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Overview and Recommendations
Background
- •Migraine — a complex neurovascular syndrome — affects approximately 1 in 7 people globally and remains the primary cause of disability among women aged 15–49 years, carrying immense socioeconomic stakes due to lost productivity and work-family conflict.
- •The trigeminovascular system serves as the central molecular axis of the disorder; its activation triggers the release of potent vasoactive neuropeptides, primarily and substance P, which induce dural vasodilation and neurogenic inflammation.
- • (CSD), often described as a 'brain tsunami,' is the electrophysiological substrate of the migraine aura, involving a wave of neuronal depolarization that activates trigeminal nociceptors and may even drive migraine without aura in 'silent' cortical regions.
- •Classification is primarily frequency-based, distinguishing between episodic migraine (less than 15 headache days per month) and (15 or more days per month for at least three months), with the latter often associated with central sensitization and medication overuse.
- •Genetic heritability is high, ranging from monogenic forms like (mutations in CACNA1A, ATP1A2, or SCN1A) to common polygenic variants involving over 120 identified risk loci related to vascular development and glutamatergic signaling.
- •Prognostic stakes are significant, as migraine with aura is an independent risk factor for ischemic stroke, a risk that is further potentiated by smoking, hypertension, and the use of combined oral contraceptives.
Evaluation
- •Suspect migraine in any patient presenting with recurrent, moderate-to-severe, pulsating headaches that last 4 to 72 hours and are aggravated by routine physical activity.
- •Apply the ICHD-3 diagnostic criteria: the patient must have at least five lifetime attacks (two if aura is present) featuring nausea, vomiting, , or in addition to the characteristic pain profile.
- •Ask specifically about the four clinical phases: the prodrome (yawning, neck stiffness, food cravings), the aura (reversible visual or sensory deficits), the headache phase, and the postdrome (the 'migraine hangover' of cognitive clouding).
- •Characterize the aura carefully; typical migraine aura develops gradually over at least 5 minutes and lasts no more than 60 minutes, helping to distinguish it from the sudden onset of a (TIA).
- •Screen for 'red flags' using the SNOOP10 mnemonic, paying close attention to systemic symptoms, neurological deficits, sudden 'thunderclap' onset, or new-onset headaches in patients over age 50.
- •Examine the patient for signs of cutaneous , such as pain when brushing hair or wearing glasses, which serves as a clinical marker for central sensitization and an increased risk of chronification.
- •Order a brain MRI only if the patient presents with atypical features, such as a strictly unilateral headache that never switches sides, a prolonged aura lasting more than a week, or a significant change in their established headache pattern.
- •Evaluate for in patients reporting episodic vertigo or motion sensitivity, even in the absence of a concurrent headache, as this is the most common cause of spontaneous episodic vertigo.
- •Assess for by quantifying the monthly use of acute treatments; thresholds for concern include 10 or more days of triptans/opioids or 15 or more days of simple NSAIDs per month.
- •Utilize validated disability scales like the Migraine Disability Assessment ( ) or the Headache Impact Test (HIT-6) to establish a baseline and guide the necessity for preventive therapy.
Management
- •Initiate acute treatment at the earliest sign of symptoms, ideally during the prodrome or at the first onset of pain, to maximize the likelihood of achieving a pain-free state within two hours.
- •Administer simple analgesics for mild-to-moderate attacks: 400–800 mg, sodium 500–1100 mg, or 650–1000 mg are effective first-line options.
- •Utilize triptans (5-HT1B/1D agonists) for moderate-to-severe attacks: 50–100 mg PO or 6 mg SC is the gold standard, though SC administration is preferred for rapid onset or severe nausea.
- •Transition to gepants for patients with cardiovascular contraindications to triptans or those who fail standard therapy: 75 mg ODT or 50–100 mg are effective and carry a lower risk of medication overuse.
- •Prescribe 50–200 mg (a 5-HT1F agonist) for patients requiring a non-vasoconstrictive option, but advise the patient not to drive for at least 24 hours after a dose due to potential dizziness.
- •Manage (attacks >72 hours) with aggressive rescue therapy, such as IV 30 mg, IV 10 mg, or IV dihydroergotamine (DHE) 1 mg.
- •Offer preventive therapy to any patient with 4 or more migraine days per month or those whose attacks cause significant life disruption despite acute treatment.
- •Start first-line oral preventives at low doses and titrate over 4–8 weeks: 40–160 mg/day, 50–100 mg/day, or 10–50 mg/day (especially if comorbid insomnia is present).
- •Consider 16 mg/day as a first-line preventive option due to its superior tolerability profile compared to traditional beta-blockers or anticonvulsants.
- •Escalate to CGRP monoclonal antibodies for refractory cases: 70–140 mg SC monthly, 225 mg SC monthly, or 120 mg SC monthly (after a 240 mg loading dose).
- •Utilize IV 100–300 mg every 12 weeks for patients requiring rapid preventive onset or those who prefer infrequent clinical administration.
- •Administer (Botox) 155–200 U via the PREEMPT protocol (31–40 injection sites) every 12 weeks specifically for the management of chronic migraine.
- •Perform a (GONB) using 2% lidocaine and 40–80 mg of methylprednisolone for acute rescue in the emergency department or as a 'bridge' to long-term prevention.
- •Recommend evidence-based nutraceuticals for patients preferring 'natural' options: oxide 400–600 mg/day, (Vitamin B2) 400 mg/day, and Coenzyme Q10 300 mg/day.
- •Integrate non-pharmacological behavioral therapies, such as (CBT) and biofeedback, which can reduce attack frequency by 30–50% by modulating autonomic arousal.
- •Avoid the routine use of opioids and butalbital-containing compounds, as these significantly increase the risk of chronification and are less effective than migraine-specific therapies.
- •Refer to a headache specialist if the patient fails two or more classes of preventives, has a rare variant like hemiplegic migraine, or requires advanced procedural interventions.
Board Review — High Yield
- •Scintillating scotomata — The most common visual aura, characterized by a flickering zig-zag pattern that expands over minutes.
- •CGRP — The primary neuropeptide mediator of migraine pain and the target of 'gepants' and monoclonal antibodies.
- •4 to 72 hours — The diagnostic duration threshold for an untreated migraine attack in adults.
- •Topiramate — A first-line preventive often associated with paresthesias, cognitive 'word-finding' difficulties, and weight loss.
- •Status Migrainosus — A debilitating migraine attack lasting longer than 72 hours, often requiring IV rescue therapy.
- •PFO (Patent Foramen Ovale) — A cardiac anomaly with a higher prevalence in patients who experience migraine with aura.
- •Allodynia — Pain resulting from a non-painful stimulus (e.g., hair brushing), indicating central sensitization.
- •Alice in Wonderland Syndrome — A rare pediatric migraine aura involving metamorphopsia (distortions in body image or object size).
Deep Dive — Evidence Details
Definition, Classification, and ICHD-3 Criteria
- ▸Migraine is a clinical diagnosis requiring specific attack counts (5 for without aura, 2 for with aura) and symptom clusters defined by ICHD-3.
- ▸Frequency-based classification into episodic and chronic migraine is essential for determining the risk of disability and the need for preventive therapy [1].
Migraine is a chronic neurovascular disorder characterized by paroxysmal, often debilitating headache episodes accompanied by autonomic and neurological dysfunction. It represents the second leading cause of disability worldwide and the primary cause of disability among women aged 15–49 years [1]B2a. Clinicians utilize the International Classification of Headache Disorders, 3rd edition (ICHD-3), to standardize diagnosis and differentiate migraine from secondary headache mimics [1]B2a[16]D5.
Epidemiology and Socioeconomic Impact
- ▸Migraine is a leading global cause of disability, with a 3:1 female-to-male prevalence ratio that peaks during reproductive years [25, 31].
- ▸Comorbidities such as PTSD, RLS (20% prevalence), and SSNHL (46% prevalence) significantly increase the clinical complexity and burden of the disorder [21, 28, 41].
Global estimates from the 2023 Global Burden of Disease (GBD) study identify headache disorders as a primary driver of non-fatal health loss, with migraine prevalence remaining high across nearly all geographic regions [25]B2c. Between 1990 and 2023, the global burden of migraine has persisted as a leading cause of disability-adjusted life years (DALYs), particularly among women in their peak productive years [25]B2c. While migraine with aura affects up to 30% of individuals with the disorder, the broader epidemiological landscape is characterized by significant sex-based disparities and a high prevalence of comorbid conditions that amplify the individual and societal burden [31]B2a.
Pathophysiology and Genetics
- ▸Cortical spreading depolarization (CSD) initiates the migraine aura and triggers the release of inflammatory mediators through the Panx1-NLRP3 inflammasome pathway.
- ▸CGRP is the primary neuropeptide mediator of neurogenic inflammation and trigeminal sensitization, with higher baseline levels observed in women.
Activation of the trigeminovascular system serves as the final common pathway for the generation of migraine pain, integrating neuronal hyperexcitability with vascular dysregulation [52]D5[58]D5. This neurovascular cascade involves a complex interplay between the cerebral cortex, the trigeminal nerve, and the intracranial vasculature, mediated by a specific array of neuropeptides and neurotransmitters [58]D5[67]D5. ### The Trigeminovascular Cascade The transition from a quiescent state to a clinical migraine attack follows a structured sequence of molecular and cellular events:
Clinical Phases and Symptomatology
- ▸Migraine progresses through four phases: premonitory (prodrome), aura, headache, and postdrome, with 'brain fog' being a hallmark of the final stage [74, 63].
- ▸Aura is driven by cortical spreading depolarization (CSD), a wave of mass depolarization that can trigger trigeminal nociceptors and lead to the headache phase [77, 80].
Premonitory symptoms signal the onset of an attack in up to 80% of patients, often appearing hours to days before the headache phase begins [63]D5. These symptoms, mediated by hypothalamic and dopaminergic signaling, include yawning, nausea, food cravings, and neck stiffness [63]D5. The subsequent aura phase, experienced by approximately 30% of individuals, is driven by (CSD)—a slowly propagating wave of mass neuronal depolarization often termed a 'brain tsunami' [77]D5[80]D5.
Migraine Variants and Phenotypes
- ▸Vestibular migraine is the most common cause of episodic vertigo, requiring at least 5 episodes of 5 minutes to 72 hours for diagnosis [95].
- ▸Hemiplegic migraine is characterized by motor weakness and ictal EEG slowing in 89% of cases, often linked to monogenic mutations in ion channel genes [27, 59].
Vestibular symptoms affect up to 30% of migraineurs, establishing (VM) as the leading cause of spontaneous episodic vertigo [95]D5. This phenotype represents a complex integration failure across vestibular, sensorimotor, and visual networks rather than a focal peripheral lesion [57]D5. While traditional migraine features like photophobia and phonophobia remain diagnostic anchors, VM is uniquely characterized by allodynia and extreme sensitivity to motion [57]D5.
Diagnostic Evaluation and Differential Diagnosis
- ▸Diagnosis is primarily clinical, based on ICHD-3 criteria, but requires active exclusion of secondary mimics using red-flag screening.
- ▸Late-onset aura (age >50) and persistent aura (>1 week) are critical diagnostic triggers for neuroimaging to rule out stroke or structural lesions.
Clinical evaluation prioritizes the identification of pathognomonic symptom clusters, as no definitive laboratory or radiologic biomarker currently exists for routine practice [106]B2a. The diagnostic process focuses on characterizing the temporal evolution of attacks, identifying associated neurological phenomena, and screening for secondary mimics using established "red flag" frameworks. While the diagnosis is primarily clinical, advanced neuroimaging and biochemical assays are increasingly utilized in research to refine phenotype classification and predict therapeutic responses [100]B2a[103]A1b.
Acute Pharmacological Management
- ▸Stratified care based on attack severity and cardiovascular risk is superior to a step-care approach.
- ▸Gepants (e.g., rimegepant 75 mg) and ditans (e.g., lasmiditan) provide safe alternatives for patients with triptan contraindications.
