{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T21:32:32Z","timestamp":1791322352621,"version":"4.3.1"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"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>Fasting-related headache has traditionally been attributed to dehydration, caffeine withdrawal, and sleep disruption, but pre-existing primary headache disorders may also play an important role in determining susceptibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the prevalence, clinical characteristics, and predictors of headache during Ramadan fasting and to explore the relative contribution of pre-existing primary headache disorders and the lifestyle-related factors assessed in this study to headache occurrence during fasting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this multinational cross-sectional survey across 14 countries, adults (18\u201365\u202fyears) observing Ramadan fasting completed a 17-item questionnaire. Headache during Ramadan was the primary outcome. Classification and regression tree (CRT) modelling were used to identify predictors and characterize fasting related headache.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Headache attacks occurred mainly in the afternoon\/pre-iftar period and improved after iftar in 54.6% of cases. Pre-existing primary headache disorders, particularly migraine, were more strongly associated with headache occurrence within the exploratory CRT model than the lifestyle variables assessed in this study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Fasting-related headache is highly prevalent and is influenced by both lifestyle-related factors and underlying headache susceptibility. A history of primary headache disorders was strongly associated with headache occurrence during Ramadan fasting, highlighting the importance of considering individual headache history alongside fasting- related exposures when assessing vulnerability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1859536","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T04:22:21Z","timestamp":1782361341000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Primary headache disorders susceptibility is associated with fasting-related headache: evidence from a multinational study across 14 countries"],"prefix":"10.3389","volume":"17","author":[{"given":"M.","family":"Ceren Akgor","sequence":"first","affiliation":[{"name":"Department of Neurology, University of Health Sciences Ankara Atat\u00fcrk Sanatorium Training and Research Hospital","place":["Ankara, T\u00fcrkiye"]},{"name":"Neuroscience and Neurotechnology Center of Excellence (N\u00d6ROM)","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Sagh\u0131r","sequence":"additional","affiliation":[{"name":"Department of Neurology and Clinical Neurophysiology, Helios University Hospital Wuppertal","place":["Wuppertal, Germany"]},{"name":"Faculty of Health, Witten\/Herdecke University","place":["Witten, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. \u0130.","family":"Can","sequence":"additional","affiliation":[{"name":"Prof. Dr. Aynur \u00d6zge Headache Clinic","place":["Mersin, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. G.","family":"Sahbaz","sequence":"additional","affiliation":[{"name":"Department of Neurology, Izmir University of Economics Medical Point Hospital","place":["\u0130zmir, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. U.","family":"\u00d6zcelik","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, Ac\u0131badem University","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. C.","family":"Atalar","sequence":"additional","affiliation":[{"name":"Department of Neurology, \u0130stanbul Physical Therapy and Rehabilitation Training and Research Hospital","place":["\u0130stanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Ergin","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medicine, Pamukkale University","place":["Denizli, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. O.","family":"Orun","sequence":"additional","affiliation":[{"name":"Department of Neurology, Van Training and Research Hospital, University of Health Sciences","place":["Van, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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