{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T01:12:14Z","timestamp":1777770734125,"version":"3.51.4"},"reference-count":42,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Viral illnesses are known to trigger chronic headaches. Following the COVID\u201019 (coronavirus disease 2019) pandemic, many patients reported prolonged headaches. However, the impact on the incidence of primary headache disorders remains unclear. The aim of our study was to evaluate whether patients with newly diagnosed primary headache disorders had higher rates of prior COVID\u201019 and Epstein\u2013Barr virus (EBV) infections, to further explore the impact of viral infections on primary headache disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A case\u2010control study using data from the Clalit Health Services database comparing patients with newly diagnosed primary headache disorders, between June 2020 and June 2023, to non\u2010headache controls, with regard to rates of prior COVID\u201019 and EBV infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our cohort comprised 39,693 patients with primary headaches: 30,956 with migraine, 7984 with tension\u2010type headache (TTH), and 753 with cluster headache (CH). The control group included 69,272 individuals. EBV infection was associated with both migraine (OR 1.13, 95% CI 1.09\u20131.17) and TTH (OR 1.11, 95% CI 1.03\u20131.20). However, in a multivariable analysis, only the association with migraine remained significant. COVID\u201019 infection was associated with migraine (OR 1.04, 95% CI 1.01\u20131.07), but lost significance when adjusted for comorbidities. The association between COVID\u201019 and TTH was nonsignificant in a univariable analysis (OR 1.05, 95% CI 1.00\u20131.12). However, in a stratified analysis, COVID\u201019 was significantly associated with TTH among patients with anxiety or depression. The CH group showed no significant differences compared to controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Different viral infections have varying effects on primary headache disorders: EBV infection is primarily associated with migraine, while COVID\u201019 is primarily associated with TTH. These findings underscore the distinct pathophysiological mechanisms underlying these disorders and suggest a differential involvement of the immune system in their development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.70858","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T04:29:26Z","timestamp":1758860966000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patterns of Past COVID\u201019 and EBV Infection in Primary Headache Disorders: A Population Study"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5056-2368","authenticated-orcid":false,"given":"Keshet","family":"Pardo","sequence":"first","affiliation":[{"name":"Neurology Department Rabin Medical Center  Petach Tikva Israel"},{"name":"Faculty of Medical &amp; Health Sciences Tel Aviv University  Tel Aviv\u2010Yafo 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