Stratified care based on attack severity and patient-specific contraindications optimizes acute migraine outcomes, moving beyond a simple "step-care" model [136]D5[138]D5. Early intervention is critical; treating during the prodromal phase or at the first sign of pain significantly reduces peak disability and prevents progression to a full-blown attack [134]D5. While traditional therapies like nonsteroidal anti-inflammatory drugs (NSAIDs) and triptans remain first-line for many, the emergence of calcitonin gene-related peptide (CGRP) receptor antagonists (gepants) and 5-HT1F receptor agonists (ditans) has provided essential alternatives for patients with cardiovascular contraindications or those who fail to respond to standard treatments [110]A1b[135]D5[138]D5.
Preventive Pharmacological Management (Traditional)
- ▸First-line traditional preventives include propranolol, metoprolol, topiramate, amitriptyline, and candesartan.
- ▸Topiramate is the most robustly evidenced oral agent for chronic migraine but requires careful titration to avoid cognitive side effects.
Preventive therapy is indicated for patients experiencing ≥4 migraine days per month or those with significant disability despite optimized acute treatment [139]A1c (1c). The American College of Physicians (ACP) 2025 guideline recommends initiating prophylaxis when attacks significantly interfere with daily life, regardless of frequency [139]A1c (1c). Traditional oral preventive medications (OPMs) aim to reduce attack frequency, severity, and duration while improving responsiveness to acute therapies [140]A1c (1c).
CGRP-Targeted Preventive Therapies
- ▸CGRP monoclonal antibodies (mAbs) target either the ligand (eptinezumab, fremanezumab, galcanezumab) or the receptor (erenumab) to provide rapid and specific migraine prevention.
- ▸Eptinezumab (IV) and erenumab (SC) have demonstrated high efficacy in reducing monthly migraine days and acute medication use in patients with comorbid medication-overuse headache.
CGRP-targeted monoclonal antibodies (mAbs) and small-molecule antagonists (gepants) have shifted the preventive paradigm by offering high specificity and rapid onset of action compared to traditional oral prophylactics. These therapies target either the (CGRP) ligand or its receptor, effectively interrupting the neurovascular cascade central to migraine pathogenesis [176]A1a. ### Monoclonal Antibodies: Ligand vs.
Neuromodulation and Procedural Interventions
- ▸OnabotulinumtoxinA (155-200 U) is effective for chronic migraine and shows emerging evidence for episodic migraine prevention.
- ▸Greater occipital nerve blocks (GONB) reduce brainstem excitability and improve acute outcomes in the emergency department when used as an adjunct to triple therapy.
Procedural interventions and neuromodulation provide critical alternatives for patients who are refractory to pharmacotherapy or limited by systemic side effects [84]A1c[197]A1a. OnabotulinumtoxinA (BoNT-A) remains the gold standard for (CM) prevention, typically administered as 155 U to 200 U across 31 to 40 injection sites every 12 weeks [177]C4[200]C4. While its primary indication is CM, the Phase 3 PRECLUDE trial demonstrated that BoNT-A also significantly reduces monthly migraine days (MMDs) in patients with (EM), suggesting a broader clinical utility than previously recognized [191]A1b.
Lifestyle, Behavioral, and Complementary Medicine
- ▸Behavioral interventions including CBT and biofeedback are first-line non-pharmacological options that reduce both attack frequency and pain catastrophizing.
- ▸The ketogenic diet and low-inflammatory diets show promise in reducing neuroinflammation and managing refractory migraine cases.
Integrating lifestyle modifications and behavioral interventions into the treatment plan addresses the underlying neurobiological sensitivity of the migraine brain, often matching the efficacy of traditional pharmacotherapy while minimizing systemic side effects [140]A1c[215]D5. These non-pharmacological strategies are particularly vital for populations where medication use is limited, such as pediatric, pregnant, or nursing patients [215]D5[217]D5. ### Behavioral and Mind-Body Interventions (CBT) and biofeedback-assisted relaxation (BAR) are established first-line behavioral treatments that reduce migraine-related disability and attack frequency [203]A1a[208]B2b.
Migraine in Special Populations
- ▸Migraine in pregnancy is associated with a significantly increased risk of preeclampsia (OR 1.5–2.0) and peripartum cardiovascular events [221, 222].
- ▸Rimegepant 75 mg ODT is the preferred acute treatment for patients who are triptan-unsuitable due to cardiovascular contraindications [110].
Reproductive-aged women and pediatric patients represent the highest-prevalence demographics, yet their is frequently complicated by physiological shifts and therapeutic contraindications [221]B2a[224]B3b. Clinical strategies must pivot from standard protocols to account for teratogenicity, developmental impact, and the heightened vascular risks associated with comorbid conditions [218]A1c[222]B2a. ### Pregnancy and Lactation Pregnancy significantly alters the neurovascular landscape, often providing symptomatic relief in the second and third trimesters, yet it simultaneously introduces a hypercoagulable state that potentiates vascular risks [221]B2a.
Complications and Comorbidities
- ▸Migraine with aura is an independent risk factor for ischemic stroke, with risks compounded by smoking and gestational diabetes [69, 226].
- ▸Psychiatric comorbidities like MDD do not diminish the efficacy of CGRP monoclonal antibodies such as fremanezumab [236].
Ischemic stroke risk is significantly elevated in patients with with aura (MA), serving as an independent risk factor that is further potentiated by smoking, , or oral contraceptive use [69]D5[238]A1a. While migrainous infarction is a rare, direct complication, the broader association between migraine and cerebrovascular disease involves shared mechanisms such as endothelial dysfunction, cortical spreading depression, and local inflammatory responses [69]D5. Typical aura without headache, once considered benign, also correlates with increased risks of stroke and composite cardiovascular outcomes [235]B2b.
Landmark Trials and Evidence Summary
- ▸Rimegepant 75 mg demonstrates long-term preventive efficacy and significant improvements in health-related quality of life [246].
- ▸Matching-adjusted indirect comparisons (MAIC) show that oral gepants achieve monthly migraine day reductions comparable to injectable CGRP monoclonal antibodies [246].
CGRP-targeted therapies have fundamentally altered the therapeutic trajectory for patients with frequent or , shifting the focus toward highly specific molecular targets. While early landmark trials established the efficacy of injectable monoclonal antibodies (mAbs), recent evidence has expanded to include oral small-molecule CGRP receptor antagonists (gepants) for both acute and preventive use [246]B2c. These trials collectively define the current standard of care by demonstrating significant reductions in monthly migraine days (MMDs) and improvements in patient-reported outcomes.
References
- [1]
Matharu MS, Silberstein S, Yuan H et al.. “Migraine-related disability according to headache frequency subclassifications: A systematic review and meta-analysis.” Cephalalgia : an international journal of headache (2025). PMID: 41105531 ↗
L2SR_OBSCited in: Definition, Classification, and ICHD-3 Criteria - [2]
Parikh SK, Deline CR, McCreary M et al.. “The contribution of lumbar puncture opening pressure in the diagnosis of spontaneous intracranial hypotension: A systematic literature review and meta-analysis.” Headache (2026). PMID: 41090555 ↗
L2SR_OBSCited in: Definition, Classification, and ICHD-3 Criteria - [3]
Sampatakakis SN, Lymperopoulos L, Mavridis T et al.. “Visual snow: A systematic review and a case series.” Cephalalgia : an international journal of headache (2022). PMID: 35945691 ↗
L4SR_OBSCited in: Definition, Classification, and ICHD-3 Criteria - [4]
Castien R, Duineveld M, Maaskant J et al.. “Pericranial Total Tenderness Score in Patients with Tension-type Headache and Migraine. A Systematic Review and Meta-analysis.” Pain physician (2021). PMID: 34793636 ↗
L3SR_OBSCited in: Definition, Classification, and ICHD-3 Criteria - [5]
Yang Y, Meng F, Zhu H et al.. “The applicability research of the diagnostic criteria for 10.2 Heamodialysis-related headache in the international classification of headache disorders-3rd edition.” The journal of headache and pain (2023). PMID: 36849915 ↗
L4RCTCited in: Definition, Classification, and ICHD-3 Criteria - [6]
Ferretti A, Velardi M, Fanfoni C et al.. “Pediatric hypnic headache: a systematic review.” Frontiers in neurology (2023). PMID: 37638182 ↗
L4SR_OBSCited in: Definition, Classification, and ICHD-3 Criteria - [7]
Lu C, Zhang L, Wang J et al.. “The applicability research of the diagnostic criteria for 6.7.2 angiography headache in the international classification of headache disorders-3rd edition.” The journal of headache and pain (2022). PMID: 35100967 ↗
L2TRIAL_NONRANDOMCited in: Definition, Classification, and ICHD-3 Criteria - [8]
Abrate G, Rossi R, Grasso G et al.. “Transient Headache and Neurological Deficits with cerebrospinal fluid Lymphocytosis (HaNDL) syndrome in children: case report and narrative review.” Italian journal of pediatrics (2025). PMID: 41257749 ↗
L5CASE_REPORTCited in: Definition, Classification, and ICHD-3 Criteria - [9]
D'Agostino S, Morea A, Meo C et al.. “Pediatric nummular headache: review of the literature and a case series with nosographic considerations.” Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology (2025). PMID: 41071455 ↗
L4CASE_REPORTCited in: Definition, Classification, and ICHD-3 Criteria - [10]
Trimboli M, Troisi L, Caricato A et al.. “Acute confusional state in HaNDL syndrome.” Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology (2023). PMID: 37010670 ↗
L4CASE_REPORTCited in: Definition, Classification, and ICHD-3 Criteria - [11]
Jeong YD, Jo Y, Son Y et al.. “Global Incidence and Prevalence of Trigeminal Neuralgia, 1945-2024: A Systematic Review and Meta-Regression Analysis.” Journal of clinical neurology (Seoul, Korea) (2026). PMID: 41517817 ↗
L2SR_OBSCited in: Definition, Classification, and ICHD-3 Criteria - [12]
Straburzyński M, Agius AM, Hopkins C et al.. “Proposed changes to current definitions of ICHD-3 regarding headache and facial pain attributed to the disorder of the nose or paranasal sinuses.” Cephalalgia : an international journal of headache (2026). PMID: 42033402 ↗
L5REVIEW_NARRATIVECited in: Definition, Classification, and ICHD-3 Criteria - [13]
Robblee J, Smith JH, Ahmad S et al.. “Redefining status migrainosus: A narrative review.” Headache (2026). PMID: 41902388 ↗
L5REVIEW_NARRATIVECited in: Definition, Classification, and ICHD-3 Criteria, Clinical Phases and Symptomatology - [14]
Gklinos P, Evangelopoulos ME, Velonakis G et al.. “Migraine and Tension-Type Headache Are Associated with Multiple Sclerosis: A Case-Control Study.” Journal of clinical medicine (2025). PMID: 40283608 ↗
L3CASE_CONTROLCited in: Definition, Classification, and ICHD-3 Criteria - [15]
Robblee J. “Nervus Intermedius Neuralgia.” Current pain and headache reports (2025). PMID: 39847207 ↗
