{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T05:06:27Z","timestamp":1779944787769,"version":"3.53.1"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015703","name":"Orient Europharma","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100015703","id-type":"DOI","asserted-by":"crossref"}]}],"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>Although diagnostic criteria and treatment guidelines for migraine are well-established, care remains suboptimal due to frequent misdiagnosis and undertreatment. This Delphi consensus aimed to explore how clinicians in the Asia-Pacific region approach migraine diagnosis and management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study used a modified-Delphi method, involving two rounds of surveys and a virtual scientific meeting with 14 headache-specialists from seven countries in Asia-Pacific. Consensus on statements was measured using a Likert scale ranging from 1 to 9, with consensus threshold set at 75%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study had 100% participation in both surveys, and the scientific meeting was attended by 64.3% of participants. Out of 21 closed-ended statements, 12 reached consensus. Notably, 93% of participants reported using only ICHD-3 for migraine diagnosis, and 79% found the criteria easy to apply. For the diagnosis of migraine, all participants evaluated migraine-related disability and depression; 93% anxiety, and 86% sleep disturbances. Neck pain and dizziness were recognised as migraine-associated symptoms by 93% of respondents, with 85% reporting that 25\u201375% of their patients experience neck pain. Anti-CGRP mAbs were considered effective and addressed unmet needs for chronic or episodic migraine by 86% of participants. Efficacy (100%) was the primary deciding factor in selecting a specific anti-CGRP mAb, followed by safety (93%) and tolerability (86%). Factors such as frequency of administration (43%), perceived wearing-off effect (43%), availability and reimbursement (57%), and cost (58%) were less influential in decision-making. While 79% of the participants would consider anti-CGRP mAbs as first-line treatment, 93% believed these therapies would improve safety, adherence, and compliance outcomes. Only 7% of the participants favoured the use of gepants. Participants unanimously supported the use of anti-CGRP mAbs in adolescents (13\u201317\u202fyears), but not in children (6\u201312\u202fyears).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Consensus was reached on key aspects of migraine diagnosis and management. Participants endorsed the ICHD-3 criteria as the diagnostic standard and favoured using headache diaries, followed by MIDAS and HIT-6 for assessment. Anti-CGRP mAbs were recognised as effective in addressing unmet needs in migraine prevention. The panel advised against using anti-CGRP mAbs in children under 12 due to insufficient evidence, highlighting the need for more paediatric data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1770966","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T04:48:13Z","timestamp":1779943693000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Delphi consensus on the real-world application of the updated diagnostic and treatment guidelines for migraine in Asia Pacific"],"prefix":"10.3389","volume":"17","author":[{"given":"Charles Hua Chiang","family":"Siow","sequence":"first","affiliation":[{"name":"The Brain Centre, Mt Elizabeth Novena Hospital","place":["Singapore, Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengyuan","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surat","family":"Tanprawate","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine (Neurology Division), Faculty of Medicine, Chiang Mai University","place":["Chiang Mai, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuu-Jiun","family":"Wang","sequence":"additional","affiliation":[{"name":"Neurological Institute, Taipei Veterans General Hospital","place":["Taipei, Taiwan"]},{"name":"College of Medicine and Brain Research Center, National Yang Ming Chiao Tung University","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elspeth J.","family":"Hutton","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, School of Translational Medicine, Monash University","place":["Melborne, VIC, Australia"]},{"name":"Department of Neurology, Alfred Health","place":["Melbourne, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byung-Kun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Eulji University School of Medicine","place":["Daejeon, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Kyung","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yonsei University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norihiro","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Shonan Keiiku Hospital","place":["Fujisawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanakorn","family":"Rattanawong","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, King Mongkut's Institute of Technology Ladkrabang","place":["Bangkok, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ka Sing","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong","place":["Hong Kong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mi Ji","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhao","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Neurology, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hebo","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hebei General Hospital","place":["Shijiazhuang, 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