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Review Article
Genetic Architecture of Migraine: From Broad Insights to East Asian Perspectives
Joonho Kim, Min Kyung Chu
Headache Pain Res. 2025;26(2):116-129.   Published online May 27, 2025
DOI: https://doi.org/10.62087/hpr.2025.0003
Funded: Korea Health Industry Development Institute, Ministry of Health and Welfare, Yonsei University College of Medicine, National Research Foundation of Korea, Ministry of Science and ICT
  • 487 View
  • 5 Download
AbstractAbstract PDF
Migraine is a complex neurological disorder with a strong genetic component, ranging from rare monogenic forms, such as familial hemiplegic migraine (FHM), to common polygenic migraine. FHM is primarily caused by mutations in CACNA1A, ATP1A2, and SCN1A, which affect ion channel function and cortical excitability. Additional genes, including PRRT2, have also been implicated, broadening the genetic landscape of monogenic migraine. Genome-wide association studies (GWAS) have identified multiple susceptibility loci for common migraine, highlighting key pathways related to neuronal excitability and vascular function. These findings have reinforced the neurovascular hypothesis of migraine pathogenesis. GWAS on other headache disorders, such as broadly defined headache or cluster headache, have also revealed both overlapping and distinct genetic risk factors. Genetic studies in East Asians have identified both ancestry-specific risk variants and overlapping loci with European populations, suggesting similarities in biological pathways while also highlighting population-specific differences in migraine susceptibility. Expanding research on the genetics of migraine in East Asian populations is essential for uncovering novel risk factors and improving the generalizability of genetic findings.
Original Article
Validity of Migraine Diagnoses in Korean National Health Insurance Claims Data
Yoonkyung Chang, Soyoun Choi, Byung-Su Kim, Tae-Jin Song
Headache Pain Res. 2025;26(2):154-161.   Published online June 19, 2025
DOI: https://doi.org/10.62087/hpr.2025.0004
Funded: Ewha Womans University
  • 437 View
  • 3 Download
AbstractAbstract PDFSupplementary Material
Purpose: Accurate case identification using administrative datasets relies on diagnostic coding, yet these codes’ accuracy for migraine remains uncertain. This study aimed to validate the diagnostic accuracy of International Statistical Classification of Diseases and Related Health Problems 10th Revision (International Classification of Diseases, ICD-10) codes for migraine, migraine without aura (MOA), and migraine with aura (MA) in the Korean National Health Insurance Service database.
Methods
We retrospectively reviewed the electronic medical records of 500 patients (migraine [G43.X], 200; MOA [G43.0], 200; MA [G43.1], 100) from secondary and tertiary hospitals between January 2019 and December 2024. Diagnoses confirmed by headache specialists using the International Classification of Headache Disorders, third edition served as the gold standard. Validation metrics included the positive predictive value (PPV), negative predictive value, sensitivity, specificity, and the kappa statistic. Diagnostic accuracy was assessed based on ICD-10 claim frequency and improved by combining diagnostic codes with prescriptions for migraine medications.
Results
A single ICD-10 claim had a PPV of 74.00%. Accuracy improved significantly with increased claim frequency (≥3 claims: PPV, 81.14%; sensitivity, 98.61%; specificity, 28.26%), particularly when combined with medication prescriptions (≥3 claims with medication: PPV, 94.96%; sensitivity, 91.87%; specificity, 85.37%). MOA (≥3 claims with medication: PPV, 95.20%) and MA (≥3 claims with medication: PPV, 93.65%) showed similar trends. Excellent inter-rater reliability was observed (kappa, 0.806–0.951), with no significant accuracy differences between hospitals.
Conclusion
Employing multiple claims and prescriptions improved the accuracy of migraine diagnoses using ICD-10 codes, supporting the use of this method in epidemiological studies and health policy decisions.
Review Article
Understanding the Connection between the Glymphatic System and Migraine: A Systematic Review
Myoung-Jin Cha, Kyung Wook Kang, Jung-won Shin, Hosung Kim, Jiyoung Kim
Headache Pain Res. 2024;25(2):86-95.   Published online July 31, 2024
DOI: https://doi.org/10.62087/hpr.2024.0014
Funded: Pusan National University Hospital
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  • 96 Download
AbstractAbstract PDF
The glymphatic system is a brain-wide perivascular pathway that functions similarly to the lymphatic system in the periphery of the body, playing a crucial role in removing waste from the brain. Although impaired glymphatic function has a well-known relationship with neurodegenerative diseases through abnormal protein accumulation, it is also associated with migraine. While still in its nascent phase, research on the glymphatic system in migraine patients is gradually increasing. This systematic literature review focuses on studies investigating the glymphatic system in migraineurs. Furthermore, it examines the methods used to evaluate the glymphatic system in these studies and their main findings.
Original Articles
Side Shift of Attacks in Cluster Headache: A Prospective Single-center Study
Michelle Sojung Youn, Jun Pyo Kim, Mi Ji Lee
Headache Pain Res. 2024;25(2):96-102.   Published online August 28, 2024
DOI: https://doi.org/10.62087/hpr.2024.0013
Funded: Seoul National University, National Research Foundation of Korea, Ministry of Science, ICT and Future Planning, Yuhan company
  • 1,202 View
  • 25 Download
  • 1 Citations
AbstractAbstract PDF
Purpose: Although strict unilaterality is a characteristic of cluster headache (CH), side shift of attacks has been reported. We aimed to assess the prevalence and patterns of side shifts, as well as their correlations with clinical characteristics and treatment response in CH patients.
Methods
We prospectively recruited and followed up CH patients at a university hospital. Patients with two or more lifetime CH bouts were interviewed about their side shift history using a structured questionnaire. The demographics and disease characteristics were collected at baseline, and the treatment response at 2- to 4-week follow-up examinations was compared between patients with versus without side shifts.
Results
Out of 124 CH patients, 26 (21.0%) experienced side shifts. Sixteen (61.5%) experienced shifts between bouts, 13 (50.0%) within a bout, and four (15.4%) within an attack, with none (0%) reporting bilateral pain during an attack. Among patients who experienced shifts between bouts, six (37.5%) reported a single shift during the entire disease course, while 10 (62.5%) reported multiple shifts between bouts. The demographics, characteristics, and treatment response did not significantly differ according to the history of side shift.
Conclusion
In our study, the prevalence and pattern of side shifts were comparable to the results from earlier studies. The presence of side shifts did not show significant association with a specific clinical profile and their incidence did not impact the treatment response. These findings suggest that side-shifting CH is not a distinct entity or migraine variant, but rather within the spectrum of CH.