L5REVIEW_NARRATIVECited in: Definition, Classification, and ICHD-3 Criteria - [16]
Ashina S, Terwindt GM, Steiner TJ et al.. “Medication overuse headache.” Nature reviews. Disease primers (2023). PMID: 36732518 ↗
L5REVIEW_NARRATIVECited in: Definition, Classification, and ICHD-3 Criteria - [17]
Navarro-Pérez MP, Bellosta-Diago E, Olesen J et al.. “Cardiac cephalalgia: a narrative review and ICHD-3 criteria evaluation.” The journal of headache and pain (2022). PMID: 36266636 ↗
L5REVIEW_NARRATIVECited in: Definition, Classification, and ICHD-3 Criteria - [18]
Nordin BA. “Differentiating Visual Symptoms in Retinal Migraine and Migraine With Aura: A Systematic Review of Shared Features, Distinctions, and Clinical Implications.” Cureus (2025). PMID: 40873917 ↗
L2SR_OBSCited in: Definition, Classification, and ICHD-3 Criteria - [19]
Khawaja SN, Mansoor M. “When persistent idiopathic facial pain is not idiopathic: Facial pain attributed to lung cancer and comparative review of classification systems.” Cranio : the journal of craniomandibular practice (2026). PMID: 41733238 ↗
L4REVIEW_NARRATIVECited in: Definition, Classification, and ICHD-3 Criteria - [20]
Robblee J. “Breaking the cycle: unraveling the diagnostic, pathophysiological and treatment challenges of refractory migraine.” Frontiers in neurology (2023). PMID: 37830088 ↗
L5REVIEW_NARRATIVECited in: Definition, Classification, and ICHD-3 Criteria - [21]
Nitsche L, Helbach J, Stubenrauch S et al.. “The association between posttraumatic stress disorder and migraine: A systematic review.” Headache (2026). PMID: 41705319 ↗
L2SR_OBSCited in: Epidemiology and Socioeconomic Impact - [22]
Stech K, Jayachandran A, Zhao H et al.. “Sexual dysfunction in women with migraines: a systematic review.” Archives of women's mental health (2026). PMID: 41632288 ↗
L2SR_OBSCited in: Epidemiology and Socioeconomic Impact, Complications and Comorbidities - [23]
Gómez-Dabó L, Jordà-Baleri T, Losa-Puig H et al.. “The interplay between migraine, endometriosis and polycystic ovarian syndrome: A systematic review.” Cephalalgia : an international journal of headache (2025). PMID: 41384854 ↗
L2SR_OBSCited in: Epidemiology and Socioeconomic Impact - [24]
Forns J, Abellan A, Riera-Guàrdia N et al.. “The Challenges for Pharmacoepidemiologists Identifying Migraine in Electronic Healthcare Data Sources: A Systematic Literature Review.” Pharmacoepidemiology and drug safety (2025). PMID: 41331742 ↗
L2SR_OBSCited in: Epidemiology and Socioeconomic Impact - [25]
. “Global, regional, and national burden of headache disorders, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023.” The Lancet. Neurology (2025). PMID: 41240916 ↗
L2SR_OBSCited in: Epidemiology and Socioeconomic Impact - [26]
Gama-Reyes EG, de Caceres-García AN, Castillo-Vaca MF et al.. “Migraine-like headaches: a systematic review of secondary etiologies, clinical features and therapeutic patterns (1977-2024).” The journal of headache and pain (2025). PMID: 41152703 ↗
L2SR_OBSCited in: Epidemiology and Socioeconomic Impact - [27]
Kedgan P, Anukoolwittaya P, Surawattanawong T et al.. “EEG patterns in each phase of hemiplegic migraine: a systematic review and pooled prevalence meta-analysis.” The journal of headache and pain (2025). PMID: 41087891 ↗
L2SR_OBSCited in: Epidemiology and Socioeconomic Impact, Pathophysiology and Genetics, Clinical Phases and Symptomatology, Migraine Variants and Phenotypes - [28]
d'Onofrio F, Cropano M, Panzino G et al.. “Migraine and Restless Legs Syndrome: A Meta-Analysis.” Journal of sleep research (2026). PMID: 40968706 ↗
L2SR_OBSCited in: Epidemiology and Socioeconomic Impact, Complications and Comorbidities - [29]
Mordehachvili Burlá M, Ximenes Mendes B, Mendes Barbosa L et al.. “Rosacea and Migraine: A Systematic Review and Meta-Analysis Update.” International journal of dermatology (2026). PMID: 40899443 ↗
L2SR_OBSCited in: Epidemiology and Socioeconomic Impact - [30]
Jeong YD, Kim S, Son Y et al.. “Global Prevalence of Functional Abdominal Pain Disorder among Children and Adolescents According to the Rome III and IV Criteria: A Systematic Review and Meta-Analysis.” Gut and liver (2026). PMID: 40852741 ↗
L2SR_OBSCited in: Epidemiology and Socioeconomic Impact, Migraine Variants and Phenotypes - [31]
Joppeková Ľ, Pinto MJ, da Costa MD et al.. “What does a migraine aura look like?-A systematic review.” The journal of headache and pain (2025). PMID: 40597581 ↗
L2SR_OBSCited in: Epidemiology and Socioeconomic Impact, Pathophysiology and Genetics, Clinical Phases and Symptomatology, Diagnostic Evaluation and Differential Diagnosis - [32]
Minen MT, George A, Bostic R et al.. “The association between insomnia and migraine disability and quality of life: a secondary analysis of a randomized controlled trial.” Pain medicine (Malden, Mass.) (2026). PMID: 41206664 ↗
L2RCTCited in: Epidemiology and Socioeconomic Impact - [33]
Lucas NH, Liu J, Asefa A et al.. “Analysis by Age, Sex, Race, and Ethnicity of Participants in Clinical Trials Supporting Recently Approved Novel Therapies.” Clinical pharmacology and therapeutics (2025). PMID: 40887862 ↗
L2TRIAL_NONRANDOMCited in: Epidemiology and Socioeconomic Impact - [34]
Grant Tejada MP, Klomhaus AM, Ortiz R et al.. “Migraine prevalence and phenotype in autism: A retrospective cohort study using a US National Health Survey and large academic health system electronic health record.” Headache (2026). PMID: 41459835 ↗
L3COHORTCited in: Epidemiology and Socioeconomic Impact - [35]
Bar M, Peles I, Ifergane G et al.. “The association between migraine and glaucoma diseases: A retrospective cohort study.” Headache (2026). PMID: 41133646 ↗
L3COHORTCited in: Epidemiology and Socioeconomic Impact - [36]
Peles I, Sharvit S, Steen YM et al.. “Invisible burdens: Gender-specific associations between migraine and work-family conflict: Insights from the SMILE project - a cohort study.” Cephalalgia : an international journal of headache (2025). PMID: 40820314 ↗
L2COHORTCited in: Epidemiology and Socioeconomic Impact - [37]
Qalawa SAA, Elbqry MG, Elmansy FM et al.. “Migraine as an occupational health risk among nurses in Qassim region, Saudi Arabia: a multicenter study of risk perceptions and associated factors.” Frontiers in public health (2026). PMID: 42221630 ↗
L4OTHERCited in: Epidemiology and Socioeconomic Impact - [38]
Jung DE, Cho S, Ha WS et al.. “Chronotype in migraine and tension-type headache: A population study.” Headache (2026). PMID: 41902429 ↗
L4OTHERCited in: Epidemiology and Socioeconomic Impact - [39]
Johansson EW, Shaaban AN, Linde M et al.. “Comorbid depression or anxiety among migraine patients aged ten years or older living in Sweden in 2015 to 2023: A nationwide study.” Cephalalgia : an international journal of headache (2026). PMID: 41869776 ↗
L4OTHERCited in: Epidemiology and Socioeconomic Impact - [40]
Ha WS, Cho S, Kim KM et al.. “Pain beyond the head: clinical implications of body pain in migraine and tension-type headache in a population-based study.” The journal of headache and pain (2026). PMID: 41857711 ↗
L4OTHERCited in: Epidemiology and Socioeconomic Impact - [41]
Yazdani Y, Lee EJ, Francis A et al.. “Migraine Features in Patients With Sudden Sensorineural Hearing Loss.” Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (2026). PMID: 41800661 ↗
L4OTHERCited in: Epidemiology and Socioeconomic Impact - [42]
Lisicki M, Muñoz-Cerón J, Sarmento EM et al.. “Pan-American migraine prevalence: Findings from the Americas' migraine observatory study (AMIGOS).” Cephalalgia : an international journal of headache (2026). PMID: 41789851 ↗
L4OTHERCited in: Epidemiology and Socioeconomic Impact - [43]
Mueller BR, Campbell MC, Kaplan M et al.. “Beyond the headache: autonomic reflex dysfunction and heightened sensory sensitivity contribute to orthostatic intolerance in migraine.” Clinical autonomic research : official journal of the Clinical Autonomic Research Society (2026). PMID: 41420770 ↗
L4OTHERCited in: Epidemiology and Socioeconomic Impact - [44]
Schwedt TJ, Starling AJ, Ailani J et al.. “Routine migraine screening as a standard of care for Women's health: A position statement from the American Headache Society.” Headache (2026). PMID: 41376343 ↗
L1REVIEW_NARRATIVECited in: Epidemiology and Socioeconomic Impact - [45]
Rui S, Cai Z, Wu J et al.. “Association Between Migraine and Frailty Among Middle-Aged and Older Adults: A Cross-Sectional Study Based on CHARLS.” Pain research & management (2025). PMID: 41367382 ↗
L4OTHERCited in: Epidemiology and Socioeconomic Impact - [46]
Hakimzadeh Z, Chaudhry BA, Al-Khazali HM et al.. “Molecular triggers of migraine aura: A systematic review of human pharmacological provocation studies.” Cephalalgia : an international journal of headache (2026). PMID: 41923467 ↗
L2SR_OBSCited in: Pathophysiology and Genetics, Clinical Phases and Symptomatology - [47]
Arquizan R, Melchior AG, Christensen RH et al.. “Vascular responses to molecular migraine triggers: a systematic review of magnetic resonance angiography studies.” The journal of headache and pain (2025). PMID: 40790620 ↗
L2SR_OBSCited in: Pathophysiology and Genetics - [48]
van der Arend BWH, van Welie FC, Olsen MH et al.. “Impact of CGRP monoclonal antibody treatment on blood pressure in patients with migraine: A systematic review and potential clinical implications.” Cephalalgia : an international journal of headache (2025). PMID: 39877974 ↗
L1SR_OBSCited in: Pathophysiology and Genetics - [49]
Gopalakrishnan R, Malan NS, Mandava N et al.. “Magnetoencephalography studies in migraine and headache disorders: A systematic review.” Headache (2025). PMID: 39523760 ↗
L2SR_OBSCited in: Pathophysiology and Genetics, Diagnostic Evaluation and Differential Diagnosis - [50]
Askari MA, Vajdi M, Khorvash F et al.. “Effect of mixodin supplementation on inflammatory and oxidative stress markers, clinical symptoms, mental health, and quality of life in patients with migraine: study protocol for a randomized clinical trial.” Trials (2025). PMID: 41131591 ↗
L5TRIAL_NONRANDOMCited in: Pathophysiology and Genetics, Clinical Phases and Symptomatology - [51]
Olesiejuk M, Chalimoniuk M, Sacewicz T. “Myofascial trigger points therapy increases neck mobility and reduces headache pain in migraine patients - pilot study.” BMC musculoskeletal disorders (2025). PMID: 39893364 ↗
L4TRIAL_NONRANDOMCited in: Pathophysiology and Genetics - [52]
Bulboacă AI, Gerdanovics A, Borlea BA et al.. “Nitric Oxide, Oxidative Stress and Endothelial Dysfunction in Migraine: Recent Advances and Molecular Mechanisms.” International journal of molecular sciences (2026). PMID: 42123296 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics - [53]
Huang Z, Qi R, Lu W et al.. “Identification of common genetic and molecular signatures in migraine and comorbid conditions.” The journal of headache and pain (2026). PMID: 41876989 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics - [54]
Chauhan SB, Bhandari A, Jain C et al.. “Circadian Regulation of m6A RNA Methylation in Migraine: Mechanisms and Therapeutic Implications.” Journal of molecular neuroscience : MN (2026). PMID: 41557243 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics - [55]
Scuteri D, Labastida-Ramirez A, Rubio-Beltran E et al.. “Epigenetics in migraine: the Junior Editorial Board Members' vision.” The journal of headache and pain (2025). PMID: 41345551 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics - [56]
