Weekly context amplified risk: hot/dry summer weeks intensified NO₂ effects (OR 2.18; 95% CI 1.06–3.30) and cold/humid winter weeks intensified PM2.5 effects (OR 3.78; 95% CI 1.74–5.82).","limitations":"- Outcomes rely on emergency encounters and pharmacy data, capturing only severe episodes and missing home-managed migraine.\n- Exposure assigned from fixed monitoring stations without individual-level data (e.g., time indoors, mobility), likely biasing associations toward the null.\n- Findings are from a single arid-climate city (Be'er Sheva) with a predominantly Jewish, female cohort, limiting generalizability.","practice_takeaway":"During forecasted high-pollution or weather-transition periods—especially hot/dry summers with elevated NO₂ or cold/humid winter days with high PM2.5—consider proactive measures for migraine patients: limiting outdoor exposure, short-term NSAID/gepant prophylaxis, or early acute treatment. Seasonal environmental context, not just daily exposure, shapes migraine trigger risk."}},{"doi":"10.1002/epi.70087","pmid":"41518480","title":"Sex‐specific elevated incidence of glaucoma associated with topiramate versus valproate or lamotrigine in epilepsy, not migraine: A population‐based cohort study","journal_title":"Epilepsia","journal_issn":"0013-9580","published_at":"2026-01-10T00:00:00.000Z","url":"https://doi.org/10.1002/epi.70087","source_score":30,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-11","doi":"10.1002/epi.70087","days":"7","issn":"0013-9580","rank":"10","field":"Clinical Medicine","score":"30","category":"Clinical Neurology","categories":["Clinical Neurology"],"_categories":["Clinical Neurology"]},"pubmed":{"doi":"10.1002/epi.70087","title":"Sex-specific elevated incidence of glaucoma associated with topiramate versus valproate or lamotrigine in epilepsy, not migraine: A population-based cohort study.","journal":"Epilepsia","methods":"","results":"The cohort included 688 topiramate, 4490 valproate, and 4179 lamotrigine initiators. After weighting, the 1-year absolute risk increase was approximately 2.4% when comparing topiramate to valproate, and about 2.0% compared to lamotrigine. Topiramate was associated with higher glaucoma risk vs valproate (adjusted HR 2.66, 95% CI 1.12-6.32) and lamotrigine (adjusted HR 3.57, 95% CI 1.76-7.26). Risks were elevated in female (vs valproate: HR 5.31, 95% CI 1.48-19.08; vs lamotrigine: HR 5.73, 95% CI 2.38-13.79) or epilepsy patients (vs valproate: HR 2.23, 95% CI 1.04-4.76; vs lamotrigine: HR 5.08, 95% CI 2.32-11.14), but not in male or migraine patients.","abstract":"$33","keywords":["glaucoma","lamotrigine","topiramate","valproate"],"pubmed_id":"41518480","conclusions":"","publication_date":"2026-01-10T00:00:00"},"crossref":{"DOI":"10.1002/epi.70087","URL":"https://doi.org/10.1002/epi.70087","ISSN":["0013-9580","1528-1167"],"link":[{"URL":"https://onlinelibrary.wiley.com/doi/pdf/10.1002/epi.70087","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Sex‐specific elevated incidence of glaucoma associated with topiramate versus valproate or lamotrigine in epilepsy, not migraine: A population‐based cohort 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Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China"}]},{"given":"Ian Chi Kei","family":"Wong","sequence":"additional","affiliation":[{"name":"Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong SAR China"},{"name":"Aston School of Pharmacy Aston University Birmingham UK"},{"name":"Laboratory of Data Discovery for Health (D²4H) Hong Kong Science Park Hong Kong SAR China"}]},{"given":"Esther Wai Yin","family":"Chan","sequence":"additional","affiliation":[{"name":"Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong SAR China"},{"name":"Department of Pharmacy The University of Hong Kong‐Shenzhen Hospital Shenzhen China"},{"name":"Laboratory of Data Discovery for Health (D²4H) Hong Kong Science Park Hong Kong SAR China"},{"name":"The 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The primary endpoint was 2‑hour pain relief (secondary: 2‑hour pain freedom and most bothersome symptom freedom; sustained outcomes at 24 and 48 hours); 92 participants treated 247 attacks.","key_result":"THC+CBD outperformed placebo at 2 hours for pain relief (67.2% vs 46.6%, OR 2.85 [1.22–6.65], p=0.016), pain freedom (34.5% vs 15.5%, OR 3.30 [1.24–8.80], p=0.017), and most bothersome symptom freedom (60.3% vs 34.5%, OR 3.32 [1.45–7.64], p=0.005), with sustained pain freedom at 24 h and sustained most bothersome symptom freedom at 24 and 48 h. 