{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:08:15Z","timestamp":1790230095377,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,11,16]],"date-time":"2017-11-16T00:00:00Z","timestamp":1510790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Multiple sclerosis (<jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>) is the most frequent immune\u2010mediated inflammation of the central nervous system that can lead to early disability. Headaches have not been considered as <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>\u2010related symptoms initially, whereas higher prevalence rates were reported since 2000. Postmortem histological analyses of <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> patients\u2019 brains revealed lymphoid follicle\u2010like structures in the cerebral meninges which suggest a possible pathophysiological explanation for the high headache prevalence in <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>. The aim of this study was to evaluate headache characteristics during the first clinical event of <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a prospective, multicenter study, 50 patients with the diagnosis of <jats:styled-content style=\"fixed-case\">CIS<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> were recruited. All participants were screened for the presence of headache within the last 4 weeks with help of the Rostock Headache Questionnaire (Rokoko).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010nine of fifty questioned patients (78%) reported headaches within the last 4 weeks. Most patients suffered from throbbing and pulsating headaches (25, 50%), 15 (30%) reported stabbing, 14 (28%) dull and constrictive headaches.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Headaches were prevalent in 78% of patients in our population with newly diagnosed <jats:styled-content style=\"fixed-case\">CIS<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>. It is among the highest prevalence rates reported so far in patients with <jats:styled-content style=\"fixed-case\">CIS<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>. Thus, headache, especially of a migraneous subtype, is a frequent symptom within the scope of the first manifestation of multiple sclerosis. If it were possible to define a <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>\u2010typical headache, patients with these headaches and with typical <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> results would be classified as <jats:styled-content style=\"fixed-case\">CIS<\/jats:styled-content> or early <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> instead of radiologically isolated syndrome and treated accordingly with an immunomodulatory therapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/brb3.852","type":"journal-article","created":{"date-parts":[[2017,11,16]],"date-time":"2017-11-16T05:09:10Z","timestamp":1510808950000},"source":"Crossref","is-referenced-by-count":19,"title":["Headache in the first manifestation of Multiple Sclerosis\u00a0\u2013\u00a0Prospective, multicenter study"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9318-3480","authenticated-orcid":false,"given":"Marcel","family":"Gebhardt","sequence":"first","affiliation":[{"name":"Krankenhaus Martha\u2010Maria Halle\u2010D\u00f6lau  Halle Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kropp","sequence":"additional","affiliation":[{"name":"Institute of Medical Psychology and Medical Sociology Medical Faculty University of Rostock  Rostock Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim P.","family":"J\u00fcrgens","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Rostock  Rostock Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Krankenhaus Martha\u2010Maria Halle\u2010D\u00f6lau  Halle Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe K.","family":"Zettl","sequence":"additional","affiliation":[{"name":"Department of Neurology Neuroimmunological Section University of Rostock  Rostock Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,16]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"199","article-title":"Statistical study of the problem of multiple sclerosis. 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