Oncel MM, Harriott AM. “Is canonical SD a clinically relevant model of migraine? Argument pro.” The journal of headache and pain (2025). PMID: 41340021 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics, Clinical Phases and Symptomatology - [57]
Villar-Martinez MD, Abdalla A, Goadsby PJ. “Vestibular migraine. Clinical and diagnostic challenges, and emerging therapeutic approaches.” Current opinion in neurology (2026). PMID: 41324222 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics, Clinical Phases and Symptomatology, Migraine Variants and Phenotypes, Diagnostic Evaluation and Differential Diagnosis - [58]
Christensen RH, Ashina H, Ashina M. “The vessel-to-neuron trigeminovascular hypothesis of migraine pathogenesis - the 'pro' argument.” The journal of headache and pain (2025). PMID: 41214549 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics - [59]
Mascarella D, Zhuang ZA, Gliga O et al.. “Migraine in monogenic disorders: Shedding light on new therapeutic targets.” Cephalalgia : an international journal of headache (2025). PMID: 41147997 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics, Migraine Variants and Phenotypes - [60]
Moreno-Ajona D. “Persistent postural-perceptual dizziness versus vestibular migraine: A narrative review.” Headache (2026). PMID: 41147266 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics, Migraine Variants and Phenotypes, Diagnostic Evaluation and Differential Diagnosis - [61]
Patel EJ, Sharon JD, Levin M et al.. “Calcitonin gene-related peptide in the audiovestibular system.” Headache (2026). PMID: 41137472 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics, Migraine Variants and Phenotypes - [62]
Kuruvilla DE, Hutchinson S, Moriarty M et al.. “Understanding migraine throughout a woman's life and the role of calcitonin gene-related peptide: A narrative review.” Women's health (London, England) (2025). PMID: 41109841 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics, Clinical Phases and Symptomatology - [63]
Hjelholt AJ, Tei RMH, Diener HC et al.. “Dopamine and prolactin in migraine: Mechanisms and potential therapeutic targets.” Journal of neuroendocrinology (2025). PMID: 41052788 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics, Clinical Phases and Symptomatology - [64]
Casillo F, Sebastianelli G, Abagnale C et al.. “Brain imaging in migraine with and without aura: Similarities and differences.” Cephalalgia : an international journal of headache (2025). PMID: 40936449 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics, Clinical Phases and Symptomatology, Diagnostic Evaluation and Differential Diagnosis - [65]
Fila M, Pawlowska E, Krekora J et al.. “Exploring the epigenetic modifications of the RONS-TRPA1-CGRP axis in migraine pathophysiology.” The journal of headache and pain (2025). PMID: 40890590 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics - [66]
Alpay B, Christensen RH, Al-Khazali HM et al.. “Substance P and the trigeminovascular system: From preclinical mechanisms to human headache induction.” Cephalalgia : an international journal of headache (2025). PMID: 40746227 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics - [67]
Martami F, Holton KF. “Unmasking the relationship between CGRP and glutamate: from peripheral excitation to central sensitization in migraine.” The journal of headache and pain (2025). PMID: 40329208 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics - [68]
Krivoshein G, Rivera-Mancilla E, MaassenVanDenBrink A et al.. “Sex difference in TRPM3 channel functioning in nociceptive and vascular systems: an emerging target for migraine therapy in females?” The journal of headache and pain (2025). PMID: 39994546 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics - [69]
Borończyk M, Zduńska A, Węgrzynek-Gallina J et al.. “Migraine and stroke: correlation, coexistence, dependence - a modern perspective.” The journal of headache and pain (2025). PMID: 39979846 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics, Complications and Comorbidities - [70]
Soylu KO, Yemisci M, Karatas H. “The link between spreading depolarization and innate immunity in the central nervous system.” The journal of headache and pain (2025). PMID: 39901107 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics - [71]
Pietrobon D, Brennan KC. “Mechanisms underlying CSD initiation implicated by genetic mouse models of migraine.” The journal of headache and pain (2025). PMID: 39871148 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics - [72]
Olesen J. “Cerebral blood flow and arterial responses in migraine: history and future perspectives.” The journal of headache and pain (2024). PMID: 39701954 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics - [73]
Raggi A, Leonardi M, Arruda M et al.. “Hallmarks of primary headache: part 1 - migraine.” The journal of headache and pain (2024). PMID: 39482575 ↗
L5REVIEW_NARRATIVECited in: Pathophysiology and Genetics - [74]
McKay K, Kelly K. “Investigating the impact of migraine on short-term and working memory: a systematic review and meta-analysis.” Journal of neurology (2026). PMID: 41843171 ↗
L1SR_OBSCited in: Clinical Phases and Symptomatology - [75]
Ulutas S, Özçelik EU, Dabó LG et al.. “Evoked potential studies in migraine: A systematic review of neurophysiological patterns across migraine subtypes.” Cephalalgia : an international journal of headache (2025). PMID: 41364425 ↗
L3SR_OBSCited in: Clinical Phases and Symptomatology - [76]
Fani M, Sharp N, Schwedt TJ. “Reducing light sensitivity during and between migraine attacks: A prospective study investigating spectral tuning of white light.” Cephalalgia : an international journal of headache (2026). PMID: 41983992 ↗
L2RCTCited in: Clinical Phases and Symptomatology - [77]
Ayata C, Hougaard A, Schiff SJ et al.. “Tsunamis hiding in plain sight: spreading depression in clinical neurology.” Nature reviews. Neurology (2026). PMID: 41814024 ↗
L5REVIEW_NARRATIVECited in: Clinical Phases and Symptomatology - [78]
Braca S, Santoro V, Sebastianelli G et al.. “Visual snow vs. migraine aura: Debate summary and novel insights into the syndrome.” Cephalalgia : an international journal of headache (2025). PMID: 40944402 ↗
L5REVIEW_NARRATIVECited in: Clinical Phases and Symptomatology, Diagnostic Evaluation and Differential Diagnosis - [79]
Viana M, Peres MFP. “The spectrum of migraine aura: Towards a precise phenotypic classification.” Cephalalgia : an international journal of headache (2025). PMID: 40891623 ↗
L5REVIEW_NARRATIVECited in: Clinical Phases and Symptomatology - [80]
Harriott AM, Ayata C. “Spreading depolarization as a therapeutic target in migraine.” Nature reviews. Neurology (2025). PMID: 40813918 ↗
L5REVIEW_NARRATIVECited in: Clinical Phases and Symptomatology - [81]
Grodzka O, Dzagoevi K, Rees T et al.. “Migraine with and without aura-two distinct entities? A narrative review.” The journal of headache and pain (2025). PMID: 40229683 ↗
L5REVIEW_NARRATIVECited in: Clinical Phases and Symptomatology, Diagnostic Evaluation and Differential Diagnosis - [82]
Silvestro M, Dortucci V, Orologio I et al.. “The relevance of cortical thickness in migraine sufferers and implications to therapy.” Expert review of neurotherapeutics (2025). PMID: 40166863 ↗
L5REVIEW_NARRATIVECited in: Clinical Phases and Symptomatology, Diagnostic Evaluation and Differential Diagnosis - [83]
Xie C, Zhang Z, Zhang Y et al.. “Multi-Spatial Voxel-Scale Modulation of Acupuncture on Abnormal Brain Activity in Migraine Patients Without Aura: A Randomized Study Neuroimaging Trial.” Brain and behavior (2025). PMID: 40341810 ↗
L1RCTCited in: Clinical Phases and Symptomatology - [84]
Yuan H, Orr SL, Al-Karagholi MAM et al.. “International Headache society evidence-based guidelines on the use of non-invasive neuromodulation devices for the acute and preventive treatment of migraine.” Cephalalgia : an international journal of headache (2025). PMID: 41117312 ↗
L1GUIDELINECited in: Migraine Variants and Phenotypes, Neuromodulation and Procedural Interventions - [85]
Aron M, Mageto R, Seth J et al.. “Ocular Findings During Vestibular Testing in Vestibular Migraine: Systematic Review.” Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale (2026). PMID: 41950055 ↗
L2SR_OBSCited in: Migraine Variants and Phenotypes - [86]
Sfakianaki I, Nikitas C, Kikidis D. “The Effectiveness of Vestibular Rehabilitation in Vestibular Migraine: A Systematic Review.” Journal of the Association for Research in Otolaryngology : JARO (2026). PMID: 41840297 ↗
L1SR_OBSCited in: Migraine Variants and Phenotypes, Complications and Comorbidities - [87]
El Ahdab J, Vilardo M, Ong B et al.. “The effect of vestibular rehabilitation in the management of vestibular migraine in adults: A systematic review and meta-analysis.” Headache (2026). PMID: 41288240 ↗
L1SR_OBSCited in: Migraine Variants and Phenotypes - [88]
Almohammed HA, Thalib HI, Kushara KF et al.. “Prophylactic Management of Vestibular Migraine: A Systematic Review.” Annals of clinical and translational neurology (2025). PMID: 41166161 ↗
L1SR_OBSCited in: Migraine Variants and Phenotypes, Preventive Pharmacological Management (Traditional), CGRP-Targeted Preventive Therapies - [89]
Vosbeek EGM, Seelen M, Schermer TR et al.. “The Differences in Caloric Test and vHIT Results Between Menière's Disease and Vestibular Migraine: A Systematic Review and Meta-Analysis.” Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (2025). PMID: 41126437 ↗
L2SR_OBSCited in: Migraine Variants and Phenotypes, Diagnostic Evaluation and Differential Diagnosis - [90]
Stuchfield-Denby E, Pereira B, Bouvier D et al.. “Distinct inflammatory profiles across migraine states: a systematic review and meta-analysis.” The journal of headache and pain (2025). PMID: 41102646 ↗
L2SR_OBSCited in: Migraine Variants and Phenotypes - [91]
Vasireddy S, Biswas S, Kollu R et al.. “Comparative effectiveness and safety of preventive treatments for vestibular migraine: a systematic review and network meta-analysis.” BMC neurology (2025). PMID: 41469852 ↗
L1SR_OBSCited in: Migraine Variants and Phenotypes, CGRP-Targeted Preventive Therapies - [92]
Arslan SG, Yılmaz MS, Kınalı KÇ et al.. “Effects of vestibular rehabilitation program on balance, dizziness severity, sleep quality and quality of life in patients with vestibular migraine.” Irish journal of medical science (2026). PMID: 41240256 ↗
L1RCTCited in: Migraine Variants and Phenotypes - [93]
Fukudo S, Aziz Q, Drossman DA et al.. “Centrally Mediated Disorders of Gastrointestinal Pain.” Gastroenterology (2026). PMID: 41692277 ↗
L5REVIEW_NARRATIVECited in: Migraine Variants and Phenotypes - [94]
Riso IL, Peres MFP, Cohen F. “Hemiplegic Cluster Headache.” Current pain and headache reports (2025). PMID: 41307608 ↗
L5REVIEW_NARRATIVECited in: Migraine Variants and Phenotypes - [95]
Baron R, Steenerson KK. “Dizziness: When Is It Migraine, and When Is It Not?” Current neurology and neuroscience reports (2025). PMID: 40762746 ↗
L5REVIEW_NARRATIVECited in: Migraine Variants and Phenotypes - [96]
Jaimes A, Rodríguez-Vico J, Pajares O et al.. “Prospective cohort study of the impact of preventive migraine treatment on vestibular function and symptoms: The SPIRAL study.” Clinical neurology and neurosurgery (2026). PMID: 41265241 ↗
