{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T12:19:28Z","timestamp":1793103568687,"version":"4.5.0"},"reference-count":31,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,10,27]],"date-time":"2024-10-27T00:00:00Z","timestamp":1729987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["K23NS102521"],"award-info":[{"award-number":["K23NS102521"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["K23NS124986"],"award-info":[{"award-number":["K23NS124986"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We used Cluster Analysis of Migraine\u2010associated Symptoms (CAMS) to critically evaluate current International Classification of Headache Disorders\u2010Third Edition (ICHD\u20103) migraine\u2010associated symptoms criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diagnostic criteria play a central role in guiding clinical trial inclusion, and therefore available treatments. Migraine and tension\u2010type headaches (TTH) are differentiated in ICHD\u20103 by many headache characteristics, including associated symptoms. A diagnosis of probable migraine indicates some but not all features of migraine are met. Photophobia and phonophobia, or nausea and\/or vomiting, are required to meet a diagnosis of migraine; however, CAMS\u2014a model that describes associated symptoms across youth with headache\u2014indicates that a broader range of symptoms contain information about migraine burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this multisite retrospective cross\u2010sectional study, we evaluated ICHD\u20103 migraine criteria. Youth aged 6\u201317\u2009years with migraine (including probable migraine) or TTH were included in the analysis. We used CAMS to evaluate the migraine\u2010associated symptom criterion. With CAMS as a guide, we evaluated how changes to the migraine\u2010associated symptom criterion altered who met the diagnosis of migraine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 9017 participants included in this study, 66.7% were female and had a median (interquartile range) age of 13\u2009(10\u201315)\u2009years. Most participants had migraine or probable migraine (99.0%), and the remainder had TTH (1.0%). A sizable percentage (10.1%) of youth under the umbrella diagnosis of migraine were diagnosed with probable migraine because they did not meet migraine\u2010associated symptom criterion D; however, many in this group reported several non\u2010ICHD migraine\u2010associated symptoms. We explored alterations to criterion D based on CAMS. Allowing for photophobia or phonophobia re\u2010categorized 55.6% of youth as having migraine, though some only had one symptom. Including lightheadedness or lightheadedness and spinning re\u2010categorized 19.7% and 25.8% of youth with migraine, respectively, but all of those who were re\u2010categorized had at least two migraine\u2010associated symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The ICHD\u20103 captures the most prevalent migraine\u2010associated symptoms; however, many youths with probable migraine who do not meet full criteria due to insufficient associated symptoms nonetheless experience multiple non\u2010ICHD migraine\u2010associated symptoms. Changes to criterion D should be considered for the ICHD\u20104.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.14858","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T02:33:42Z","timestamp":1730082822000},"page":"1217-1229","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["A critical appraisal of the International Classification of Headache Disorders migraine diagnostic criteria based on a retrospective multicenter cross\u2010sectional headache registry study in youth"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4996-2457","authenticated-orcid":false,"given":"Carlyn","family":"Patterson Gentile","sequence":"first","affiliation":[{"name":"Division of Neurology Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Perelman School of Medicine at the University of Pennsylvania  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":"Department of Pediatrics Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine  Cincinnati Ohio USA"},{"name":"Department of Neurology Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina L.","family":"Szperka","sequence":"additional","affiliation":[{"name":"Division of Neurology Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,27]]},"reference":[{"key":"e_1_2_12_2_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":"International Headache Society","year":"2018","journal-title":"Cephalalgia"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.332.7532.25"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2005.00260.x"},{"key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3233\/VES-201644","article-title":"Vestibular migraine: Diagnostic criteria (Update)1","volume":"32","author":"Lempert T","year":"2022","journal-title":"J. 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