{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T16:24:19Z","timestamp":1788279859048,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T00:00:00Z","timestamp":1747699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["6\u20102021\u20100229"],"award-info":[{"award-number":["6\u20102021\u20100229"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify natural subtypes of tension\u2010type headache (TTH) based on clinical characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tension\u2010type headache is generally recognized as a bilateral, non\u2010pulsating headache of mild\u2010to\u2010moderate intensity, with minimal accompanying symptoms. However, diverse symptomatology can be present with current diagnostic criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was a cross\u2010sectional, secondary analysis of data previously collected from a nationwide population\u2010based web survey data on headache and sleep, conducted in South Korea in October 2020. Categorical variables for TTH diagnostic criteria according to the third edition of the International Classification of Headache Disorders were analyzed to determine the natural subtypes of TTH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 3030 participants, 954 were identified with TTH. A four\u2010class model was selected as optimal, revealing subtypes named \u201cclassic TTH,\u201d \u201csevere TTH,\u201d \u201cunilateral TTH,\u201d and \u201cTTH with photophobia,\u201d comprising 413 (43.3%), 66 (6.9%), 376 (39.4%), and 99 (10.4%) individuals, respectively. The most common, \u201cclassic TTH,\u201d featured typical bilateral (413\/413 [100.0%]), non\u2010pulsatile headaches (220\/413 [53.3%]) of mild\u2010to\u2010moderate intensity (400\/413 [96.9%]). The \u201csevere TTH\u201d class exhibited the highest headache intensity (moderate headache intensity, 35\/66 [53.0%]), and the greatest impact of headache (mean\u2009[\u00b1\u2009standard deviation, SD] six\u2010item Headache Impact Test [HIT\u20106] score, 55.1\u2009[6.0]). The \u201cunilateral TTH\u201d class was primarily mild headache intensity (277\/376 [73.7%]) and lowest impact of headache (mean [SD] HIT\u20106 score 48.8\u2009[8.3]). \u201cTTH with photophobia\u201d involved exclusive photophobia (99\/99 [100%]) and was second to \u201csevere TTH\u201d in headache intensity (moderate intensity, 43\/99 [43.4%]) and impact of headache (mean [SD] HIT\u20106 score 53.2\u2009[8.1]). Of 954 total TTH participants, 56.7% were not \u201cclassic TTH\u201d subtype and 51.4% had unilateral headache.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We identified four TTH subgroups, each with unique clinical features, providing additional insights into TTH subtypes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.14950","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T07:23:24Z","timestamp":1747725804000},"page":"1160-1169","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Natural subgroups of tension\u2010type headache: A population\u2010based study"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0907-4212","authenticated-orcid":false,"given":"Wonwoo","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Neurology, Yongin Severance Hospital Yonsei University College of Medicine  Yongin Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8764-7995","authenticated-orcid":false,"given":"Seok\u2010Jae","family":"Heo","sequence":"additional","affiliation":[{"name":"Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics Yonsei University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6221-1346","authenticated-orcid":false,"given":"Min Kyung","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Severance Hospital Yonsei University College of Medicine  Seoul 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