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Objective Previous studies have demonstrated that emotional stress, changes in lifestyle habits and infections can worsen the clinical course of migraine. We hypothesize that changes in habits and medical care during coronavirus disease 2019 (COVID-19) lockdown might have worsened the clinical course of migraine. Design Retrospective survey study collecting online responses from migraine patients followed-up by neurologists at three tertiary hospitals between June and July 2020. Methods We used a web-based survey that included demographic data, clinical variables related with any headache (frequency) and migraine (subjective worsening, frequency, and intensity), lockdown, and symptoms of post-traumatic stress. Results The response rate of the survey was 239/324 (73.8%). The final analysis included 222 subjects. Among them, 201/222 (90.5%) were women, aged 42.5 ± 12.0 (mean±SD). Subjective improvement of migraine during lockdown was reported in 31/222 participants (14.0%), while worsening in 105/222 (47.3%) and was associated with changes in migraine triggers such as stress related to going outdoors and intake of specific foods or drinks. Intensity of attacks increased in 67/222 patients (30.2%), and it was associated with the subjective worsening, female sex, recent insomnia, and use of acute medication during a headache. An increase in monthly days with any headache was observed in 105/222 patients (47.3%) and was related to symptoms of post-traumatic stress, older age and living with five or more people. Conclusions Approximately half the migraine patients reported worsening of their usual pain during the lockdown. Worse clinical course in migraine patients was related to changes in triggers and the emotional impact of the lockdown. [ABSTRACT FROM AUTHOR]

Background: Previous studies have shown worse cognitive performance in cluster headache (CH) patients compared to healthy controls; however, little is known about cognitive performance in episodic CH (ECH) patients outside and inside the active cluster (AC). Objective: Our aim is to compare cognitive function in ECH patients outside and inside the AC. Methods: In this cross‐sectional, observational study, four neuropsychological tests (Trail Making Test [TMT], Stroop Test [ST], verbal fluency [VF], and Symbol Digit Modalities Test [SDT]) were completed by 21 ECH patients at two different points in time: outside and inside the AC. We also assessed self‐reported sleep quality and the presence of anxiety or depressive symptoms. Scores were compared. Results: There was not any difference between the scores of the neuropsychological tests performed outside and inside the AC (TMT‐A: 23 vs. 23.5; p = 0.984; TMT‐B: 96.5 vs. 85.9; p = 0.104; ST word reading: 101.0 vs. 101.2; p = 0.938; ST color naming: 73.0 vs. 73.4; p = 0.858; ST color word: 44.0 vs. 46.0; p = 0.498; SDMT: 44.0 vs. 44.6; p = 0.961; VF phonemic: 29.5 vs. 30.2; p = 0.714; VF semantic: 20 vs. 21; p = 0.489). We found a worsening in the sleep quality component of the Pittsburgh Sleep Quality Index median scores in patients outside the AC (2 vs. 1; p = 0.046). Conclusions: Our findings suggest that patients with ECH have a similar cognitive performance outside and during the AC. [ABSTRACT FROM AUTHOR]

Background: During 24‐hour on‐call shifts medical residents are exposed to diverse circumstances such as sleep deprivation and stress. Objective: Our aim is to assess the effect of 24‐hour on‐call shifts on medical residents' headache‐related disability. Methods: The Migraine Disability Assessment Scale (MIDAS), the Headache Impact Test (HIT–6), the Pittsburgh Sleep Quality Index (PSQI), and the Hospital Anxiety and Depression Scale (HADS) questionnaires were administered to medical residents who had never performed on‐call shifts at baseline and 6 months after beginning 24‐hour on‐call shifts. Scores were compared. Results: About 66 medical residents completed this study. About 21.2% (n = 14) had history of migraine, 42.4% (n = 28) had a history of tension‐type headache (TTH) and 12.1% (n = 8) had a history of both migraine and TTH. Among medical residents with migraine, the median MIDAS score was significantly higher after starting 24‐hour on‐call shifts than at a baseline (4.0 vs 8.0; Wilcoxon, P =.001), meaning that, on average, disability increased from little or no disability, to moderate disability. No difference in HIT‐6 scores was found. The median score of PSQI and HADS was higher at 6 months (PSQI: 7.0 vs 8.0; P =.003), (HADS: 5.0 vs 8.0; P <.001) for the general group. Conclusions: In medical residents with migraine, migraine‐related disability increased after starting 24‐hour on‐call shifts. We also found a worsening in depression and anxiety symptoms and self‐reported sleep quality in medical residents with and without headache history. [ABSTRACT FROM AUTHOR]

Background Cluster headache is one of the most disabling of all headache conditions. Although some studies have investigated the psychological profile of patients with cluster headache, research on its impact on cognitive function in patients with episodic cluster headache outside the cluster bout is scant. Methods Cross-sectional study to evaluate various aspects of neuropsychological assessment and cognitive function including working memory, selective attention, verbal fluency, and executive function in 40 patients with episodic cluster headache. The patients were compared with 40 age-, gender-, and level of education–matched healthy controls. Results Episodic cluster headache patients performed significantly worse than healthy controls on all cognitive tests, except for the Interference Score (P  = 0.281). They had significantly higher Hospital Anxiety Scale scores (P  = 0.002). However, we found no significant association between cognitive performance, anxiety, sleep quality, and disease duration. Conclusions Patients with episodic cluster headache outside the bout showed worse executive functioning, working memory, language, and selective attention compared with healthy controls, regardless of the duration of disease or sleep quality. [ABSTRACT FROM AUTHOR]