Citations

Citations to this article as recorded by  
  • Pain Lateralization in Cluster Headache and Associated Clinical Factors
    Soohyun Cho, Mi Ji Lee, Min Kyung Chu, Jeong Wook Park, Heui-Soo Moon, Pil-Wook Chung, Jong-Hee Sohn, Byung-Su Kim, Daeyoung Kim, Kyungmi Oh, Byung-Kun Kim, Soo-Jin Cho
    Journal of Clinical Neurology.2025; 21(3): 220.     CrossRef
Associations of Migraine and Tension-type Headache with Glaucoma
Jong-Ho Kim, Young-Suk Kwon, Sang-Hwa Lee, Jong-Hee Sohn
Headache Pain Res. 2024;25(1):54-62.   Published online March 29, 2024
DOI: https://doi.org/10.62087/hpr.2024.0002
Funded: Physician scientist training and future medical technology implementation for solving clinical challenges in nervous system
  • 2,371 View
  • 51 Download
  • 3 Citations
AbstractAbstract PDF
Purpose: It remains unclear whether primary headaches, particularly migraine, are associated with glaucoma. We investigated potential associations between primary headaches, including migraine and tension-type headache (TTH), and primary glaucoma, including open-angle glaucoma (OAG) and closed-angle glaucoma (CAG).
Methods
We used data from the Clinical Data Warehouse collected between 2008 and 2023 to investigate whether migraine and TTH influence the risk of primary glaucoma. We compared the prevalence of primary glaucoma, including OAG, CAG, other glaucoma, and total glaucoma (TG), among patients with migraine, those with TTH, and controls.
Results
This study analyzed 46,904 patients with migraine, 48,116 patients with TTH, and 455,172 controls. Controls were selected based on propensity score matching (PSM). After adjustment for covariates and PSM, the fully adjusted odds ratios (ORs) for patients with migraine were 1.83 for OAG (95% confidence interval [95% CI], 1.33–2.51; p<0.004) and 1.55 for TG (95% CI, 1.26–1.91; p<0.004) compared to controls. Furthermore, in patients with TTH, the ORs for CAG were 2.20 (95% CI, 1.40–3.47; p<0.004) compared to controls. Additionally, patients with migraine had fully adjusted ORs of 1.71 for OAG (95% CI, 1.24–2.36; p<0.004) and 1.41 for TG (95% CI, 1.15–1.73; p<0.004) compared to those with TTH.
Conclusion
Migraine is associated with primary glaucoma, particularly OAG.

Citations

Citations to this article as recorded by  
  • Exploring Secondary Headaches: Insights from Glaucoma and COVID-19 Infection
    Soo-Kyoung Kim
    Headache and Pain Research.2025; 26(1): 3.     CrossRef
  • Association between migraine and primary open-angle glaucoma: A two-sample Mendelian randomization study
    Dima L Chaar, Aliya Yakubova, Chen Jiang, Thomas J Hoffmann, Alice Pressman, Denis Plotnikov, Hélène Choquet
    Cephalalgia Reports.2025;[Epub]     CrossRef
  • Subjective Cognitive Decline Patterns in Patients with Migraine, with or without Depression, versus Non-depressed Older Adults
    Sun Hwa Lee, Soo-Jin Cho
    Headache and Pain Research.2024; 25(2): 103.     CrossRef
Review Articles
COVID-19 Infection-related Headache: A Narrative Review
Yoonkyung Chang, Tae-Jin Song
Headache Pain Res. 2024;25(1):24-33.   Published online April 2, 2024
DOI: https://doi.org/10.62087/hpr.2024.0008
Funded: Korea Health Industry Development Institute, Ministry of Health and Welfare
  • 2,464 View
  • 33 Download
  • 3 Citations
AbstractAbstract PDF
Severe acute respiratory syndrome coronavirus 2 is the virus responsible for coronavirus disease 2019 (COVID-19), which caused a global pandemic and then became an endemic condition. COVID-19 infection may be associated with clinical manifestations such as respiratory symptoms and systemic diseases, including neurological disorders, notably headaches. Headaches are a common neurological symptom in individuals infected with COVID-19. Furthermore, with the transition to endemicity, COVID-19 infection-related headaches may reportedly persist in the acute phase of COVID-19 infection and in the long term after COVID-19 infection resolves. Persistent headaches after COVID-19 infection can be a significant concern for patients, potentially leading to disability. The present review discusses the clinical characteristics and potential underlying mechanisms of COVID-19 infection-related headaches.

