Migraine lacks an objective, scalable signature that captures its heterogeneous phenotypes and fluctuating clinical states. We investigated whether spontaneous resting facial activity reflects migraine phenotype, headache phase, preventive treatment status, and clinical burden. Facial activity was extracted from 10-s resting videos and quantified as the magnitude and temporal variability of 31 facial action units. Healthy controls (HCs) and patients with episodic (EM) or chronic migraine (CM) were examined, with the patients stratified by preventive treatment and interictal or ictal phase. Group differences were evaluated using age- and sex-adjusted rank-based permutation analysis of covariance with false discovery rate correction. Behavioural partial least squares (PLS) analysis identified facial patterns covarying with disease burden, emotional distress, and current headache intensity. We consecutively recruited 842 participants: 90 HCs, 252 patients with CM and 500 with EM. Migraine was characterised by a multiregional pattern dominated by diminished bilateral lip-corner pulling, which persisted across phenotypes, phases, and treatment groups. Drug-naïve patients exhibited broader reductions in cheek and lower-face activity, whereas treated patients retained the core perioral alteration with greater periocular, brow, and lower-face involvement. Direct comparisons between EM and CM revealed few statistically significant differences. Increased bilateral lid-tightening magnitude and variability represented the clearest ictal feature, particularly in drug-naïve EM. PLS revealed coordinated patterns associated with disease burden and emotional distress. Greater burden covaried with reduced cheek and perioral activity and increased brow activity; emotional distress was associated with reduced lip-corner pulling, cheek raising and lip stretching, together with greater lip-corner depression. Pain intensity categories, but not current headache intensity, was associated with a predominantly periocular pattern in the overall group and drug-naïve subgroups. Emotional-distress and current-pain models were not significant in treated patients. Brief resting facial recordings revealed complementary group-level patterns associated with migraine status, current clinical state, and clinical burden. A consistent perioral signature accompanied ictal periocular activation and treatment-status differences, but these comparisons cannot establish preventive-therapy effects. Resting facial activity may represent a contactless digital phenotype, although longitudinal studies with disease controls and external validation are required to establish its diagnostic or monitoring utility. Not applicable.
To explore the predictive effect of workplace mistreatment on migraine progression among employed patients and provide evidence for occupational risk prevention of migraine. This 2-year prospective cohort study enrolled 2217 employed migraine patients at baseline. Workplace mistreatment (past 12-month exposure) and clinical indicators were repeatedly measured. Migraine progression was defined based on standardized 4-week headache diary outcomes. Cox regression, stratified interaction analysis, and multiple sensitivity analyses were performed to verify the association and its robustness. A total of 2049 participants completed follow-up (loss rate: 7.58
Environmental exposures may be associated with trigeminal neuralgia (TN), but evidence regarding the roles of air pollution and meteorological factors remains limited, and the potential biological pathways are not well understood. Identifying environmental factors associated with TN may improve understanding of disease exacerbation patterns and provide insights that could complement existing pharmacological and surgical management strategies. We conducted a time-stratified case-crossover study among patients with TN-related hospital admissions. Conditional logistic regression was used to estimate odds ratio (OR) and 95
Twelve years ago, in a nationwide survey of headache among children (aged 6–11 years) and adolescents (12–17) in Türkiye, many participants reported mild headache of usual duration < 1 h. Recognising that the characteristics of adult headache disorders might be undeveloped among young people, we introduced a new diagnostic category of “undifferentiated headache” (UdH). Here, informed by subsequent studies in other countries, we use a modified definition of UdH, re-analysing the prevalence data alongside those regarding attributed burden. The purposes were to inform national health and educational policies, and to contribute to understanding of headache in young people. Pupils in 31 nationally representative schools completed the child and adolescent versions of the structured HARDSHIP questionnaire in class under supervision. Headache diagnoses followed ICHD-3, except for UdH (now defined as mild or moderate headache lasting < 1 h). Burden enquiries were in multiple domains (symptoms, medication use, impaired participation in school and other activities, parental work loss, emotional impact and quality of life [QoL]), with timeframes of 4 weeks and 1 day (headache yesterday). One-year headache prevalence (age- and gender-adjusted) was 66.1
Migraine and depression disproportionately affect women. However, their global trends, prospective associations, and genetic causal mechanisms remain largely uninvestigated. This study aimed to integrate multi-level evidence to comprehensively dissect the relationship between these two conditions in women. We analyzed temporal trends in incidence and DALY rates utilizing data from the Global Burden of Disease (GBD) Study 1990–2023. Within the UK Biobank (UKB) prospective cohort (N = 249,322), Cox proportional hazards models were employed to examine the association between migraine and incident depression. Two-sample Mendelian randomization (MR) analyses, with supplementary bidirectional analysis using FinnGen data, were performed to evaluate genetic causality between the two disorders. Between 1990 and 2023, age-specific incidence and DALY rates of depression in women rose across all age groups, whereas those of migraine remained essentially stable, with slight increases only at middle and older ages. In 2023, migraine DALY rates remained high across 35–59 years, while depression rates declined steadily with age. In the UKB, migraine was associated with a significantly increased risk of incident depression(HR = 1.46, 95
