{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T20:50:51Z","timestamp":1788468651962,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T00:00:00Z","timestamp":1628467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to describe patterns of peak attack severity from day\u2010to\u2010day, and in relation to same\u2010day perceived stress, in individuals with chronic migraine (CM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although changes in perceived stress are often believed to trigger attacks, little is known about the relationship between perceived stress and attack severity, and about the role of perceived stress in the day\u2010to\u2010day experience of individuals with CM, as opposed to those with less frequent attacks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was an observational prospective longitudinal cohort study among adults with CM. Daily data about headache, symptoms, and lifestyle factors were collected using the N1\u2010Headache\u2122 digital health platform for 90\u00a0days. Days were classified as \u201cmigraine days\u201d when a headache occurred that met the\n                      <jats:italic>International Classification of Headache Disorders<\/jats:italic>\n                      criteria. Perceived stress was measured using a 0\u201310 rating scale. On migraine days, peak pain severity was recorded on a four\u2010point categorical pain scale. Participant\u2010level plots of daily peak severity, colored by perceived stress score, were generated. The relationship between peak severity and perceived stress was also modeled and adjusted for sex, age, continuous headache, presence of menstrual bleeding, day of the week, and disability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Data on 136 participants with 8216\u00a0migraine days were analyzed. Sixty\u2010nine percent (94\/136) of participants reported the same peak severity on the majority (\u226550%) of their migraine days. For every one unit increase in perceived stress, the odds of reporting a higher peak severity were 10% higher (adjusted OR [95% CI]\u00a0=\u00a01.10 [1.07\u20131.14]). The inclusion of random effects for the intercept and slope improved the model and demonstrated that there were large differences in individuals\u2019 reporting of peak severity and in the relationship between perceived stress and peak severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Individuals with CM report distinct patterns of peak severity from day\u2010to\u2010day. Although overall higher perceived stress was associated with higher peak severity, there is a substantial amount of variation between individuals in this relationship.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.14199","type":"journal-article","created":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T16:09:58Z","timestamp":1628525398000},"page":"1245-1254","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Perceived stress and pain severity in individuals with chronic migraine: A longitudinal cohort study using daily prospective diary data"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8304-257X","authenticated-orcid":false,"given":"Marina","family":"Vives\u2010Mestres","sequence":"first","affiliation":[{"name":"Analytics Curelator Inc. Cambridge MA USA"},{"name":"Departament d'Inform\u00e0tica i Matem\u00e0tica Aplicada Universitat de Girona Girona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2507-0286","authenticated-orcid":false,"given":"Amparo","family":"Casanova","sequence":"additional","affiliation":[{"name":"Analytics Curelator Inc. Cambridge MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1598-7536","authenticated-orcid":false,"given":"Andrew D.","family":"Hershey","sequence":"additional","affiliation":[{"name":"Division of Neurology Cincinnati Children\u2019s Hospital Medical Center Cincinnati OH USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2879-811X","authenticated-orcid":false,"given":"Serena L.","family":"Orr","sequence":"additional","affiliation":[{"name":"Section of Neurology Alberta Children's Hospital Calgary AB Canada"},{"name":"Department of Pediatrics Cumming School of Medicine University of Calgary Calgary AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102417738202"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2982.2009.01941.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-017-0787-1"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2008.01217.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32279-7"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2012.02223.x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2009.01369.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2011.01945.x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2012.08.2212"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(03)00293-8"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2982.2008.01634.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2009.01571.x"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10194-011-0397-2"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1590\/0004-282X20150093"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12817"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.12669\/pjms.332.12139"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0883073817705251"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102417727535"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000332"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2012.08.014"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.13137"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.13943"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.56.suppl_1.S20"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.4135\/9781412984812"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2008.02204.x"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2010.06.013"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102415625613"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-017-0748-8"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/1751-0759-2-14"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.13422"}],"container-title":["Headache: The Journal of Head and Face Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/head.14199","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/head.14199","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/headachejournal.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/head.14199","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T13:31:03Z","timestamp":1762090263000},"score":1,"resource":{"primary":{"URL":"https:\/\/headachejournal.onlinelibrary.wiley.com\/doi\/10.1111\/head.14199"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,9]]},"references-count":30,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1111\/head.14199"],"URL":"https:\/\/doi.org\/10.1111\/head.14199","archive":["Portico"],"relation":{},"ISSN":["0017-8748","1526-4610"],"issn-type":[{"value":"0017-8748","type":"print"},{"value":"1526-4610","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,9]]},"assertion":[{"value":"2021-05-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}