L2COHORTCited in: Migraine Variants and Phenotypes - [97]
Hotz JF, Kaindl L, Krebs S et al.. “Reduced Frequency of Prolonged Sporadic Hemiplegic Migraine Attacks Following Fremanezumab Treatment-A Case Report.” European journal of neurology (2026). PMID: 41589756 ↗
L4CASE_REPORTCited in: Migraine Variants and Phenotypes, CGRP-Targeted Preventive Therapies - [98]
Radutiu DI, Szabo E, Christensen RH et al.. “Magnetic resonance spectroscopy during migraine attacks: A systematic review.” Cephalalgia : an international journal of headache (2026). PMID: 42135598 ↗
L2SR_OBSCited in: Diagnostic Evaluation and Differential Diagnosis - [99]
Christensen RH, Vashchenko N, Eigenbrodt AK et al.. “PET and fMRI insights into experimentally-induced premonitory symptoms in migraine: A systematic review.” Cephalalgia : an international journal of headache (2026). PMID: 41776969 ↗
L2SR_OBSCited in: Diagnostic Evaluation and Differential Diagnosis - [100]
Petrušić I, Messina R, Pellesi L et al.. “Application of machine learning in migraine classification: a call for study design standardization and global collaboration.” The journal of headache and pain (2025). PMID: 41039195 ↗
L2SR_OBSCited in: Diagnostic Evaluation and Differential Diagnosis - [101]
Chen Q, Liu Y, Yang X et al.. “Aberrant Spontaneous Low-Frequency Brain Activity in Migraine: A Meta-Analysis of Resting-State fMRI Studies.” Journal of neuroimaging : official journal of the American Society of Neuroimaging (2025). PMID: 40420335 ↗
L2SR_OBSCited in: Diagnostic Evaluation and Differential Diagnosis - [102]
Suarez-Barcena PD, Parra-Perez AM, Martín-Lagos J et al.. “Machine learning models and classification algorithms in the diagnosis of vestibular migraine: A systematic review and meta-analysis.” Headache (2025). PMID: 40079713 ↗
L2SR_OBSCited in: Diagnostic Evaluation and Differential Diagnosis - [103]
Zhang X, Chen Q, Liu Y et al.. “Acupuncture for Migraine Without Aura and Connection-Based Efficacy Prediction: A Randomized Clinical Trial.” JAMA network open (2026). PMID: 41591775 ↗
L1RCTCited in: Diagnostic Evaluation and Differential Diagnosis - [104]
Atalar AÇ, Özçelik EU, Vanlı-Yavuz EN et al.. “Systematic review of late-onset aura related to migraine: an overlooked phenomenon.” Acta neurologica Belgica (2025). PMID: 40381181 ↗
L2SR_OBSCited in: Diagnostic Evaluation and Differential Diagnosis - [105]
Schuman-Olivier Z, Marin F, Kinder LD et al.. “Evaluating brain mechanisms of combined vagus nerve stimulation and mindfulness training for migraine: A randomized 2 × 2 factorial clinical trial protocol.” Contemporary clinical trials (2025). PMID: 40409681 ↗
L5TRIAL_NONRANDOMCited in: Diagnostic Evaluation and Differential Diagnosis - [106]
Różycka K, Siwak N, Rucka A et al.. “A Review of the Biochemical Diagnostic Biomarkers in Migraine: New Perspectives in Diagnostics.” Pain research & management (2025). PMID: 41496770 ↗
L2REVIEW_NARRATIVECited in: Diagnostic Evaluation and Differential Diagnosis - [107]
Chaudhry BA, Younis S, Messina R et al.. “Cortical thickness studies in migraine: Current evidence and future directions.” Cephalalgia : an international journal of headache (2025). PMID: 40474701 ↗
L5REVIEW_NARRATIVECited in: Diagnostic Evaluation and Differential Diagnosis - [108]
Severino M, Green MW. “Persistent aura without infarction.” Current opinion in neurology (2025). PMID: 40062461 ↗
L5REVIEW_NARRATIVECited in: Diagnostic Evaluation and Differential Diagnosis - [109]
Charleston L, Armand CE, Monteith TS et al.. “Efficacy and safety of rimegepant for the acute treatment of migraine in Black or African American adults: A post hoc pooled subgroup analysis from three randomized, placebo-controlled clinical trials.” Headache (2026). PMID: 41652666 ↗
L1RCTCited in: Acute Pharmacological Management - [110]
Ashina M, McAllister P, Gaul C et al.. “Rimegepant for acute treatment of migraine in triptan-unsuitable adults: A randomized, double-blind, placebo-controlled phase 4 trial.” Cephalalgia : an international journal of headache (2025). PMID: 41255093 ↗
L1RCTCited in: Acute Pharmacological Management, Migraine in Special Populations - [111]
Turan Y, Akoglu H, Unal E et al.. “Efficacy of Adding Intravenous Saline Solution to Nonsteroidal Anti-Inflammatory Drug-Based Treatment of Acute Migraine in the Emergency Department.” Annals of emergency medicine (2026). PMID: 41071134 ↗
L1RCTCited in: Acute Pharmacological Management - [112]
Alsaadi T, Suliman R, Yang J et al.. “A randomized open-label study to evaluate the effectiveness and safety of once-daily rimegepant 75 mg orally disintegrating tablet for the short-term preventive treatment of fasting-triggered headache in individuals with migraine.” Cephalalgia : an international journal of headache (2025). PMID: 40734466 ↗
L1RCTCited in: Acute Pharmacological Management - [113]
Ikeda K, Matsumori Y, Kudo M et al.. “Efficacy and safety of rimegepant for the acute treatment of migraine in Japan: A dose-ranging, double-blind, randomized controlled trial.” Headache (2025). PMID: 40586377 ↗
L1RCTCited in: Acute Pharmacological Management - [114]
Khodeer DM, Abdelmonem SM, Dossouvi KM et al.. “Efficacy and safety of rimegepant for acute and preventive treatment of migraine: a systematic review and meta-analysis of randomized controlled trials.” BMC pharmacology & toxicology (2026). PMID: 42152069 ↗
L1SR_MA_RCTCited in: Acute Pharmacological Management - [115]
Giacon M, Terrazzino S. “Post-marketing safety of CGRP monoclonal antibodies and gepants: A systematic review of spontaneous reporting system data.” Headache (2026). PMID: 41834180 ↗
L4SR_OBSCited in: Acute Pharmacological Management, CGRP-Targeted Preventive Therapies, Migraine in Special Populations - [116]
Santos-Lasaosa S, Armada B, Moya-Alarcón C et al.. “Cost of rimegepant and lasmiditan associated adverse events, for acute treatment in migraine in Spain.” Expert review of pharmacoeconomics & outcomes research (2026). PMID: 41508870 ↗
L2SR_OBSCited in: Acute Pharmacological Management - [117]
Bruijn NRA, Huessler EM, MaassenVanDenBrink A et al.. “Placebo Response in Acute and Prophylactic Treatment of Migraine: A Systematic Review and Meta-Analysis Covering 36 Years of Research.” Neurologic clinics (2026). PMID: 41232995 ↗
L1SR_OBSCited in: Acute Pharmacological Management - [118]
Sharma R, Pandey A, Agarwal R et al.. “Network meta-analysis of migraine therapies: balancing efficacy and safety.” Brain research (2025). PMID: 40972699 ↗
L1SR_OBSCited in: Acute Pharmacological Management - [119]
Rashidi A, Keramati M, Esmaily H et al.. “Cost-effectiveness of abortive and preventative treatments in patients with migraine: a systematic review.” European journal of clinical pharmacology (2025). PMID: 40663117 ↗
L2SR_OBSCited in: Acute Pharmacological Management, CGRP-Targeted Preventive Therapies - [120]
Boinpally RR, Trugman JM. “Ubrogepant Plasma and Cerebrospinal Fluid Exposures in Participants With a History of Migraine: Findings From a Phase 1b Open-Label Trial.” Clinical and translational science (2026). PMID: 42012062 ↗
L4TRIAL_NONRANDOMCited in: Acute Pharmacological Management - [121]
Antinew J, Fountaine RJ, Loprinzo V et al.. “A phase 4, 24-week, open-label study to evaluate the safety and tolerability of once-daily dosing of 75 mg rimegepant for episodic migraine prevention.” The journal of headache and pain (2025). PMID: 41366286 ↗
L4TRIAL_NONRANDOMCited in: Acute Pharmacological Management - [122]
Lim CN, Mo G, Bhardwaj R et al.. “A phase 1, multicenter, open-label study to evaluate the pharmacokinetics, safety, and tolerability of a single dose of rimegepant in children (aged ≥6 to <12 years) with a history of migraine.” Headache (2026). PMID: 41133671 ↗
L4TRIAL_NONRANDOMCited in: Acute Pharmacological Management - [123]
Zhang M, Guo A, Wu J et al.. “Rimegepant for the acute treatment of migraine: A phase 3, multicenter, open-label, long-term safety and effectiveness study in adults from China.” Cephalalgia : an international journal of headache (2025). PMID: 41066271 ↗
L4TRIAL_NONRANDOMCited in: Acute Pharmacological Management - [124]
Ailani J, Pavlovic J, Pixton GC et al.. “Rimegepant safety and patient-reported outcomes among triptan-naïve, triptan-using, and triptan-failure participants: Subgroup analysis of an open-label, multicenter study.” Cephalalgia : an international journal of headache (2025). PMID: 40629887 ↗
L4TRIAL_NONRANDOMCited in: Acute Pharmacological Management - [125]
Chou CC, Wu JW, Lin HJ et al.. “Glaucoma Risk Associated With Calcitonin Gene-Related Peptide Inhibitor Use in Migraine: A Multinational Cohort Study.” Neurology (2026). PMID: 42090640 ↗
L2COHORTCited in: Acute Pharmacological Management, CGRP-Targeted Preventive Therapies - [126]
Phillips K, Gokhale K, Damase-Michel C et al.. “Migraine, associated treatments and risk of miscarriage: A matched cohort study and nested case-control study using the CPRD pregnancy register.” Cephalalgia : an international journal of headache (2026). PMID: 41603448 ↗
L2COHORTCited in: Acute Pharmacological Management, Migraine in Special Populations - [127]
Vollono C, Romozzi M, Munafò A et al.. “Influence of triptans use on anti-CGRP mAbs response: a prospective, cohort study.” Journal of neurology (2025). PMID: 40536712 ↗
L2COHORTCited in: Acute Pharmacological Management - [128]
Huang Q, Li N, Dou H et al.. “Circulating CGRP as a diagnostic biomarker in female migraine patients: a single-center case-control study.” The journal of headache and pain (2025). PMID: 41107707 ↗
L3CASE_CONTROLCited in: Acute Pharmacological Management - [129]
Wennersten T, Lindh JD, Nilsson Remahl AIM et al.. “Higher socioeconomic status is associated with dispensation of monoclonal antibodies against calcitonin gene-related peptide in migraine: A nested case-control study.” Cephalalgia : an international journal of headache (2025). PMID: 40528434 ↗
L3CASE_CONTROLCited in: Acute Pharmacological Management - [130]
Andreata VG, Freitas RPD, Nascimento JDS et al.. “Genetic Basis of the Negative Response to the Use of Triptans for the Treatment of Migraine-A Systematic Review and Meta-Analysis.” Brain and behavior (2025). PMID: 41121943 ↗
L3SR_OBSCited in: Acute Pharmacological Management - [131]
Imanuel CA, Atwan Z, Tabche C. “The public health impact of the Rx-to-OTC switch of triptan in Germany: Systematic review and framework analysis.” Journal of the American Pharmacists Association : JAPhA (2025). PMID: 40716573 ↗
L2SR_OBSCited in: Acute Pharmacological Management - [132]
Libman H, Smetana GW, Hovaguimian AE et al.. “How Would You Manage This Patient With Frequent Migraine Headaches? Grand Rounds Discussion From Beth Israel Deaconess Medical Center.” Annals of internal medicine (2026). PMID: 41974011 ↗
L5CASE_REPORTCited in: Acute Pharmacological Management - [133]
Berger CT, Villena FB, Vogt SB et al.. “Delayed urticaria during treatment with anti-CGRP monoclonal antibodies in migraine.” Headache (2026). PMID: 41834416 ↗
L4CASE_REPORTCited in: Acute Pharmacological Management, CGRP-Targeted Preventive Therapies - [134]
Ngo M, Ehsani-Nia MI, Ailani J. “Focus on migraine prodrome: what should clinicians know?” Current opinion in neurology (2026). PMID: 41952417 ↗
L5REVIEW_NARRATIVECited in: Acute Pharmacological Management - [135]
