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Objective.-This study sought to compare ambulatory physical activity (PA) between young adults with migraine, tensiontype headache (TTH), and non-headache controls and determine if differences in PA were attributable to headache activity or other relevant covariates. Background.-PA has been implicated in the development, manifestation, and treatment of various headache disorders. However, objective quantification of PA across headache types is lacking, and no study has quantified both prospective PA and the influence of headache occurrence on PA. Methods.-A prospective cohort study followed university participants with migraine, with TTH, or without headache for 7 days using an Omron HJ-112 pedometer and daily headache diaries. Daily free-living PA was compared between groups, and differences in PA as a function of headache day vs non-headache day were compared among those with migraine and TTH. Results.-The final sample consisted of 516 observations from 100 young adults (81/100 female, mean age = 19.0 ± 1.7) comprised of 28 individuals with migraine, 37 individuals with TTH, and 35 non-headache controls. On average, individuals with migraine engaged in less total PA than non-headache controls (6847 vs 8573 steps/day; mean difference = −1726 [95% CI: −3135 to −318], P = .017) across the 7-day monitoring period. After adjusting for relevant covariates (psychological symptoms, body mass index, weekend vs weekday), this difference was evident on both non-headache days (adjusted mean = 5987 vs 8610, P = .002) and headache days (adjusted mean = 6986 vs 9958, P = .017). In contrast, PA of individuals with TTH (mean = 7691 steps/day) did not significantly differ from those with migraine. PA within groups as a function of headache day (vs non-headache day) did not significantly differ for individuals with migraine (mean = 7357 vs 6191, P = .061) or individuals with TTH (mean = 7814 vs 7641, P = .736). Conclusions.-Consistent with other studies, individuals with migraine reported lower levels of PA compared to non-headache controls. Notably, relative reductions in PA occurred even on days in which headache was not experienced and were not attributable to the examined covariates, instead supporting a more global pattern of reduced PA. Further research is needed to isolate the mechanisms underlying interictal reductions in PA among those with migraine.

Three cases of dyskinesia attributable to selective serotonergic antidepressant drugs are presented. The patients were not on other medication nor had they been in preceding weeks. The movement disorder disappeared on cessation of the drug within a time period corresponding to the expected wash-out for the different preparations. The emergence of dyskinesic symptoms coincided with a significant deterioration in mental state after an initial good response to the particular medication. Considering the apparently selective action of the serotonin re-uptake inhibitors, these cases suggest that movement disorders and psychiatric symptoms are unlikely to be due to single neurotransmitter mechanisms and that a disturbance of the balance between the different systems is a more likely hypothesis.

Purpose of Review The purpose of this review is to summarize advances in behavioral treatments for pain and headache disorders, as well as recent innovations in telemedicine for behavioral treatments. Recent Findings Research for behavioral treatments continues to support their use as part of a multidisciplinary approach to comprehensive management for pain and headache conditions. Behavioral treatments incorporate both behavioral change and cognitive interventions and have been shown to improve outcomes beyond that of medical management alone. The onset of the COVID-19 public health emergency necessitated the rapid uptake of nontraditional modalities for behavioral treatments, particularly telemedicine. Telemedicine has long been considered the answer to several barriers to accessing behavioral treatments, and as a result of COVID-19 significant progress has been made evaluating a variety of telemedicine modalities including synchronous, asynchronous, and mobile health applications. Researchers are encouraged to continue investigating how best to leverage these modalities to improve access to behavioral treatments and to continue evaluating the efficacy of telemedicine compared to traditional in-person care. Summary Comprehensive pain and headache management should include behavioral treatments to address a variety of behavior change and cognitive targets. Policy changes and advances in telemedicine for behavioral treatments provide the opportunity to address historical barriers limiting access.