{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T00:17:39Z","timestamp":1792887459829,"version":"4.5.0"},"reference-count":52,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cephalalgia"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Greater occipital nerve block (GONB) has become an established treatment for migraine. Though numerous systematic reviews and randomised control trials (RCTs) are cited as supporting evidence, the quality and consistency of this data remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An umbrella review of systematic reviews investigating GONB for migraine was conducted. Additionally, an independent systematic review and meta-analysis of relevant RCTs was performed in accordance with PRISMA guidelines. Both evaluated MEDLINE (\u2018PubMed\u2019), Embase, and CENTRAL databases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nine relevant systematic reviews were identified; all had significant limitations and\/or contained methodological errors. The reviews had been cited 256 times. None were eligible for statistical analysis.<\/jats:p>\n                    <jats:p>\n                      Sixteen RCTs (930 patients) and seven RCTs (401 patients) were included for qualitative and quantitative analyses respectively. Studies were heterogeneous in their methodologies. No serious adverse effects were identified. With moderate certainty, local anaesthetic (LA) GONB reduces headache severity in acute migraine attacks at 30\u2005min (\u22122.08;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). With low certainty, weekly bilateral LA GONB injections reduce headache severity (\u22121.33;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and monthly headache days (\u22124.46;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) at one month for chronic migraine. Sustained benefits of GONB remain unclear. Data was insufficient to analyse the efficacy of steroid GONB, LA-steroid GONB, nor unilateral GONB for chronic migraine, and GONB \u2014 of any type \u2014 for episodic migraine.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is limited RCT evidence supporting GONB for the treatment of migraine. Existing systematic reviews should be interpreted with caution. RCTs with homogeneous methodologies are required to evaluate GONB in the management of disability in migraine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO registration ID: CRD42024595492.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03331024251398390","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T18:27:46Z","timestamp":1764700066000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Greater occipital nerve block for the treatment of migraine: An umbrella review, systematic review, and meta-analysis"],"prefix":"10.1177","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5881-5275","authenticated-orcid":false,"given":"Dominic","family":"Atraszkiewicz","sequence":"first","affiliation":[{"name":"Broomfield Hospital, Mid and South Essex NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1958-4024","authenticated-orcid":false,"given":"Emre","family":"\u00dcnal","sequence":"additional","affiliation":[{"name":"Ankara Etlik City Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7830-4563","authenticated-orcid":false,"given":"Paul","family":"Bassett","sequence":"additional","affiliation":[{"name":"Statsconsultancy Ltd"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9293-1886","authenticated-orcid":false,"given":"Fausto","family":"Morell-Ducos","sequence":"additional","affiliation":[{"name":"University College London Hospitals NHS Foundation Trust"},{"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9495-9006","authenticated-orcid":false,"given":"Anish","family":"Bahra","sequence":"additional","affiliation":[{"name":"University College London Hospitals NHS Foundation Trust"},{"name":"Barts Health NHS Trust"},{"name":"John Radcliffe Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,2]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-022-00763-1"},{"key":"e_1_3_2_3_2","unstructured":"Global Burden of Disease Collaborator Network Global burden of disease study 2021 (GBD 2021) https:\/\/vizhub.healthdata.org\/gbd-compare\/ (2021 accessed 5 June 2025)."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002275"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-019-0993-0"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0333102417738202"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/ncn3.12551"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-011-0233-z"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/0333102419879363"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.07.015"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2017.08.027"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2017.12.026"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/0333102416655159"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/ane.12393"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.36076\/ppj\/2015.18.153"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/ane.12716"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2007.124420"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/0333102414561872"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.5539\/gjhs.v6n6p209"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000006059"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1533-2500.2006.00068.x"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/ane.12692"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnab236"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/ane.13634"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000010429"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-024-03834-6"},{"key":"e_1_3_2_28_2","article-title":"Influence of greater occipital nerve block on the relief of acute migraine: a meta-analysis","volume":"103","author":"Li W","year":"2024","unstructured":"Li W, Tang L. 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