{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T22:31:36Z","timestamp":1791585096964,"version":"4.3.4"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T00:00:00Z","timestamp":1725235200000},"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":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To better understand the breadth and frequency of symptoms across the phases of the migraine cycle using data captured from qualitative patient interviews conducted through the Migraine Clinical Outcome Assessment System (MiCOAS) project.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People living with migraine experience a range of symptoms across the pre\u2010headache, headache, post\u2010headache, and interictal phases of the migraine cycle. Although clinical diagnostic criteria and clinical trial endpoints focus largely on cardinal symptoms or monthly migraine days, migraine symptom profiles are far more complex. As a part of the MiCOAS project, semi\u2010structured qualitative interviews were undertaken to better understand the migraine\u2010related symptomology from the patient's viewpoint.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This concept elicitation study used iterative purposeful sampling to select 40 people with self\u2010reported medical diagnosis of migraine for interviews that were conducted via audio\u2010only web conferencing. Key topics related to migraine symptoms, including mood\/emotion symptoms, were identified using content analysis. Interview transcripts were also coded to reflect the phase of migraine under discussion, so that patient experiences could be compared by phase.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty participants (50%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200920 episodic migraine; 50%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200920 chronic migraine), aged from 21 to 70\u2009years old reported a total of 60 unique symptoms, which were categorized into 30 broader symptom categories. Participants reported between 7 and 22 unique symptom categories across all phases. During pre\u2010headache and headache, participants reported a median of 7.5 (interquartile range [IQR]\u2009=\u20095.5) and 8 (IQR\u2009=\u20094.0) different symptom categories compared to 4 (IQR\u2009=\u20093.0) and 1.5 (IQR\u2009=\u20092.5) for the post\u2010headache and interictal periods, respectively. Head pain during the headache phase was the only universally reported symptom (100%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200940). Pooling across all phases, the next most reported symptoms were light sensitivity (93%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200937), nausea (88%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200935), irritability\/impatience (83%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200924), sound sensitivity (80%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200932), and fatigue\/exhaustion (80%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200932). One or more interictal symptoms were reported by 73% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200929) of participants and included mood\/emotion symptoms, such as anxiety (30%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912), depression (18%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097), and anger (15%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096), as well as cardinal symptoms, such as light sensitivity (13%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095) and nausea (13%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients experience a range of symptoms across the phases of the migraine cycle. Results often aligned with clinical expectations, but non\u2010cardinal migraine\u2010related symptoms were reported both inside and outside the headache phase, including between attacks. These discoveries highlight the importance of assessing a range of symptoms and timing when developing patient\u2010reported outcome measures for migraine clinical trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.14817","type":"journal-article","created":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T06:55:07Z","timestamp":1725260107000},"page":"303-314","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Symptoms across the phases of the migraine cycle from the patient's perspective: Results of the\n                    <scp>MiCOAS<\/scp>\n                    qualitative study"],"prefix":"10.1111","volume":"65","author":[{"given":"James S.","family":"McGinley","sequence":"first","affiliation":[{"name":"Vector Psychometric Group, LLC  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6231-5890","authenticated-orcid":false,"given":"Rikki","family":"Mangrum","sequence":"additional","affiliation":[{"name":"Vector Psychometric Group, LLC  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2035-0828","authenticated-orcid":false,"given":"Maya T.","family":"Gerstein","sequence":"additional","affiliation":[{"name":"Patient Centered Outcomes Open Health Group  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly P.","family":"McCarrier","sequence":"additional","affiliation":[{"name":"Patient Centered Outcomes Open Health Group  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie R.","family":"Houts","sequence":"additional","affiliation":[{"name":"Vector Psychometric Group, LLC  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn C.","family":"Buse","sequence":"additional","affiliation":[{"name":"Vector Psychometric Group, LLC  Chapel Hill North Carolina USA"},{"name":"Neurology Albert Einstein College of Medicine  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra L.","family":"Bryant","sequence":"additional","affiliation":[{"name":"Vector Psychometric Group, LLC  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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