Lin L, Wu J, Wang T et al.. “From structural evolution to an AI-driven future of 5-HT1F receptor agonists for migraine therapy.” European journal of medicinal chemistry (2026). PMID: 41864040 ↗
L5REVIEW_NARRATIVECited in: Acute Pharmacological Management - [136]
Silberstein S, Rapoport AM. “Novel optimization of multi-mechanistic approaches for the acute treatment of a migraine attack: A review.” Headache (2026). PMID: 41781342 ↗
L5REVIEW_NARRATIVECited in: Acute Pharmacological Management - [137]
Patel EJ, Koziol K, Sharon JD. “Early Experience Treating Vestibular Migraine With Small Molecule CGRP Antagonists.” Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (2026). PMID: 41774573 ↗
L4OTHERCited in: Acute Pharmacological Management - [138]
Lipton RB, Dodick DW, Davis L et al.. “Integrating gepants into clinical practice for the acute treatment of migraine.” Headache (2026). PMID: 41709494 ↗
L5REVIEW_NARRATIVECited in: Acute Pharmacological Management - [139]
Qaseem A, Cooney TG, Etxeandia-Ikobaltzeta I et al.. “Prevention of Episodic Migraine Headache Using Pharmacologic Treatments in Outpatient Settings: A Clinical Guideline From the American College of Physicians.” Annals of internal medicine (2025). PMID: 39899861 ↗
L1GUIDELINECited in: Preventive Pharmacological Management (Traditional) - [140]
Sico JJ, Antonovich NM, Ballard-Hernandez J et al.. “2023 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline for the Management of Headache.” Annals of internal medicine (2024). PMID: 39467289 ↗
L1GUIDELINECited in: Preventive Pharmacological Management (Traditional), Lifestyle, Behavioral, and Complementary Medicine - [141]
Abouelmagd ME, Aldemerdash MA, Khatatbeh AA et al.. “Efficacy and Safety of Melatonin in Migraine Prophylaxis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” Current pain and headache reports (2026). PMID: 41627537 ↗
L1SR_MA_RCTCited in: Preventive Pharmacological Management (Traditional) - [142]
Pozo-Rosich P, López JAG, Lisewski P et al.. “A phase 4, randomized, double-blind, placebo-controlled trial evaluating the efficacy and tolerability of rimegepant for the prevention of episodic migraine in adults with a history of inadequate response to traditional oral preventive medications.” Cephalalgia : an international journal of headache (2025). PMID: 41255098 ↗
L1RCTCited in: Preventive Pharmacological Management (Traditional) - [143]
Øie LR, Wergeland T, Salvesen Ø et al.. “Candesartan versus placebo for migraine prevention in patients with episodic migraine: a randomised, triple-blind, placebo-controlled, phase 2 trial.” The Lancet. Neurology (2025). PMID: 40975098 ↗
L1RCTCited in: Preventive Pharmacological Management (Traditional) - [144]
Liu L, Chen Q, Zhao L et al.. “Acupuncture plus topiramate placebo versus topiramate plus sham acupuncture for the preventive treatment of chronic migraine: A single-blind, double-dummy, randomized controlled trial.” Cephalalgia : an international journal of headache (2024). PMID: 38860524 ↗
L1RCTCited in: Preventive Pharmacological Management (Traditional) - [145]
Olfat M, Hosseinpour S, Masoumi S et al.. “A comparative study on prophylactic efficacy of cinnarizine and amitriptyline in childhood migraine: a randomized double-blind clinical trial.” Cephalalgia : an international journal of headache (2024). PMID: 38641932 ↗
L1RCTCited in: Preventive Pharmacological Management (Traditional) - [146]
Ashina M, Mitsikostas DD, Ramirez Campos V et al.. “Numbers needed to treat or harm and likelihood of being helped versus harmed for fremanezumab in patients who had prior inadequate response to two to four classes of migraine preventive medications: A post hoc analysis.” Headache (2023). PMID: 37955395 ↗
L1RCTCited in: Preventive Pharmacological Management (Traditional) - [147]
Gibler RC, Peugh JL, Coffey CS et al.. “Impact of preventive pill-based treatment on migraine days: A secondary outcome study of the Childhood and Adolescent Migraine Prevention (CHAMP) trial and a comparison of self-report to nosology-derived assessments.” Headache (2023). PMID: 36757131 ↗
L1RCTCited in: Preventive Pharmacological Management (Traditional) - [148]
Moisset X, Demarquay G, de Gaalon S et al.. “Migraine treatment: Position paper of the French Headache Society.” Revue neurologique (2024). PMID: 39406556 ↗
L1GUIDELINECited in: Preventive Pharmacological Management (Traditional), Migraine in Special Populations - [149]
Shaukat A, Shakeel L, Riaz R et al.. “"The efficacy and safety of Atogepant for migraine prophylaxis: a systematic review and meta-analysis of randomized controlled trials".” BMC neurology (2025). PMID: 40783748 ↗
L1SR_MA_RCTCited in: Preventive Pharmacological Management (Traditional) - [150]
Abdi A, Abbasi E, Abazarlou A. “Cinnarizine vs. topiramate for migraine prophylaxis in children: a randomized, double-blind, parallel-group clinical trial.” BMC neurology (2026). PMID: 42106656 ↗
L1RCTCited in: Preventive Pharmacological Management (Traditional) - [151]
Roy V, Banu N, Meshram GG et al.. “Low-Dose Propranolol versus Amitriptyline for Episodic Migraine Prophylaxis: A Randomized Controlled Trial Assessing Efficacy, Safety, and Cost-Effectiveness.” Clinical drug investigation (2025). PMID: 40932597 ↗
L1RCTCited in: Preventive Pharmacological Management (Traditional) - [152]
Zeinhom MG, Elsayed Khalil MF, Omar Youssif TY et al.. “Efficacy and tolerability of valproate versus topiramate in migraine prevention, a randomized controlled multi-center trial.” Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia (2025). PMID: 40020561 ↗
L1RCTCited in: Preventive Pharmacological Management (Traditional) - [153]
Juica-Avello S, Riquelme-Vergara C, Condeza-Riquelme F et al.. “[Comparison of tiapride and topiramate in the prophylactic treatment of chronic migraine: a randomised, double-blind, pilot study].” Revista de neurologia (2022). PMID: 35548913 ↗
L1RCTCited in: Preventive Pharmacological Management (Traditional) - [154]
Riise HS, Thorvik H, Øie LR et al.. “The effects of angiotensin receptor blockers as prophylactic migraine treatment: A systematic review and meta-analysis.” Cephalalgia : an international journal of headache (2026). PMID: 42213459 ↗
L1SR_OBSCited in: Preventive Pharmacological Management (Traditional) - [155]
Damen JAA, Yang B, Idema DL et al.. “Comparative Effectiveness of Pharmacologic Treatments for the Prevention of Episodic Migraine Headache: A Systematic Review and Network Meta-analysis for the American College of Physicians.” Annals of internal medicine (2025). PMID: 39899873 ↗
L1SR_OBSCited in: Preventive Pharmacological Management (Traditional) - [156]
Kohandel Gargari O, Aghajanian S, Togha M et al.. “Preventive Medications in Pediatric Migraine: A Network Meta-Analysis.” JAMA network open (2024). PMID: 39388181 ↗
L1SR_OBSCited in: Preventive Pharmacological Management (Traditional), Lifestyle, Behavioral, and Complementary Medicine, Migraine in Special Populations - [157]
Mistry H, Naghdi S, Brown A et al.. “Preventive drug treatments for adults with chronic migraine: a systematic review with economic modelling.” Health technology assessment (Winchester, England) (2024). PMID: 39365169 ↗
L1SR_OBSCited in: Preventive Pharmacological Management (Traditional) - [158]
Zhao C, Li C, Yu X et al.. “Effectiveness and safety of pharmacological prophylaxis for chronic migraine: a systematic review and network meta-analysis.” Journal of neurology (2024). PMID: 38910144 ↗
L1SR_OBSCited in: Preventive Pharmacological Management (Traditional) - [159]
Naghdi S, Underwood M, Madan J et al.. “Clinical effectiveness of pharmacological interventions for managing chronic migraine in adults: a systematic review and network meta-analysis.” The journal of headache and pain (2023). PMID: 38057728 ↗
L1SR_OBSCited in: Preventive Pharmacological Management (Traditional) - [160]
Raffaelli B, García-Azorín D, Boucherie DM et al.. “European Headache Federation (EHF) critical reappraisal and meta-analysis of oral drugs in migraine prevention - part 3: topiramate.” The journal of headache and pain (2023). PMID: 37814223 ↗
L1SR_OBSCited in: Preventive Pharmacological Management (Traditional) - [161]
Carcel C, Haghdoost F, Shen J et al.. “The effect of blood pressure lowering medications on the prevention of episodic migraine: A systematic review and meta-analysis.” Cephalalgia : an international journal of headache (2023). PMID: 37350141 ↗
L1SR_OBSCited in: Preventive Pharmacological Management (Traditional) - [162]
Lampl C, MaassenVanDenBrink A, Deligianni CI et al.. “The comparative effectiveness of migraine preventive drugs: a systematic review and network meta-analysis.” The journal of headache and pain (2023). PMID: 37208596 ↗
L1SR_OBSCited in: Preventive Pharmacological Management (Traditional) - [163]
Robblee J, Minen MT, Friedman BW et al.. “2025 guideline update to acute treatment of migraine for adults in the emergency department: The American Headache Society evidence assessment of parenteral pharmacotherapies.” Headache (2026). PMID: 41321235 ↗
L1GUIDELINECited in: CGRP-Targeted Preventive Therapies, Neuromodulation and Procedural Interventions - [164]
Khalili M, Haghdoost F, Liaghatdar A et al.. “Effectiveness and tolerability of pharmacological prophylaxis in migraine patients with prior preventive treatment failure: A systematic review and network meta-analysis of randomized controlled trials.” Cephalalgia : an international journal of headache (2026). PMID: 42011527 ↗
L1SR_MA_RCTCited in: CGRP-Targeted Preventive Therapies - [165]
Tepper SJ, Schytz HW, Jensen RH et al.. “Benefits of eptinezumab on patient-reported disease burden and health-related quality of life in adults with chronic migraine and medication-overuse headache: Results from the placebo-controlled RESOLUTION trial.” Cephalalgia : an international journal of headache (2026). PMID: 42142011 ↗
L1RCTCited in: CGRP-Targeted Preventive Therapies - [166]
Jensen RH, Lundqvist C, Schytz HW et al.. “Eptinezumab With Patient Education for Chronic Migraine and Medication-Overuse Headache: The Randomized, Placebo-Controlled RESOLUTION Trial.” Neurology (2026). PMID: 41886713 ↗
L1RCTCited in: CGRP-Targeted Preventive Therapies - [167]
Ailani J, Ashina M, Awad SF et al.. “Long-Term Improvements Following Initial Migraine Response in Eptinezumab-Treated Participants With Migraine for Whom 2-4 Prior Preventive Treatments Have Failed.” European journal of neurology (2026). PMID: 41834318 ↗
L1RCTCited in: CGRP-Targeted Preventive Therapies - [168]
Hershey AD, Szperka CL, Barbanti P et al.. “Fremanezumab in Children and Adolescents with Episodic Migraine.” The New England journal of medicine (2026). PMID: 41534042 ↗
L1RCTCited in: CGRP-Targeted Preventive Therapies - [169]
Tassorelli C, Starling AJ, Awad SF et al.. “Early and Sustained Shift in Headache Day Frequency Following Eptinezumab Treatment in Adults With Migraine for Whom 2-4 Previous Preventive Treatments Have Failed: A Post Hoc Analysis of the Randomized DELIVER Trial.” European journal of neurology (2025). PMID: 41395928 ↗
L1RCTCited in: CGRP-Targeted Preventive Therapies - [170]
Yu S, Matsumori Y, Kim BK et al.. “Efficacy and safety of eptinezumab in a predominantly Asian population with chronic migraine: Results of the randomized, double-blind, placebo-controlled SUNRISE trial.” Cephalalgia : an international journal of headache (2025). PMID: 41091746 ↗
