{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:10:21Z","timestamp":1753891821719,"version":"3.41.2"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:00:00Z","timestamp":1738713600000},"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. Pain Res."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The aim of this study was to determine if specific anatomical changes were present in patients with recurrent headaches including patients with chronic migraines, chronic tension-type headaches, and daily persistent headaches. A retrospective study of 200 patients was performed to evaluate the potential of measuring the amount of nasal blood pool activity (nasal congestion) as a predictive marker for recurrent headaches.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cohort analysis was performed involving patients who had been referred to the Nuclear Medicine Clinic over a 3-year period for whole-body blood pool scans. The scans were evaluated by region of interest (ROI) analysis of nasal and heart max pixel count ratios (NHMRs) to determine an association between nasal blood pooling activity and recurrent headaches at the time of the initial scan and in follow-up evaluations over a period of 3\u20136 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significantly greater NHMRs were observed in 122 patients with chronic headaches at the time of referral for their initial whole-body blood pool scan when compared with those patients without recurrent headaches (<jats:italic>p<\/jats:italic>\u2009=\u20090.004; OR 10.5; 95% CI 2.22\u201356.7). An additional 15 patients, for a total of 137, developed recurrent headaches following their initial scan and before their follow-up evaluation. NHMRs were also significantly increased in the additional patients when compared to those without recurrent headaches (<jats:italic>p<\/jats:italic>\u2009=\u20090.004; OR 12.3; 95% CI 2.34\u201375.5).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with recurrent headaches have significantly increased nasal activity as observed on <jats:sup>99m<\/jats:sup>Tc-MDP whole-body blood pool scans, supporting the hypothesis that nasal lymphatic dysfunction plays a role in the etiology of recurrent headaches. This research highlights a novel diagnostic use of the whole-body blood pool scan for the assessment of nasal turbinate vasodilation as well as a possible new target for the treatment of recurrent headaches.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpain.2025.1521500","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T07:33:13Z","timestamp":1738740793000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Anatomical and physiological contributions of nasal turbinate vessels and lymphatics to the pathogenesis of nasal congestion in recurrent headaches: a pilot study"],"prefix":"10.3389","volume":"6","author":[{"given":"Jacob M.","family":"Chmielecki","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aishwarya","family":"Vemula","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joyce G.","family":"Schwartz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan A.","family":"Gelfond","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William T.","family":"Phillips","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,5]]},"reference":[{"key":"B1","first-page":"42","article-title":"The best ways to stop a headache","volume":"89","author":"Gill","year":"2024","journal-title":"Consum Rep"},{"key":"B2","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1016\/j.pmr.2015.01.001","article-title":"Chronic daily headache","volume":"26","author":"Murinova","year":"2015","journal-title":"Phys Med Rehabil Clin N Am"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1675","DOI":"10.1111\/head.12881","article-title":"Chronic daily headache: ten steps for primary care providers to regain control","volume":"56","author":"Sheeler","year":"2016","journal-title":"Headache"},{"key":"B4","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1111\/head.14024","article-title":"The prevalence and impact of migraine and severe headache in the United States: updated age, sex, and socioeconomic-specific estimates from government health surveys","volume":"61","author":"Burch","year":"2021","journal-title":"Headache"},{"key":"B5","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1186\/s10194-020-01208-0","article-title":"Migraine remains second among the world\u2019s causes of disability, and first among young women: findings from Gbd2019","volume":"21","author":"Steiner","year":"2020","journal-title":"J Headache Pain"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: a systematic analysis for the global burden of disease study 2019","volume":"396","author":"Vos","year":"2020","journal-title":"Lancet"},{"key":"B7","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1111\/j.1526-4610.2012.02117.x","article-title":"Migraine headaches and suicide attempt","volume":"52","author":"Breslau","year":"2012","journal-title":"Headache"},{"key":"B8","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1016\/j.jbmt.2023.11.011","article-title":"Differences in musculoskeletal dysfunctions and in postural alterations between chronic migraine and chronic tension type headache: a cross-sectional study","volume":"37","author":"Deodato","year":"2024","journal-title":"J Bodyw Mov Ther"},{"key":"B9","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1097\/WNP.0000000000001055","article-title":"Neurophysiological and clinical outcomes in episodic migraine without aura: a cross-sectional study","volume":"41","author":"Deodato","year":"2024","journal-title":"J Clin Neurophysiol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1016\/j.otc.2013.10.009","article-title":"Imaging for headache: what the neuroradiologist looks for","volume":"47","author":"Bricker","year":"2014","journal-title":"Otolaryngol Clin North Am"},{"key":"B11","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1007\/s12070-019-01603-3","article-title":"\u201cSinus headache\u201d: diagnosis and dilemma?? 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