{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T11:31:08Z","timestamp":1781177468702,"version":"3.54.1"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T00:00:00Z","timestamp":1719446400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2024,9]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n To describe the association between day\u2010to\u2010day peak pain severity and clinical factors in individuals with chronic migraine (CM).<\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n Little is known about how clinical factors relate to day\u2010to\u2010day pain severity in individuals with CM.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Adults with CM were enrolled into this observational prospective cohort study that collected daily data about headache, associated symptoms, and lifestyle factors using a digital health platform (N1\u2010Headache\u2122) for 90\u2009days. \u201cMigraine days\u201d were defined as days in which a headache occurred that had features described by the International Classification of Headache Disorders criteria. On these days, peak pain severity was recorded on a 4\u2010point scale; on non\u2010headache days peak pain severity was imputed as \u201c0\/none\u201d. The associations between peak pain severity and 12 clinical factors were modeled and adjusted for sex, age, daily headache, presence of menstrual bleeding, day of the week, and disability. All numerical and Likert scale variables were standardized prior to analysis.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Data were available for 392 participants (35,280 tracked days). The sample was predominantly female (90.6%), with a mean (standard deviation) age of 39.9\u2009(12.8)\u2009years. In the final multivariable model with random intercept and slopes, higher than typical self\u2010reported levels of standardized stress (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.04\u20131.11), standardized irritability (OR 1.05, 95% CI 1.02\u20131.08), standardized sadness (OR 1.05, 95% CI 1.02\u20131.07), fatigue (OR 1.25, 95% CI 1.15\u20131.36), eyestrain (OR 1.38, 95% CI 1.26\u20131.52), neck pain (OR\u20091.94, 95% CI 1.76\u20132.13), skin sensitivity (OR 1.61, 95% CI 1.44\u20131.80), and dehydration (OR 1.29, 95% CI 1.18\u20131.42) were associated with higher reported peak pain severity levels, while standardized sleep quality (OR 0.96, 95% CI 0.93\u20130.99) and standardized waking feeling refreshed (OR 0.84, 95% CI 0.81\u20130.88) were associated with lower reported peak pain severity levels. The inclusion of a random intercept and random slopes improved upon more parsimonious models and illustrated large differences in individuals\u2019 reporting of peak severity according to the levels of the associated clinical factors.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Our data showed that the experience of CM, from a pain severity perspective, is complex, related to multiple clinical variables, and highly individualized. These results suggest that future work should aim to study a personalized approach to both medical and behavioral interventions for CM based on which clinical factors relate to the individual's experience of pain severity.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/head.14745","type":"journal-article","created":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T03:20:27Z","timestamp":1719458427000},"page":"995-1004","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical factors associated with day\u2010to\u2010day peak pain severity in individuals with chronic migraine: A cohort study using daily prospective diary data"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8304-257X","authenticated-orcid":false,"given":"Marina","family":"Vives\u2010Mestres","sequence":"first","affiliation":[{"name":"Department of Clinical Statistics Curelator Inc. Cambridge Massachusetts USA"},{"name":"Department of Computer Science, Applied Mathematics and Statistics 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":"Department of Clinical Statistics Curelator Inc. Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen D.","family":"Silberstein","sequence":"additional","affiliation":[{"name":"Jefferson Headache Center Thomas Jefferson University Philadelphia Pennsylvania 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's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio 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 Alberta Canada"},{"name":"Department of Pediatrics, Cumming School of Medicine University of Calgary Calgary Alberta Canada"},{"name":"Department of Community Health Sciences, Cumming School of Medicine University of Calgary Calgary Alberta Canada"},{"name":"Department of Clinical Neurosciences, Cumming School of Medicine University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,27]]},"reference":[{"issue":"1","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1111\/head.14024","article-title":"The prevalence and impact of migraine and severe headache in the United States: updated age, sex, and socioeconomic\u2010specific estimates from government health surveys","volume":"61","author":"Burch R","year":"2021","journal-title":"Headache"},{"issue":"1","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/0333102417738202","article-title":"The International Classification of Headache Disorders, 3rd edition","volume":"38","author":"Headache Classification Committee of the International Headache Society","year":"2018","journal-title":"Cephalalgia"},{"issue":"5","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1111\/j.1468-2982.2009.01941.x","article-title":"Global prevalence of chronic migraine: a systematic review","volume":"30","author":"Natoli JL","year":"2010","journal-title":"Cephalalgia"},{"issue":"1","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s10194-017-0787-1","article-title":"Fluctuations in episodic and chronic migraine status over the course of 1 year: implications for diagnosis, treatment and clinical trial design","volume":"18","author":"Serrano D","year":"2017","journal-title":"J Headache Pain"},{"issue":"12","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"e1326","DOI":"10.1212\/WNL.0000000000200887","article-title":"Association of a cyclical migraine phenotype with disease progression: a 1\u2010year time series analysis","volume":"99","author":"Gallardo VJ","year":"2022","journal-title":"Neurology"},{"issue":"8","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1111\/j.1526-4610.2008.01217.x","article-title":"Acute migraine medications and evolution from episodic to chronic migraine: a longitudinal