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Accessed August 12, 2025. https://d3dkdvqff0zqx.cloudfront.net/groups/apaadvocacy/attachments/NDP%20Approps%20Conference%20Letter_FY25%20November%20with%20Signatories.pdf","article-title":null,"journal-title":null,"doi-asserted-by":null}],"short-title":[],"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1,1]]}},"content-domain":{"domain":[],"crossmark-restriction":false},"original-title":[],"container-title":["JAMA Neurology"],"published-print":{"date-parts":[[2026,1,1]]},"reference-count":44,"published-online":null,"references-count":44,"short-container-title":["JAMA Neurol"],"is-referenced-by-count":1},"unpaywall":{"doi":"10.1001/jamaneurol.2025.4470","is_oa":false,"title":"US Burden of Disorders Affecting the Nervous System","updated":"2025-11-25T15:53:31+00:00","published_date":"2025-11-24","best_oa_location":null}},"created_at":"2025-12-08T12:24:58.509Z","updated_at":"2026-01-21T12:05:26.220Z","tags":[{"paper_doi":"10.1001/jamaneurol.2025.4470","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4470","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4470","tag_type":"condition","value":"Dementia","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4470","tag_type":"condition","value":"Diabetic Neuropathy","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4470","tag_type":"condition","value":"Migraine","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4470","tag_type":"condition","value":"Neurological Disorders","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4470","tag_type":"condition","value":"Stroke","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4470","tag_type":"condition","value":"Tension-Type Headache","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4470","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4470","tag_type":"study_design","value":"Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4470","tag_type":"warning","value":"Burden estimates come from GBD 2021 modeled data; the excerpt does not detail case definitions or modeling methods.","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2025.4470","tag_type":"warning","value":"Population-level figures are provided; no discrete sample size is reported.","value_numeric":null}],"summaries":{"what_studied":"Cross-sectional analysis of Global Burden of Disease 2021 data for the United States (1990–2021) assessing health loss from 36 conditions that damage the nervous system using DALYs, YLDs, YLLs, deaths, and prevalence.","key_result":"In 2021, 180.3 million (95% UI, 170.7–190.4 million) US residents were affected, accounting for 16.6 million (95% UI, 12.9–20.9 million) DALYs; the most common were tension-type headache 121.9 million (95% UI, 109.4–135.1), migraine 57.7 million (95% UI, 50.1–66.1), and diabetic neuropathy 17.1 million (95% UI, 14.4–19.9). Disability was highest for stroke 3.9 million DALYs (95% UI, 3.5–4.2), Alzheimer disease and other dementias 3.3 million (95% UI, 1.6–6.9), diabetic neuropathy 2.2 million (95% UI, 1.5–3.0), and migraine 2.1 million (95% UI, 0.4–4.6); since 1990, age-standardized prevalence was flat (-0.2%; 95% UI, -1.5 to 1.9), deaths fell (-14.6%; 95% UI, -18.3 to -11.3), and YLDs rose (9.8%; 95% UI, 4.6–16.6), with the highest DALY rates in Mississippi, Alabama, and Louisiana and the lowest in New York, Massachusetts, and New Jersey.","practice_takeaway":"Disorders affecting the nervous system are widespread and now the top cause of disability in the US; falling mortality means more people are living with disability. Health systems should prioritize prevention, effective therapies, and focused rehabilitation for these conditions."}}],"initialOffset":15,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Migraine"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Migraine"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Migraine"}}}]]

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