{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T22:27:13Z","timestamp":1793312833958,"version":"4.5.0"},"reference-count":28,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T00:00:00Z","timestamp":1633392000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Objective: The aim of this study was to investigate sex differences in the burden of migraine and tension-type headache (TTH). Background: Migraine and TTH are more common in women than in men, with differences in comorbidities, treatment responses, disease-modifying factors, and ictal and interictal burden of disease. Information about sex-related influences on ictal and interictal burden is limited, and an increased understanding is mandatory to provide tailored individual treatment for female and male patients. Methods: Participants answered an online survey based on the EUROLIGHT questionnaire. Inclusion criteria were the consent to participate, complete responses to the diagnostic questions, and information about their sex. Sex differences were investigated using the Mann\u2013Whitney U test or Chi-square test. For detecting factors that influence the burden of disease, we built binary regression models. Results: We included 472 (74.6% female) migraineurs and 161 (59.6% female) participants with TTH. Women with migraine reported significantly more problems in their love lives, more self-concealment, less feelings of being understood by family and friends, more interictal anxiety, a higher pain severity, and more depression and anxiety symptoms than men. For TTH, we did not find significant sex-related differences. A higher headache frequency was the factor that increased the burden of disease in female but not in male migraneurs. Conclusion: The burden of disease was higher in women than men with migraine in many aspects, but not with TTH. Therefore, according to our results, there is a need for sex-specific precision medicine for migraine but not TTH. Controlling the headache frequency with a proper acute or prophylactic treatment and treating comorbid depression and anxiety symptoms is crucial to ease migraine\u2019s burden, especially in women.<\/jats:p>","DOI":"10.3390\/brainsci11101323","type":"journal-article","created":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T09:24:04Z","timestamp":1633598644000},"page":"1323","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Dealing with Headache: Sex Differences in the Burden of Migraine- and Tension-Type Headache"],"prefix":"10.3390","volume":"11","author":[{"given":"Maria Susanne","family":"Neumeier","sequence":"first","affiliation":[{"name":"Department of Neurology, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2778-6790","authenticated-orcid":false,"given":"Heiko","family":"Pohl","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter S.","family":"Sandor","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Zurich, 8091 Zurich, Switzerland"},{"name":"Zurzach Care, 5330 Bad Zurzach, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Gut","sequence":"additional","affiliation":[{"name":"Migraine Action Switzerland, 4103 Bottmingen, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele S.","family":"Merki-Feld","sequence":"additional","affiliation":[{"name":"Department of Reproductive Endocrinology, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6620-8398","authenticated-orcid":false,"given":"Colette","family":"Andr\u00e9e","sequence":"additional","affiliation":[{"name":"Migraine Action Switzerland, 4103 Bottmingen, Switzerland"},{"name":"Department of Pharmaceutical Sciences, University of Basel, 4001 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/j.1468-2982.2007.01288.x","article-title":"The Global Burden of Headache: A Documentation of Headache Prevalence and Disability Worldwide","volume":"27","author":"Stovner","year":"2007","journal-title":"Cephalalgia"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1212\/WNL.53.3.537","article-title":"The prevalence and characteristics of migraine in a population-based cohort: The GEM Study","volume":"53","author":"Launer","year":"1999","journal-title":"Neurology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/S0072-9752(10)97001-2","article-title":"Epidemiology of headache","volume":"97","author":"Boller","year":"2010","journal-title":"Handbook of Clinical Neurology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1080\/03630242.2019.1696440","article-title":"Gender differences in clinical and psychological variables associated with the burden of headache in tension-type headache","volume":"60","author":"Castaldo","year":"2020","journal-title":"Women Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1111\/head.13470","article-title":"Sex Differences in Prevalence, Symptoms, Impact, and Psychiatric Comorbidities in Migraine and Probable Migraine: A Population-Based Study","volume":"59","author":"Song","year":"2019","journal-title":"Headache J. 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