{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:16:10Z","timestamp":1792026970633,"version":"4.4.0"},"reference-count":71,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Migraine is a leading cause of disability worldwide, yet national-level epidemiological data are often lacking, hindering public health planning. This study aimed to provide the first comprehensive, population-based assessment of migraine epidemiology, comorbidity burden, and preventive treatment patterns in Israel.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using electronic health records from Clalit Health Services (CHS), which insures over 50% of the Israeli population. 4,614,331 adults were included in the analysis. Patients with migraine were identified between 2000 and 2023 using physician-recorded ICD-9 codes or dispensed triptan prescription. Patients with migraine were matched 1:2 with non-migraine controls to assess comorbidities. We calculated point prevalence, annual incidence, and analyzed the preventive treatment landscape before and after the introduction of calcitonin gene related peptide (CGRP)-related migraine-specific preventive treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 356,441 patients with migraine and 4,257,890 controls. Migraine disproportionately affected females (75.8%) and younger adults (mean age 30.7\u202f\u00b1\u202f13.2\u202fyears). Observed prevalence was lower than global estimates across most age strata. Incidence peaked among women aged 18\u201324 at 7.5 cases per 1,000 individuals. Patients with migraine carried a substantial comorbidity burden compared with age- and sex-matched controls. The highest adjusted odds ratios (ORs) were observed for chronic pain and psychiatric diseases (ORs for low back pain 2.67, fibromyalgia 2.42, endometriosis 1.86, anxiety 2.02, and depression 1.81). Vascular and metabolic conditions (hypertension, dyslipidemia, atrial fibrillation, and cerebrovascular disease) were more frequent, and stroke risk was significantly elevated. A negative association was found with diabetes. The proportion of patients who used preventive medication was low (9.6 and 8.8%, in 2018 and 2022 respectively) and did not increase after the introduction of migraine-specific treatments. Preventive use was most common in young adults (18\u201324 age group) and middle-aged adults (45\u201354 age group).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This large national population-based study reveals a high comorbidity burden among patients with migraine and suggests significant underdiagnosis compared to global benchmarks. The use of preventive treatment remained strikingly low, including novel migraine-specific therapies. These findings underscore the need for improved migraine recognition, integrated multidisciplinary care, and policy-level strategies to reduce the burden of this disabling condition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1743203","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T05:40:39Z","timestamp":1769406039000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Migraine epidemiology, comorbidities and therapeutic landscape: a national population-based study"],"prefix":"10.3389","volume":"17","author":[{"given":"Nirit","family":"Lev","sequence":"first","affiliation":[{"name":"Department of Neurology, Meir Medical Center, Clalit Health Services","place":["Kfar Sava, Israel"]},{"name":"Gray Faculty of Medical and Health Sciences, Sagol School of Neuroscience, Tel Aviv University","place":["Tel Aviv, Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihie","family":"Sheffer","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Soroka University Medical Center and Faculty of Health Sciences, Ben Gurion University of the Negev","place":["Beer Sheva, Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ido","family":"Peles","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Soroka University Medical Center and Faculty of Health Sciences, Ben Gurion University of the Negev","place":["Beer Sheva, Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Elefant","sequence":"additional","affiliation":[{"name":"Department of Neurology, Meir Medical Center, Clalit Health Services","place":["Kfar Sava, Israel"]},{"name":"Gray Faculty of Medical and Health Sciences, Sagol School of Neuroscience, Tel Aviv University","place":["Tel Aviv, Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gal","family":"Ifergane","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Soroka University Medical Center and Faculty of Health Sciences, Ben Gurion University of the Negev","place":["Beer Sheva, Israel"]},{"name":"Division of Brain Medicine, Department of Neurology, Soroka University Medical Center, Clalit Health Services","place":["Beer Sheva, Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/S1474-4422(24)00038-3","article-title":"Global, regional, and national burden of disorders affecting the nervous system, 1990-2021: a systematic analysis for the global burden of disease study 2021","volume":"23","year":"2024","journal-title":"Lancet 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