Citations

Citations to this article as recorded by  
  • Unclosing Clinical Criteria and the Role of Cytokines in the Pathogenesis of Persistent Post-COVID-19 Headaches: A Pilot Case-Control Study from Egypt
    Ahmed Abualhasan, Shereen Fathi, Hala Gabr, Abeer Mahmoud, Diana Khedr
    Clinical and Translational Neuroscience.2025; 9(1): 5.     CrossRef
  • Exploring Secondary Headaches: Insights from Glaucoma and COVID-19 Infection
    Soo-Kyoung Kim
    Headache and Pain Research.2025; 26(1): 3.     CrossRef
  • Calcitonin Gene-Related Peptide Monoclonal Antibody Treatment in Nine Cases of Persistent Headache Following COVID-19-Infection
    Soyoun Choi, Yooha Hong, Mi-Kyoung Kang, Tae-Jin Song, Soo-Jin Cho
    Journal of Korean Medical Science.2025;[Epub]     CrossRef
Update on Cluster Headaches: From Genetic to Novel Therapeutic Approaches
Myun Kim, Je Kook Yu, Yoo Hwan Kim
Headache Pain Res. 2024;25(1):42-53.   Published online April 22, 2024
DOI: https://doi.org/10.62087/hpr.2024.0009
Funded: Hallym University Medical Center Research Fund
  • 4,434 View
  • 73 Download
  • 6 Citations
AbstractAbstract PDF
Cluster headaches affect 0.1% of the population and are four times more common in males than in females. Patients with this condition present with severe unilateral head pain localized in the frontotemporal lobe, accompanied by ipsilateral lacrimation, conjunctival injection, nasal congestion, diaphoresis, miosis, and eyelid edema. Recently, the first genome-wide association study of cluster headaches was conducted with the goal of aggregating data for meta-analyses, identifying genetic risk variants, and gaining biological insights. Although little is known about the pathophysiology of cluster headaches, the trigeminovascular and trigeminal autonomic reflexes and hypothalamic pathways are involved. Among anti-calcitonin gene-related peptide monoclonal antibodies, galcanezumab has been reported to be effective in preventing episodic cluster headaches.

Citations

Citations to this article as recorded by  
  • Exercise as an abortive treatment for cluster headaches: Insights from a large patient registry
    Mi‐Kyoung Kang, Yooha Hong, Soo‐Jin Cho
    Annals of Clinical and Translational Neurology.2025; 12(1): 149.     CrossRef
  • Morning Headaches: An In-depth Review of Causes, Associated Disorders, and Management Strategies
    Yooha Hong, Mi-Kyoung Kang, Min Seung Kim, Heejung Mo, Rebecca C. Cox, Hee-Jin Im
    Headache and Pain Research.2025; 26(1): 66.     CrossRef
  • Does Laterality Matter? Insights Into Unilateral Pain in Cluster Headache
    Tae-Jin Song
    Journal of Clinical Neurology.2025; 21(3): 157.     CrossRef
  • Pain Lateralization in Cluster Headache and Associated Clinical Factors
    Soohyun Cho, Mi Ji Lee, Min Kyung Chu, Jeong Wook Park, Heui-Soo Moon, Pil-Wook Chung, Jong-Hee Sohn, Byung-Su Kim, Daeyoung Kim, Kyungmi Oh, Byung-Kun Kim, Soo-Jin Cho
    Journal of Clinical Neurology.2025; 21(3): 220.     CrossRef
  • Side Shift of Attacks in Cluster Headache: A Prospective Single-center Study
    Michelle Sojung Youn, Jun Pyo Kim, Mi Ji Lee
    Headache and Pain Research.2024; 25(2): 96.     CrossRef
  • Reduction of neck pain severity in patients with medication-overuse headache
    Yooha Hong, Hong-Kyun Park, Mi-Kyoung Kang, Sun-Young Oh, Jin-Ju Kang, Heui-Soo Moon, Tae-Jin Song, Mi Ji Lee, Min Kyung Chu, Soo-Jin Cho
    The Journal of Headache and Pain.2024;[Epub]     CrossRef

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