Headache and Pain Research

Original Article

Clinical Characteristics of Migraine and Serum Beta-Endorphin Levels in Undergraduate Students in Osun State, Nigeria: Adebimpe Ogunmodede, Ahmed Idowu, Ahmad Sanusi, Uchenna Eke, Akintunde Adebowale, Michael Fawale, Morenikeji Komolafe; Headache Pain Res. 2025;26(2):162-170. Published online June 30, 2025; DOI: https://doi.org/10.62087/hpr.2025.0006

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Abstract PDF: Purpose: Migraine is a common neurological disorder diagnosed using the International Classification of Headache Disorders (ICHD). Beta-endorphin has pain-reducing properties and may serve as a future prognostic marker for migraine. This study aimed to assess the clinical characteristics of migraine and compare serum beta-endorphin levels in migraine patients and healthy controls among young undergraduate students.
Methods
This comparative cross-sectional study was conducted among undergraduate students at Obafemi Awolowo University, Nigeria. Fifty participants with migraine headaches were recruited using purposive sampling according to the ICHD-3 criteria. Healthy controls were recruited using convenience sampling and matched for age and sex. A study questionnaire was administered to all participants. Serum beta-endorphin concentrations in both migraineurs and healthy controls were measured using enzyme-linked immunosorbent assays. The beta-endorphin levels between migraine patients and healthy controls were compared using the Mann-Whitney U-test. The data were analyzed using SPSS version 26.0. A p-value of <0.05 was considered statistically significant.
Results
A total of 12 males and 38 females were recruited in both groups.The most commonly used medication for acute migraine treatment was paracetamol, while amitriptyline was the most frequently used prophylactic. Median serum beta-endorphin levels were significantly lower in the migraine group, at 385.4 pg/mL (328.5–423.4 pg/mL), compared to the control group, at 442.9 pg/mL (357.5–477.6 pg/mL) (p=0.01).
Conclusion
Serum beta-endorphin levels were significantly lower in young adults with migraine, suggesting a potential role for reduced endogenous analgesia in migraine pathophysiology. This supports the potential utility of beta-endorphin as a prognostic biomarker for migraine.

Review Article

Vestibular Migraine: Challenges in Diagnosis and Management: Byung-Kun Kim; Headache Pain Res. 2025;26(2):106-115. Published online June 11, 2025; DOI: https://doi.org/10.62087/hpr.2025.0001

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Abstract PDF: Vestibular migraine (VM) remains a clinical challenge due to its heterogeneous presentation and the frequent absence of typical migraine features during vestibular episodes. Although many studies have adopted the diagnostic criteria defined by the International Classification of Headache Disorders (ICHD), interpretation of findings is often complicated by variability in how these criteria are applied across studies. VM is frequently underdiagnosed or misdiagnosed, owing to its clinical overlap with other vestibular disorders. This review provides a comprehensive overview of the epidemiology, diagnostic criteria, differential diagnosis, and treatment strategies for VM. Particular emphasis is placed on distinguishing VM from other causes of vertigo to support accurate diagnosis and tailored management. By synthesizing current evidence, this review aims to improve clinical recognition, diagnostic precision, and therapeutic outcomes for patients with this under-recognized and often debilitating condition.

Original Article

Bilateral Greater Occipital Nerve Block for Preventing the OnabotulinumtoxinA Wear-off Phenomenon in the Treatment of Chronic Migraine: A Case Series of 12 Patients: Sanghyun Kim, Jae Young An, Dae Woong Bae; Headache Pain Res. 2024;25(2):111-116. Published online October 23, 2024; DOI: https://doi.org/10.62087/hpr.2024.0021