L1RCTCited in: CGRP-Targeted Preventive Therapies - [171]
Paiva da Silva Lima G, Rao R, Szabó G et al.. “Comprehensive assessment of erenumab efficacy in participants with high-frequency episodic migraine with at least one previously failed preventive treatment: The EMBRACE study.” Headache (2026). PMID: 41084999 ↗
L1RCTCited in: CGRP-Targeted Preventive Therapies - [172]
Mitsikostas DD, Awad SF, Kongerslev R et al.. “Number Needed to Treat and Cost Per Responder Analysis of Anti-CGRP Monoclonal Antibodies for Migraine Prevention in Adults for Whom Prior Preventive Treatments have Failed.” Advances in therapy (2025). PMID: 40986186 ↗
L1RCTCited in: CGRP-Targeted Preventive Therapies - [173]
Tepper SJ, Dodick DW, Lanteri-Minet M et al.. “Efficacy and Safety of Erenumab in Adults With Medication Overuse Headache: Final Results From a Phase 4 Randomized Placebo-Controlled Study.” European journal of neurology (2025). PMID: 40838472 ↗
L1RCTCited in: CGRP-Targeted Preventive Therapies - [174]
Fernández-Bravo-Rodrigo J, Pascual-Morena C, Saz-Lara A et al.. “Real-world effectiveness and safety of galcanezumab for the treatment of migraine: A systematic review and meta-analysis.” Headache (2026). PMID: 41246917 ↗
L2SR_OBSCited in: CGRP-Targeted Preventive Therapies - [175]
Oliveira da Silva R, Mendes Filho FSM, Pedrosa JGG et al.. “Efficacy and tolerability of erenumab for chronic migraine in association with medication overuse: A systematic review and meta-analysis.” Headache (2026). PMID: 41123228 ↗
L1SR_OBSCited in: CGRP-Targeted Preventive Therapies - [176]
Shakir I, Shahzad F, Shabbir A et al.. “Efficacy and safety of CGRP monoclonal antibodies for migraine prevention in episodic migraine; a network Meta-analysis.” European journal of clinical pharmacology (2026). PMID: 41546694 ↗
L1SR_OBSCited in: CGRP-Targeted Preventive Therapies - [177]
Rothrock J, Najib U, Ailani J et al.. “Safety, tolerability, and efficacy of atogepant added to onabotulinumtoxinA for the preventive treatment of chronic migraine: A phase 3, multicenter, 24-week, open-label study.” Cephalalgia : an international journal of headache (2026). PMID: 41944477 ↗
L4TRIAL_NONRANDOMCited in: CGRP-Targeted Preventive Therapies, Neuromodulation and Procedural Interventions - [178]
Ashina M, Tassorelli C, Kokturk P et al.. “Addressing unmet needs in migraine: Real-world fremanezumab effectiveness in participants of the PEARL study with at least three prior preventive treatment failures.” Cephalalgia : an international journal of headache (2025). PMID: 41432610 ↗
L2TRIAL_NONRANDOMCited in: CGRP-Targeted Preventive Therapies, Neuromodulation and Procedural Interventions - [179]
Vernieri F, Ambrosini A, Bartolini M et al.. “The second interim analysis of Italian participants enrolled in the real-world, Pan-European, prospective, observational, Phase 4 PEARL study of fremanezumab effectiveness.” Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology (2025). PMID: 41102549 ↗
L2TRIAL_NONRANDOMCited in: CGRP-Targeted Preventive Therapies - [180]
Ashina M, Mitsikostas DD, Amin FM et al.. “Long-term real-world effectiveness and safety of fremanezumab in 1140 patients with migraine and at least 6 months of treatment: third interim analysis of the pan-European PEARL study.” Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology (2025). PMID: 41032235 ↗
L2TRIAL_NONRANDOMCited in: CGRP-Targeted Preventive Therapies - [181]
Ashina S, Ashina M, Holle-Lee D et al.. “Long-term safety, efficacy and functional outcomes of atogepant for the preventive treatment of migraine.” Cephalalgia : an international journal of headache (2025). PMID: 40831083 ↗
L4TRIAL_NONRANDOMCited in: CGRP-Targeted Preventive Therapies - [182]
Chamani G, Jasim H, Minston A et al.. “Botulinum Toxin Type A for the Prevention of Migraines: An Umbrella Review of Systematic Reviews.” Toxins (2026). PMID: 41591179 ↗
L1SR_OBSCited in: CGRP-Targeted Preventive Therapies - [183]
Wang J, Li X, Yang Z et al.. “Comparison of eptinezumab 300 mg with 100 mg for the treatment of migraine: a meta-analysis of randomized controlled studies.” African health sciences (2024). PMID: 40777959 ↗
L1SR_OBSCited in: CGRP-Targeted Preventive Therapies - [184]
Chen J, Huang S, Chen Y et al.. “Comprehensive safety analysis of adverse events associated with eptinezumab in migraine treatment.” Scientific reports (2025). PMID: 40628864 ↗
L1SR_OBSCited in: CGRP-Targeted Preventive Therapies - [185]
Gerard B, Praudel H, Lanteri-Minet M et al.. “First successful protocol for desensitization to eptinezumab.” Headache (2026). PMID: 41420316 ↗
L4CASE_REPORTCited in: CGRP-Targeted Preventive Therapies - [186]
Tana C, Raffaelli B, Moffa L et al.. “Digital and virtual interventions for migraine: A systematic review of randomized controlled trials.” Cephalalgia : an international journal of headache (2026). PMID: 41776980 ↗
L1SR_MA_RCTCited in: Neuromodulation and Procedural Interventions, Lifestyle, Behavioral, and Complementary Medicine - [187]
Haghdoost F, Salam A, Seyed-Kolbadi FZ et al.. “Transcranial Direct Current Stimulation in Episodic Migraine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” Medical sciences (Basel, Switzerland) (2025). PMID: 40700113 ↗
L1SR_MA_RCTCited in: Neuromodulation and Procedural Interventions - [188]
Üstün C, Perdecioğlu GRG, Akkaya ÖT et al.. “A Novel Neuromodulation Method for Childhood Migraine: Comparing Noninvasive Pulsed Radiofrequency Therapy With Calcium Channel Blockers, a Randomized Controlled Trial.” Pediatric neurology (2026). PMID: 41518855 ↗
L1RCTCited in: Neuromodulation and Procedural Interventions - [189]
Cheng N, Anderson CC, Zhang N et al.. “Remote electrical neuromodulation for reducing procedural pain in patients with chronic migraine receiving onabotulinumtoxinA injections: A randomized sham-controlled study.” Headache (2026). PMID: 41472639 ↗
L1RCTCited in: Neuromodulation and Procedural Interventions - [190]
Tamayo de Leon CD, Gama-Reyes EG, Paredes Moreno FA et al.. “Adjunctive occipital nerve block for emergency treatment of acute migraine: A randomized, controlled trial.” Cephalalgia : an international journal of headache (2025). PMID: 41100185 ↗
L2RCTCited in: Neuromodulation and Procedural Interventions - [191]
Pozo-Rosich P, Blumenfeld AM, Lipton RB et al.. “OnabotulinumtoxinA for the preventive treatment of episodic migraine: Results from the phase 3, multicenter randomized, double-blind, placebo-controlled phase of the PRECLUDE trial.” Cephalalgia : an international journal of headache (2025). PMID: 41091731 ↗
L1RCTCited in: Neuromodulation and Procedural Interventions - [192]
Başarı A, Arslan İ, Cansu Ç et al.. “Does Greater Occipital Nerve Block Modulate Brainstem Excitability? Insights From a Randomized Controlled Study in Migraine.” Neuromodulation : journal of the International Neuromodulation Society (2025). PMID: 40531077 ↗
L1RCTCited in: Neuromodulation and Procedural Interventions - [193]
Ornello R, D'Atri A, De Icco R et al.. “Effectiveness of transcranial direct current stimulation and monoclonal antibodies acting on the CGRP as a combined treatment for migraine (TACTIC): Results of a randomized controlled trial.” Cephalalgia : an international journal of headache (2025). PMID: 40384614 ↗
L1RCTCited in: Neuromodulation and Procedural Interventions - [194]
Taha NA, Fathy M, Elsadek A et al.. “Efficacy and safety of ultrasound-guided peripheral nerve blocks in management of chronic resistant migraine.” The journal of headache and pain (2025). PMID: 40240919 ↗
L1RCTCited in: Neuromodulation and Procedural Interventions - [195]
Sforza M, Mariani I, Fazzini F et al.. “Interventions for Migraine and Sleep: A Systematic Review Exploring Their Bidirectional Association.” European journal of neurology (2026). PMID: 41874004 ↗
L1SR_OBSCited in: Neuromodulation and Procedural Interventions, Lifestyle, Behavioral, and Complementary Medicine - [196]
Hassan A, Elmazny A, Elgenidi A et al.. “Management of migraine in children and adolescents: A systematic review of guidelines and practice recommendations.” Cephalalgia : an international journal of headache (2026). PMID: 41699419 ↗
L1SR_OBSCited in: Neuromodulation and Procedural Interventions, Migraine in Special Populations - [197]
Xie J, Zhang Z, Guo J. “Multilevel Network Meta-Analysis of Nonpharmacological Interventions for Migraine: Focusing on the Dose-Effect of Physical Exercise and Its Moderators.” The Clinical journal of pain (2026). PMID: 41368711 ↗
L1SR_OBSCited in: Neuromodulation and Procedural Interventions - [198]
Atraszkiewicz D, Ünal E, Bassett P et al.. “Greater occipital nerve block for the treatment of migraine: An umbrella review, systematic review, and meta-analysis.” Cephalalgia : an international journal of headache (2025). PMID: 41329694 ↗
L1SR_OBSCited in: Neuromodulation and Procedural Interventions - [199]
Christofilos SI, Mavridis T, Gkotzamanis V et al.. “Repurposed versus disease-specific medicinals for the prophylaxis of migraine: an updated systematic review.” Pain management (2025). PMID: 40447296 ↗
L1SR_OBSCited in: Neuromodulation and Procedural Interventions - [200]
Blumenfeld AM, Charleston L, Kuruvilla D et al.. “OnabotulinumtoxinA treatment among diverse racial groups: Post hoc analysis of the phase 4 Chronic migraine OnabotulinuMtoxinA Prolonged Efficacy open-Label (COMPEL) trial.” Headache (2026). PMID: 41393002 ↗
L4TRIAL_NONRANDOMCited in: Neuromodulation and Procedural Interventions - [201]
Sagui E, Kereun E, Guillemet G et al.. “Auricular neuromodulation by low level laser therapy versus placebo laser therapy in prophylactic treatment of episodic migraine: a randomized controlled study protocol.” BMC complementary medicine and therapies (2025). PMID: 41088062 ↗
L5TRIAL_NONRANDOMCited in: Neuromodulation and Procedural Interventions - [202]
Martello E, Aiyelabegan F, Orr J et al.. “Systematic Review Suggests Nutraceuticals Containing Vitamin B2 Could Provide an Alternative Treatment for Paediatric Migraines.” Acta paediatrica (Oslo, Norway : 1992) (2025). PMID: 40411246 ↗
L1SR_OBSCited in: Lifestyle, Behavioral, and Complementary Medicine - [203]
Paudel P, Sah A. “Efficacy of biofeedback for migraine: A systematic review and meta-analysis.” Complementary therapies in medicine (2025). PMID: 40064357 ↗
L1SR_OBSCited in: Lifestyle, Behavioral, and Complementary Medicine - [204]
Roldán-Ruiz A, Bertotti G, López-Moreno M. “Effects of Dietary Interventions in Patients With Migraine: A Systematic Review.” Nutrition reviews (2025). PMID: 39749874 ↗
L1SR_OBSCited in: Lifestyle, Behavioral, and Complementary Medicine - [205]
Alqahtani NS, Zaroog MS, Albow BMA. “Dietary inflammatory potential and severe headache or migraine: a systematic review of observational studies.” Nutritional neuroscience (2025). PMID: 39248716 ↗
L2SR_OBSCited in: Lifestyle, Behavioral, and Complementary Medicine - [206]
Szuhany KL, Dorf J, Bostic RC et al.. “Predictors of response to biofeedback-assisted relaxation for migraine: An exploratory analysis.” Cephalalgia : an international journal of headache (2026). PMID: 42220255 ↗
L2RCTCited in: Lifestyle, Behavioral, and Complementary Medicine - [207]
Kruse JA, Seng EK. “Changes in cognitive appraisal in a randomized controlled trial of mindfulness-based cognitive therapy for patients with migraine.” Headache (2023). PMID: 37723970 ↗
