{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:55:18Z","timestamp":1787028918369,"version":"build-2736575974"},"reference-count":41,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Chronic migraines are a disabling neurological disorder with limited response to preventive pharmacological treatments. Greater occipital nerve (GON)-targeted radiofrequency (RF) procedures have emerged as promising interventions, yet long-term comparative data between pulsed RF (PRF) and continuous-lesion RF (LesionRF) remain scarce. This study evaluated the 12-month efficacy and safety of PRF versus LesionRF. Materials and Methods: A single-center cohort of 211 patients with chronic migraine diagnosed by ICHD-3 criteria (PRF = 107; LesionRF = 104) was analyzed. All patients had a positive diagnostic block and \u226512 months of follow-up. Interventions were performed under ultrasound guidance with standardized protocols (PRF: 42 \u00b0C, 4 min, 45 V; LesionRF: 80 \u00b0C, 90 s). The primary outcome was a change in monthly migraine days (MMD), while secondary outcomes included responder rates (\u226550% MMD reduction), pain intensity (VAS), functional outcomes (HIT-6, MIDAS), quality of life (SF-36, EQ-5D), medication use, retreatment, and complications. Results: Both groups improved, but LesionRF showed greater benefit. At 12 months, LesionRF achieved a larger MMD reduction (\u22124.8 days vs. PRF, p &lt; 0.001), higher responder rates (83% vs. 65%, p = 0.01), and greater VAS decreases (\u22121.6, p &lt; 0.001). Functional and quality-of-life scores improved more with LesionRF, with MIDAS reductions surpassing MCID and responder rates meeting PASS. Retreatment was less frequent with LesionRF (8% vs. 19%; HR 2.15, p = 0.037), and two LesionRF patients (1.9%) developed hematomas that resolved conservatively. Conclusions: Compared with PRF, LesionRF provided more sustained and clinically meaningful benefits for chronic migraines. Both approaches appeared to be safe, though confirmation in larger randomized trials is warranted.<\/jats:p>","DOI":"10.3390\/medicina61111893","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T01:14:02Z","timestamp":1761182042000},"page":"1893","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative Long-Term Outcomes of Pulsed and Lesion Radiofrequency of the Greater Occipital Nerve in Chronic Migraine: A 12-Month Cohort Study"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0200-9328","authenticated-orcid":false,"given":"Ahmet","family":"Yilmaz","sequence":"first","affiliation":[{"name":"Department of Algology, Adana City Training and Research Hospital, Adana 01370, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2527-3510","authenticated-orcid":false,"given":"Cagatay","family":"Kucukbingoz","sequence":"additional","affiliation":[{"name":"Department of Algology, Adana City Training and Research Hospital, Adana 01370, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1016\/S1474-4422(18)30322-3","article-title":"Global, regional, and national burden of migraine and tension-type headache, 1990\u20132016: A systematic analysis for the Global Burden of Disease Study 2016","volume":"17","author":"Stovner","year":"2018","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1177\/0333102410381145","article-title":"Disability, HRQoL and resource use among chronic and episodic migraineurs: Results from the International Burden of Migraine Study (IBMS)","volume":"31","author":"Blumenfeld","year":"2011","journal-title":"Cephalalgia"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1177\/0333102416678382","article-title":"Persistence and switching patterns of oral migraine prophylactic medications among patients with chronic migraine","volume":"37","author":"Hepp","year":"2017","journal-title":"Cephalalgia"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.pain.2006.01.016","article-title":"Greater occipital nerve injection in primary headache syndromes\u2014Prolonged effects from a single injection","volume":"122","author":"Afridi","year":"2006","journal-title":"Pain"},{"key":"ref_5","first-page":"E1219","article-title":"Pulsed radiofrequency treatment in interventional pain management: Mechanisms and potential indications\u2014A review","volume":"19","author":"Chua","year":"2016","journal-title":"Pain Physician"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1007\/s40122-024-00639-w","article-title":"Transforaminal Steroid Injection After Dorsal Root Ganglion Pulsed Radiofrequency (DRG-PRF): Impact on Pain Intensity and Disability","volume":"13","author":"Leoni","year":"2024","journal-title":"Pain Ther."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1111\/j.1526-4637.2012.01348.x","article-title":"Occipital nerve pulsed radiofrequency treatment: A multi-center study evaluating predictors of outcome","volume":"13","author":"Huang","year":"2012","journal-title":"Pain Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1186\/s10194-022-01431-x","article-title":"European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention\u20142022 update","volume":"23","author":"Sacco","year":"2022","journal-title":"J. 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