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Abstract PDF

Purpose: OnabotulinumtoxinA is widely used to treat chronic migraines; however, the wear-off phenomenon before the next scheduled dose has emerged as a challenge. This study suggests a new strategy for preventing the wear-off phenomenon using bilateral greater occipital nerve block.
Methods
We conducted a retrospective review of patients diagnosed with chronic migraine who were treated with onabotulinumtoxinA and bilateral greater occipital nerve block at St. Vincent Hospital from January 2023 to December 2023. Twelve chronic migraine patients with a history of the wear-off phenomenon received a greater occipital nerve block 8 weeks after the initial onabotulinumtoxinA injection for two sessions. Responses to treatment were evaluated with regular follow-ups and daily headache diaries.
Results
All patients who had previously experienced the wear-off phenomenon with conventional onabotulinumtoxinA treatment did not experience the wear-off phenomenon during two sessions with an additional greater occipital nerve block administered 8 weeks after each onabolulinumtoxinA injection.
Conclusion
Bilateral greater occipital nerve block administered 8 weeks after the initial onabotulinumtoxinA injection effectively prevents the wear-off phenomenon, enabling sustained therapeutic benefits in chronic migraine patients. Further research is needed to confirm these findings in larger cohorts.

Citations

Citations to this article as recorded by

When Should Headache Specialists Hold a Needle? The Role of Botulinum Toxin Injections and Occipital Nerve Blocks
Soo-Jin Cho
Headache and Pain Research.2024; 25(2): 73. CrossRef

Review Article

Menstrual Migraine: A Review of Current Research and Clinical Challenges: Jong-Geun Seo; Headache Pain Res. 2024;25(1):16-23. Published online April 22, 2024; DOI: https://doi.org/10.62087/hpr.2024.0004

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Abstract PDF

The term “menstrual migraine” is commonly used to describe migraines that occur in association with menstruation, as distinct from other migraine types. A significant proportion of women of reproductive age experience migraine attacks related to their menstrual cycle. Menstrual migraine is characterized by migraine attacks occurring on day 1±2 (i.e., days −2 to +3) of menstruation in at least two out of three menstrual cycles. Although the reported prevalence of menstrual migraine varies considerably, population-based studies have found that menstrual migraine affects up to 60% of women with migraines. Several hypotheses have been proposed to explain the etiology of menstrual migraine, among which the estrogen withdrawal hypothesis is the most widely accepted. Women who experience menstrual migraines often face considerable disability due to perimenstrual attacks. Studies have reported that perimenstrual attacks are more severe and more difficult to manage. The principles of acute managing perimenstrual attacks are the same as those for managing nonmenstrual attacks. Short-term preventive therapy is needed to prevent menstrual migraines before they occur during the perimenstrual period. This review summarizes the prevalence, distinct clinical features, pathophysiological mechanisms, and management of menstrual migraine.

Citations

Citations to this article as recorded by

Sex hormones and diseases of the nervous system
Hyman M. Schipper
Brain Medicine.2025; : 1. CrossRef
Evidence-Based Recommendations on Pharmacologic Treatment for Migraine Prevention: A Clinical Practice Guideline from the Korean Headache Society
Byung-Su Kim, Pil-Wook Chung, Jae Myun Chung, Kwang-Yeol Park, Heui-Soo Moon, Hong-Kyun Park, Dae-Woong Bae, Jong-Geun Seo, Jong-Hee Sohn, Tae-Jin Song, Seung-Han Lee, Kyungmi Oh, Mi Ji Lee, Myoung-Jin Cha, Yun-Ju Choi, Miyoung Choi
Headache and Pain Research.2025; 26(1): 5. 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
Migraine in Women: Inescapable Femaleness?
Soo-Kyoung Kim
Headache and Pain Research.2024; 25(1): 1. CrossRef
Three-month treatment outcome of medication-overuse headache according to classes of overused medications, use of acute medications, and preventive treatments
Sun-Young Oh, Jin-Ju Kang, Hong-Kyun Park, Soo-Jin Cho, Yooha Hong, Mi-Kyoung Kang, Heui-Soo Moon, Mi Ji Lee, Tae-Jin Song, Young Ju Suh, Min Kyung Chu
Scientific Reports.2024;[Epub] CrossRef
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 and Pain Research.2024; 25(2): 86. CrossRef

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