{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:50:37Z","timestamp":1791204637441,"version":"4.2.0"},"reference-count":39,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014832","name":"American Headache Society","doi-asserted-by":"publisher","award":["International Headache Academy Research Award"],"award-info":[{"award-number":["International Headache Academy Research Award"]}],"id":[{"id":"10.13039\/100014832","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006920","name":"University of Pennsylvania","doi-asserted-by":"publisher","award":["CHOP\/Penn NeuroNEXT fellowship"],"award-info":[{"award-number":["CHOP\/Penn NeuroNEXT fellowship"]}],"id":[{"id":"10.13039\/100006920","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005339","name":"American Academy of Neurology","doi-asserted-by":"publisher","award":["Clinical Research Training Scholarship"],"award-info":[{"award-number":["Clinical Research Training Scholarship"]}],"id":[{"id":"10.13039\/100005339","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","award":["Grant for Learning and Change"],"award-info":[{"award-number":["Grant for Learning and Change"]}],"id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"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\/100010210","name":"Defense Human Resources Activity","doi-asserted-by":"publisher","award":["W81XWH-151-0447"],"award-info":[{"award-number":["W81XWH-151-0447"]}],"id":[{"id":"10.13039\/100010210","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cephalalgia"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the underlying relationships between a broad range of headache-associated symptoms and how they relate to headache burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Symptoms associated with head pain inform classification of headache disorders. However, many headache-associated symptoms are not included in the diagnostic criteria, which is largely based on expert opinion. Large symptom databases can assess headache-associated symptoms irrespective of pre-existing diagnostic categories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a large single-center cross-sectional study on youth (6\u201317 years old) assessing patient-reported outpatient headache questionnaires between June 2017 and February 2022. Multiple correspondence analysis, an exploratory factor analysis, was applied to 13 headache-associated symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>6662 participants (64% female; median age 13.6 years) were included. Multiple correspondence analysis dimension 1 (25.4% of the variance) captured the absence or abundance of headache-associated symptoms. A greater number of headache-associated symptoms correlated with greater headache burden. Dimension 2 (11.0% of the variance) revealed three symptom clusters: (1) cardinal features of migraine (light, sound, and smell sensitivity, nausea, and vomiting), (2) nonspecific global neurologic dysfunction symptoms (lightheadedness, trouble thinking, blurry vision), (3) vestibular and brainstem dysfunction symptoms (vertigo, balance problems, ear ringing, double vision).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Assessing a broader range of headache-associated symptoms reveals clustering of symptomatology and a strong relationship with headache burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03331024231187162","type":"journal-article","created":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T05:31:47Z","timestamp":1689139907000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Symptoms associated with headache in youth"],"prefix":"10.1177","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4996-2457","authenticated-orcid":false,"given":"Carlyn","family":"Patterson Gentile","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA"},{"name":"Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4028-3100","authenticated-orcid":false,"given":"Geoffrey K.","family":"Aguirre","sequence":"additional","affiliation":[{"name":"Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew D.","family":"Hershey","sequence":"additional","affiliation":[{"name":"Cincinnati Children\u2019s Hospital Medical Center & University of Cincinnati College of Medicine, Cincinnati, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4786-8889","authenticated-orcid":false,"given":"Christina L.","family":"Szperka","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA"},{"name":"Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,7,12]]},"reference":[{"key":"bibr1-03331024231187162","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.332.7532.25"},{"key":"bibr2-03331024231187162","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-014-0458-8"},{"key":"bibr3-03331024231187162","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2005.00260.x"},{"key":"bibr4-03331024231187162","doi-asserted-by":"publisher","DOI":"10.1177\/0333102417738202"},{"key":"bibr5-03331024231187162","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"bibr6-03331024231187162","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"bibr7-03331024231187162","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.57.11.2034"},{"key":"bibr8-03331024231187162","doi-asserted-by":"publisher","DOI":"10.1177\/03331024221131331"},{"key":"bibr9-03331024231187162","unstructured":"Patterson-Gentile C. Headache Symptom Clusters Repository. https:\/\/github.com\/carlynpatterson\/Headache-symptom-clusters.git (2023, accessed 13 June 2023)."},{"key":"bibr10-03331024231187162","doi-asserted-by":"publisher","DOI":"10.6339\/JDS.2004.02(1).122"},{"key":"bibr11-03331024231187162","unstructured":"Trujillo-Ortiz A. Multiple Correspondence Analysis Based on the Indicator Matrix. https:\/\/www.mathworks.com\/matlabcentral\/fileexchange\/22154-multiple-correspondence-analysis-based-on-the-indicator-matrix, MATLAB Central File Exchange (retrieved 22 February 2022)."},{"key":"bibr12-03331024231187162","unstructured":"Pennsylvania Census Data. https:\/\/www.census.gov\/library\/stories\/state-by-state\/pennsylvania-population-change-between-census-decade.html. 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Racial and ethnic disparities in headache management in the pediatric emergency room. 2023."},{"key":"bibr38-03331024231187162","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.1993.hed3309497.x"},{"key":"bibr39-03331024231187162","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2982.2006.01275.x"}],"container-title":["Cephalalgia"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03331024231187162","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/03331024231187162","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03331024231187162","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03331024231187162","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:45:56Z","timestamp":1777387556000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.sagepub.com\/doi\/10.1177\/03331024231187162"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7]]},"references-count":39,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1177\/03331024231187162"],"URL":"https:\/\/doi.org\/10.1177\/03331024231187162","relation":{},"ISSN":["0333-1024","1468-2982"],"issn-type":[{"value":"0333-1024","type":"print"},{"value":"1468-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7]]},"article-number":"03331024231187162"}}