{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T12:20:22Z","timestamp":1778070022709,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Tokyo Dental College Ichikawa Genral Hospital"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cephalalgia"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The discrepancy in headache perception between people with and without headache disorders remains poorly studied. We aimed to gain insights into the factors that determine headache perception in individuals with and without headache disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A questionnaire-based headache survey was administered to municipal employees in the Tokyo Metropolitan Area. The participants were divided into four groups: Group A, individuals with current headache; Group B, individuals with a history of headache; Group C, individuals without headache and without nearby individuals with headaches; and Group D, individuals without headache but with nearby individuals with headaches. In Groups A and B, migraine without aura (MO), migraine with aura (MA), probable MO (pMO), and tension-type headache (TTH) were classified according to the International Classification of Headache Disorders, 3rd edition (ICHD-3). All participants were asked about their perceptions of headaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The response rate was 52.3% (1156 males and 764 females). There were 518 individuals in Group A (MO, 116; MA, 93; pMO, 95; TTH, 214) and 137 in Group B (MO, 24; MA, 24; probable MO, 29; TTH, 60). In Group A, headache severity (headache intensity, duration, and frequency), visual aura, and throbbing pain contributed to the perception of headaches as disabling. Individuals with MA were more likely to consider their headaches disabling than those with TTH (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.0003). However, there were no differences in the proportion of respondents who perceived headaches as disabling across headache disorders in Group B. The perception of headaches as disabling was more common in individuals without headaches (Groups C and D combined) than in those with headaches (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.0001 vs. Group A;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.0078 vs. Group B). However, 9.7% of them responded that headaches were not a disease. In individuals without headaches, males were more likely than females to consider headaches life-threatening (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.0037). Among females, more individuals considered headaches disabling in Group D than in Group C (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.0306).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Headache severity, visual aura, and throbbing pain appear to be key therapeutic targets for attenuating headache-related disability. Headache perception varied between individuals with and without headaches, and these differences were further modified by sex among those without headaches. These findings suggest that males without headaches are more likely to perceive headaches as a serious condition, whereas females without headaches appear to be influenced by the presence of nearby individuals with headaches.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03331024261444665","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T14:51:21Z","timestamp":1777906281000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Perception of headache-related disability in individuals with and without headache disorders working in a municipal government in the Tokyo Metropolitan Area"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2416-4259","authenticated-orcid":false,"given":"Mamoru","family":"Shibata","sequence":"first","affiliation":[{"name":"Tokyo Dental College Ichikawa General Hospital (now International University of Health and Welfare Ichikawa General Hospital), Chiba, Japan"},{"name":"Department of Neurology, Keio University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshihiko","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Keio University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3733-7411","authenticated-orcid":false,"given":"Ryo","family":"Takemura","sequence":"additional","affiliation":[{"name":"Keio University Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumihiko","family":"Sakai","sequence":"additional","affiliation":[{"name":"Saitama International Headache Center, Saitama Neuropsychiatric Institute, Saitama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"89","article-title":"Hallmarks of primary headache: part 1\u2014migraine","volume":"25","author":"Raggi A","unstructured":"Raggi A, Leonardi M, Arruda M, et al. Hallmarks of primary headache: part 1\u2014migraine. J Headache Pain 2024 Oct 31; 25: 89.","journal-title":"J Headache Pain"},{"key":"e_1_3_3_3_2","first-page":"64","article-title":"Hallmarks of primary headache: part 2- Tension-type headache","volume":"26","author":"Pan LH","unstructured":"Pan LH, Ling YH, Wang SJ, et al. Hallmarks of primary headache: part 2- Tension-type headache. J Headache Pain 2025 Jul 17; 26: 64.","journal-title":"J Headache Pain"},{"key":"e_1_3_3_4_2","first-page":"96","article-title":"Hallmarks of primary headache: part 3\u2014Cluster headache","volume":"26","author":"Coppola G","unstructured":"Coppola G, Arruda MA, Ashina M, et al. Hallmarks of primary headache: part 3\u2014Cluster headache. J Headache Pain 2025 Oct 2; 26: 96.","journal-title":"J Headache Pain"},{"key":"e_1_3_3_5_2","first-page":"1005","article-title":"Global, regional, and national burden of headache disorders, 1990\u20132023: a systematic analysis for the Global Burden of Disease Study 2023","volume":"24","author":"GBD 2023 Headache Collaborators","unstructured":"GBD 2023 Headache Collaborators. Global, regional, and national burden of headache disorders, 1990\u20132023: a systematic analysis for the Global Burden of Disease Study 2023. Lancet Neurol 2025 Dec; 24: 1005\u20131015.","journal-title":"Lancet Neurol"},{"key":"e_1_3_3_6_2","first-page":"03","article-title":"Stigmatizing attitudes toward people with migraine by people without active migraine: results of the OVERCOME (US) study","volume":"25","author":"Shapiro RE","unstructured":"Shapiro RE, Viktrup L, Muenzel EJ, et al. Stigmatizing attitudes toward people with migraine by people without active migraine: results of the OVERCOME (US) study. 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