L2RCTCited in: Lifestyle, Behavioral, and Complementary Medicine - [208]
Klan T, Gaul C, Liesering-Latta E et al.. “Behavioral treatment for migraine prophylaxis in adults: Moderator analysis of a randomized controlled trial.” Cephalalgia : an international journal of headache (2023). PMID: 37291853 ↗
L2RCTCited in: Lifestyle, Behavioral, and Complementary Medicine - [209]
Alipouri M, Amiri E, Hoseini R et al.. “Effects of eight weeks of aerobic exercise and vitamin D supplementation on psychiatric comorbidities in men with migraine and vitamin D insufficiency: A randomized controlled clinical trial.” Journal of affective disorders (2023). PMID: 37146906 ↗
L1RCTCited in: Lifestyle, Behavioral, and Complementary Medicine - [210]
Cuneo A, Yang R, Zhou H et al.. “The Utility of a Novel, Combined Biofeedback-Virtual Reality Device as Add-on Treatment for Chronic Migraine: A Randomized Pilot Study.” The Clinical journal of pain (2023). PMID: 37026763 ↗
L1RCTCited in: Lifestyle, Behavioral, and Complementary Medicine - [211]
Lovati C, d'Alessandro CM, Ventura SD et al.. “Ketogenic diet in refractory migraine: possible efficacy and role of ketone bodies-a pilot experience.” Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology (2022). PMID: 35948778 ↗
L4TRIAL_NONRANDOMCited in: Lifestyle, Behavioral, and Complementary Medicine - [212]
Poole AC, Stubberud A, Simpson M et al.. “Biofeedback therapy using Cerebri for the prevention of migraine attacks in adults with episodic migraine (BioCer): a randomized, wait-list controlled trial - the study protocol.” F1000Research (2024). PMID: 40909914 ↗
L5TRIAL_NONRANDOMCited in: Lifestyle, Behavioral, and Complementary Medicine - [213]
Poole AC, Winnberg IG, Simpson MR et al.. “Feasibility of a 12-Week, Therapist-Independent, Smartphone-Based Biofeedback Treatment for Episodic Migraine in Adults: Single-Center, Open-Label, 1-Armed Trial.” JMIR human factors (2025). PMID: 40489633 ↗
L4TRIAL_NONRANDOMCited in: Lifestyle, Behavioral, and Complementary Medicine - [214]
Law EF, Ritterband L, Zhou C et al.. “Intervention for Sleep and Pain in Youth (ISPY-RCT): protocol for a two-phase randomized controlled trial of sequenced cognitive-behavioral therapy for insomnia and pain management in adolescents with migraine.” Trials (2023). PMID: 36635741 ↗
L5TRIAL_NONRANDOMCited in: Lifestyle, Behavioral, and Complementary Medicine - [215]
Bonakdar RA, Sweeney M, Simi J et al.. “Integrative migraine management within a healthcare system Part 1: Overview and conventional approaches.” The American journal of medicine (2026). PMID: 41679365 ↗
L5REVIEW_NARRATIVECited in: Lifestyle, Behavioral, and Complementary Medicine - [216]
Ebbert PT, Natbony LR. “Fasting and Headache.” Current pain and headache reports (2025). PMID: 40117066 ↗
L5REVIEW_NARRATIVECited in: Lifestyle, Behavioral, and Complementary Medicine - [217]
Gazerani P. “Episodic Migraine in the Pediatric Population: Behavioral Therapies and other Non-Pharmacological Treatment Options.” Current pain and headache reports (2025). PMID: 40029442 ↗
L5REVIEW_NARRATIVECited in: Lifestyle, Behavioral, and Complementary Medicine - [218]
Fehér G, Szok D, Ambrus JS et al.. “[Joint guideline of the Headache Working Group of the Hungarian Headache Society (MFT) and the Hungarian Pain Society (MOFT) for the practical care of acute and chronic migraine].” Ideggyogyaszati szemle (2024). PMID: 39635817 ↗
L1GUIDELINECited in: Migraine in Special Populations - [219]
Baykan Çopuroğlu Ö, Çopuroğlu M. “Multistrategic Approaches in the Treatment of Acute Migraine During Pregnancy: The Effectiveness of Physiotherapy, Exercise, and Relaxation Techniques.” Medicina (Kaunas, Lithuania) (2024). PMID: 39859010 ↗
L1RCTCited in: Migraine in Special Populations - [220]
Pellesi L, Celik Z, Sari MF et al.. “Where are the men? A systematic review of sex bias in human provocation models of migraine.” Cephalalgia : an international journal of headache (2026). PMID: 41789859 ↗
L1SR_OBSCited in: Migraine in Special Populations - [221]
Mohamed MI, Sameh R, Salib M et al.. “Migraine and pregnancy-related headaches as a risk factor for cardiovascular and cerebrovascular events in pregnancy: a systematic review and meta-analysis of over 94 million pregnancies.” The journal of headache and pain (2025). PMID: 41233752 ↗
L2SR_OBSCited in: Migraine in Special Populations, Complications and Comorbidities - [222]
Hansen AS, Christiansen CH, Rom AL et al.. “Association between migraine, migraine subtype, and adverse pregnancy outcomes: A systematic review and meta-analysis.” Acta obstetricia et gynecologica Scandinavica (2025). PMID: 40304220 ↗
L2SR_OBSCited in: Migraine in Special Populations - [223]
Gokce M, Bektay MY, Uzun M et al.. “Cardiovascular comorbidities are risk factors for increased oxidative stress and DNA damage in migraine patients: a prospective cohort study.” Journal of translational medicine (2025). PMID: 41063121 ↗
L2COHORTCited in: Migraine in Special Populations - [224]
Smirnoff L, Moskatel L, Shaw B et al.. “A retrospective cohort study to evaluate the effectiveness and safety profile of occipital nerve blocks in the treatment of migraine during pregnancy.” Headache (2025). PMID: 40621922 ↗
L3COHORTCited in: Migraine in Special Populations - [225]
Eid K, Torkildsen Ø, Aarseth J et al.. “Migraine in the multiple sclerosis prodrome: a prospective nationwide cohort study in pregnant women.” The journal of headache and pain (2024). PMID: 39710642 ↗
L2COHORTCited in: Migraine in Special Populations - [226]
Fuglsang CH, Pedersen L, Schmidt M et al.. “The combined impact of migraine and gestational diabetes on long-term risk of premature myocardial infarction and stroke: A population-based cohort study.” Headache (2024). PMID: 39193995 ↗
L2COHORTCited in: Migraine in Special Populations, Complications and Comorbidities - [227]
Mitter VR, Lupattelli A, Bjørk MH et al.. “Identification and characterization of migraine in pregnancy: A Norwegian registry-based cohort study.” Cephalalgia : an international journal of headache (2024). PMID: 38663979 ↗
L2COHORTCited in: Migraine in Special Populations - [228]
Rezk A, Liu W, Nijs K et al.. “Brain and Heart Interactions Delineating Cardiac Dysfunction in Four Common Neurological Disorders: A Systematic Review and Meta-analysis.” Journal of neurosurgical anesthesiology (2025). PMID: 39171885 ↗
L1SR_OBSCited in: Migraine in Special Populations - [229]
Biswas S, Singh R, Radhika AG. “Association between migraine and pre-eclampsia among pregnant women: a single hospital-based case-control study in India.” BMC pregnancy and childbirth (2024). PMID: 38755536 ↗
L3CASE_CONTROLCited in: Migraine in Special Populations - [230]
Collings S, Patel A, Gowman H et al.. “The cost of migraine to the NHS in England: a retrospective cohort study using electronic health record data from Clinical Practice Research Datalink (CPRD) and Hospital Episode Statistics (HES).” Current medical research and opinion (2025). PMID: 41058444 ↗
L3COHORTCited in: Migraine in Special Populations - [231]
Staccioli S, Mariani R, Bompard S et al.. “Alice in Wonderland Syndrome in Children With Severe Acute Respiratory Syndrome SARS-CoV-2 Infection: A Case Series of Two Patients in an Italian Hospital.” Pediatric neurology (2025). PMID: 39531962 ↗
L4CASE_REPORTCited in: Migraine in Special Populations - [232]
Asheer J, Ali F, Hilker R et al.. “Methodological challenges in using screening tools for depression in migraine: A systematic review.” Cephalalgia : an international journal of headache (2025). PMID: 40017055 ↗
L1SR_OBSCited in: Complications and Comorbidities - [233]
Paschali M, Bernstein CA, Paschalis T et al.. “The cortisol awakening response in women with episodic migraine receiving acceptance and commitment therapy.” Journal of psychiatric research (2026). PMID: 41825324 ↗
L1RCTCited in: Complications and Comorbidities - [234]
Thevar P, Wong D, Hutton E et al.. “Cognitive behaviour therapy tailored to migraine in multiple sclerosis: A pilot randomized controlled trial.” Neuropsychological rehabilitation (2026). PMID: 40835234 ↗
L1RCTCited in: Complications and Comorbidities - [235]
Dudukina E, Nagy D, Fuglsang CH et al.. “Risk of stroke, myocardial infarction, coronary intervention, and atrial fibrillation or flutter in individuals experiencing typical migraine aura without headache: a Danish registry-based cohort study.” International journal of epidemiology (2025). PMID: 40587417 ↗
L2COHORTCited in: Complications and Comorbidities - [236]
Lipton RB, Ramirez Campos V, Roth-Ben Arie Z et al.. “Fremanezumab for the Treatment of Patients With Migraine and Comorbid Major Depressive Disorder: The UNITE Randomized Clinical Trial.” JAMA neurology (2025). PMID: 40323613 ↗
L1RCTCited in: Complications and Comorbidities - [237]
Shaw L, Isaac J, Scott J et al.. “Development of a Standardised stroke risk assessment for patients with MigraAinous symptoms Reviewed as suspected TIA (SMART): study protocol for a mixed methods study.” BMJ open (2025). PMID: 41448715 ↗
L2TRIAL_NONRANDOMCited in: Complications and Comorbidities - [238]
Zhao W, Wang D, Tan Y et al.. “Migraine and the correlation between stroke: A systematic review and meta-analysis.” Medicine (2024). PMID: 39533604 ↗
L1SR_OBSCited in: Complications and Comorbidities - [239]
Grodzka O, Borończyk M, Zduńska A et al.. “Migraine and patent foramen ovale: correlation, coexistence, dependence. A narrative review.” Headache (2026). PMID: 41090556 ↗
L5REVIEW_NARRATIVECited in: Complications and Comorbidities - [240]
Fernandes C, Gil-Gouveia R. “Deciphering the mechanisms: Pathophysiology of migraine-related cognitive dysfunction.” Cephalalgia : an international journal of headache (2025). PMID: 40936446 ↗
L5REVIEW_NARRATIVECited in: Complications and Comorbidities - [241]
Zhou W. “Plasma Galectin-3 as a potential predictor of chronic insomnia and its association with NLRP3 inflammasome activation in chronic migraine: A case-control study.” Sleep medicine (2025). PMID: 40907401 ↗
L3CASE_CONTROLCited in: Complications and Comorbidities - [242]
Eller MT, Schwarzová K, Gufler L et al.. “CGRP-Targeted Migraine Therapies in Patients With Vascular Risk Factors or Stroke: A Review.” Neurology (2025). PMID: 40537071 ↗
L5REVIEW_NARRATIVECited in: Complications and Comorbidities - [243]
Fernandes C, Dapkute A, Watson E et al.. “Migraine and cognitive dysfunction: a narrative review.” The journal of headache and pain (2024). PMID: 39701926 ↗
L5REVIEW_NARRATIVECited in: Complications and Comorbidities - [244]
Ma YM, Zhang DP, Zhang HL et al.. “Why is vestibular migraine associated with many comorbidities?” Journal of neurology (2024). PMID: 39302416 ↗
L5REVIEW_NARRATIVECited in: Complications and Comorbidities - [245]
Lin H, Zhang N, Diao T et al.. “[Efficacy analysis of anti-migraine therapy for acute low-frequency hearing loss and investigation of its mechanisms].” Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology head and neck surgery (2025). PMID: 41089002 ↗
L1RCTCited in: Complications and Comorbidities - [246]
Popoff E, Johnston K, Croop R et al.. “Matching-adjusted indirect comparisons of oral rimegepant versus placebo, erenumab, and galcanezumab examining monthly migraine days and health-related quality of life in the treatment of migraine.” Headache (2021). PMID: 34021585 ↗
L2OTHERCited in: Landmark Trials and Evidence Summary