population\u2010based study","volume":"48","author":"Bigal ME","year":"2008","journal-title":"Headache"},{"issue":"10","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1111\/j.1526-4610.2012.02223.x","article-title":"Chronic migraine prevalence, disability, and sociodemographic factors: results from the American Migraine Prevalence and Prevention Study","volume":"52","author":"Buse DC","year":"2012","journal-title":"Headache"},{"key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1111\/j.1526-4610.2009.01369.x","article-title":"Economic burden of transformed migraine: results from the American Migraine Prevalence and Prevention (AMPP) Study","volume":"49","author":"Munakata J","year":"2009","journal-title":"Headache"},{"issue":"7","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1111\/j.1526-4610.2011.01945.x","article-title":"Cost of health care among patients with chronic and episodic migraine in Canada and the USA: results from the International Burden of Migraine Study (IBMS)","volume":"51","author":"Stokes M","year":"2011","journal-title":"Headache"},{"issue":"1","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.jval.2012.08.2212","article-title":"Cost and predictors of lost productive time in chronic migraine and episodic migraine: results from the American Migraine Prevalence and Prevention (AMPP) Study","volume":"16","author":"Serrano D","year":"2013","journal-title":"Value Health"},{"issue":"8","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1111\/j.1468-1331.2008.02204.x","article-title":"Assessing migraine disability by diary\u2010based measurement: relationship to the characteristics of individual headache attacks","volume":"15","author":"Park JW","year":"2008","journal-title":"Eur J Neurol"},{"issue":"2","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.ejpain.2010.06.013","article-title":"Characteristics, impact and treatment of 6000 headache attacks: the PAMINA study","volume":"15","author":"Lieba\u2010Samal D","year":"2011","journal-title":"Eur J Pain"},{"issue":"10","key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.1111\/head.14328","article-title":"An observational study of self\u2010reported migraine triggers and prospective evaluation of the relationships with occurrence of attacks enabled by a smartphone application (app)","volume":"62","author":"Casanova A","year":"2022","journal-title":"Headache"},{"issue":"16","key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1212\/WNL.0000000000000332","article-title":"Reduction in perceived stress as a migraine trigger","volume":"82","author":"Lipton RB","year":"2014","journal-title":"Neurology"},{"issue":"8","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1111\/head.14199","article-title":"Perceived stress and pain severity in individuals with chronic migraine\u2009: a longitudinal cohort study using daily prospective diary data","volume":"61","author":"Vives\u2010Mestres M","year":"2021","journal-title":"Headache"},{"key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"4675","DOI":"10.1002\/sim.9089","article-title":"Analyzing categorical time series in the presence of missing observations","volume":"40","author":"Weiss C","year":"2021","journal-title":"Stat Med"},{"issue":"5","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/0167-9473(96)00004-7","article-title":"Random effects in ordinal regression models. Computational statistics & data analysis","volume":"22","author":"Tutz G","year":"1996","journal-title":"Comput Stat Data Anal"},{"issue":"1","key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2307\/2529336","article-title":"A biometrics invited paper. The analysis and selection of variables in linear regression","volume":"32","author":"Hocking RR","year":"1976","journal-title":"Biometrics"},{"key":"e_1_2_11_20_1","volume-title":"R: a language and environment for statistical computing","author":"R Core Team","year":"2021"},{"key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1111\/j.1526-4610.2006.00443.x","article-title":"Pain characteristics of the acute migraine attack","volume":"46","author":"Kelman L","year":"2006","journal-title":"Headache"},{"key":"e_1_2_11_22_1","doi-asserted-by":"crossref","first-page":"2340","DOI":"10.1111\/head.13966","article-title":"Demographics, headache features, and comorbidity profiles in relation to headache frequency in people with migraine: results of the American MIgraine Prevalence and Prevention (AMPP) Study","volume":"60","author":"Buse DC","year":"2020","journal-title":"Headache"},{"key":"e_1_2_11_23_1","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2021.831035","article-title":"Cutaneous allodynia in migraine: a narrative review","volume":"12","author":"M\u00ednguez\u2010Olaondo A","year":"2022","journal-title":"Front Neurol"},{"key":"e_1_2_11_24_1","doi-asserted-by":"crossref","first-page":"2673","DOI":"10.2147\/JPR.S329280","article-title":"Central sensitization in migraine: a narrative review","volume":"15","author":"Suzuki K","year":"2022","journal-title":"J Pain Res"},{"issue":"10","key":"e_1_2_11_25_1","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1111\/head.13422","article-title":"Anxiety, incentives, and adherence to self\u2010monitoring on a mobile health platform: a naturalistic longitudinal cohort study in people with headache","volume":"58","author":"Seng EK","year":"2018","journal-title":"Headache"},{"issue":"1","key":"e_1_2_11_26_1","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/S0304-3959(00)00305-5","article-title":"Validity of the migraine disability assessment (MIDAS) score in comparison to a diary\u2010based measure in a population sample of migraine sufferers","volume":"88","author":"Stewart WF","year":"2000","journal-title":"Pain"}],"container-title":["Headache: The Journal of Head and Face Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/headachejournal.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/head.14745","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T11:31:54Z","timestamp":1762083114000},"score":1,"resource":{"primary":{"URL":"https:\/\/headachejournal.onlinelibrary.wiley.com\/doi\/10.1111\/head.14745"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,27]]},"references-count":25,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1111\/head.14745"],"URL":"https:\/\/doi.org\/10.1111\/head.14745","archive":["Portico"],"relation":{},"ISSN":["0017-8748","1526-4610"],"issn-type":[{"value":"0017-8748","type":"print"},{"value":"1526-4610","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,27]]},"assertion":[{"value":"2023-09-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}