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Diagnostic tests and headache misdiagnoses in individuals with resistant and refractory migraine - data from the REFINE study

2026-06-01Artigo de investigação Acesso aberto
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dc.contributor.authorSantis, Federico De
dc.contributor.authorRosignoli, Chiara
dc.contributor.authorOnofri, Agnese
dc.contributor.authorBraschinsky, Mark
dc.contributor.authorSved, Olga
dc.contributor.authorGil-Gouveia, Raquel
dc.contributor.authorOliveira, Renato
dc.contributor.authorLampl, Christian
dc.contributor.authorPaungarttner, Jakob
dc.contributor.authorMartelletti, Paolo
dc.contributor.authorWells-Gatnik, William David
dc.contributor.authorMartins, Isabel Pavao
dc.contributor.authorMitsikostas, Dimos D.
dc.contributor.authorApostolakopoulou, Loukia
dc.contributor.authorOzge, Aynur
dc.contributor.authorNarin, Dilan Bayar
dc.contributor.authorPozo-Rosich, Patricia
dc.contributor.authorMunoz-Vendrell, Albert
dc.contributor.authorPrudenzano, Maria Pia
dc.contributor.authorGentile, Martino
dc.contributor.authorRyliskiene, Kristina
dc.contributor.authorVainauskiene, Jurgita
dc.contributor.authorSanchez-Del-Rio, Margarita
dc.contributor.authorVernieri, Fabrizio
dc.contributor.authorIaccarino, Gianmarco
dc.contributor.authorWaliszewska-Prosół, Marta
dc.contributor.authorBudrewicz, Sławomir
dc.contributor.authorCarnovali, Marta
dc.contributor.authorKatsarava, Zaza
dc.contributor.authorSacco, Simona
dc.contributor.authorOrnello, Raffaele
dc.date.accessioned2026-06-23T16:11:28Z
dc.date.available2026-06-23T16:11:28Z
dc.date.issued2026-06-01
dc.description.abstractBackground: Individuals with difficult-to-treat migraine, including resistant migraine (ResM) and refractory migraine (RefM), might experience treatment delays, undergo unnecessary diagnostic tests and receive misdiagnoses, which might influence treatment outcomes. For this reason, we hypothesized that individuals with ResM and RefM might report more diagnostic tests and misdiagnoses in their medical history compared with those with non-resistant/non-refractory migraine (NRNRM).MethodsThis analysis used baseline, cross-sectional data from the REFINE study, a multicenter, prospective observational study conducted in 15 European tertiary headache centers. Adults with episodic or chronic migraine were classified into RefM, ResM, or NRNRM groups. Baseline data were analyzed to assess the frequency of previous diagnostic tests and misdiagnoses.ResultsOverall, 689 participants were included with a median age of 46 years (interquartile range 36-53); 570 participants (82.7%) were female; 355 (51.5%) had NRNRM, 261 (37.9%) ResM, and 73 (10.9%) RefM. Referring to diagnostic tests, 335 participants (48.7%) had one and 237 (34.4%) multiple brain magnetic resonance imaging scans. ResM and RefM participants underwent more diagnostic tests than NRNRM. Overall, 193 participants (28.0%) had at least one prior headache misdiagnosis, most commonly cervical spine disorders and sinusitis; misdiagnoses were more frequent in NRNRM and ResM than in RefM (31.1%, 28.5%, and 15.1%, respectively; p = 0.025). Misdiagnosis rates were not influenced by age, sex, disease duration, or comorbidities.ConclusionsDiagnostic tests use and misdiagnoses are highly prevalent in all the three groups of individuals with ResM, RefM, and NRNRM with some differences across the three groups that may depend on multiple factors. Our findings emphasize a need for better diagnostic accuracy and care pathway across the entire spectrum of migraine, to avoid unnecessary diagnostic tests and misdiagnoses.<p/>eng
dc.identifier.doi10.1177/03331024261443712
dc.identifier.eid105041470492
dc.identifier.other259e25ec-b6ba-4c85-a378-7018f66c58fb
dc.identifier.pmid42244176
dc.identifier.urihttp://hdl.handle.net/10400.14/58233
dc.language.isoeng
dc.peerreviewedyes
dc.publisherSAGE Publications Ltd
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectChronic migraineeng
dc.subjectDisabilityeng
dc.subjectHeadacheeng
dc.subjectHeadache diagnosiseng
dc.subjectMisdiagnosiseng
dc.titleDiagnostic tests and headache misdiagnoses in individuals with resistant and refractory migraine - data from the REFINE study
dc.typeresearch article
dspace.entity.typePublication
oaire.citation.issue6
oaire.citation.volume46
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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