Update in the understanding of new daily persistent headache

Peng, Kuan‐Po; Rozen, Todd D.

doi:10.1177/03331024221146314

Cited by 18 publications

(20 citation statements)

References 73 publications

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“…Firstly, NDPH may not be a single disease entity. Several authors have proposed that NDPH is a heterogenous group of conditions with different pathophysiology (61,62). Secondly, there may be cultural or biological reasons why the presentation of NDPH differs by country or region.…”

Section: Discussionmentioning

confidence: 99%

New daily persistent headache: A systematic review and meta-analysis

et al. 2023

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Objective To perform a systematic review and meta-analysis of the epidemiology, precipitants, phenotype, comorbidities, pathophysiology, treatment, and prognosis of primary new daily persistent headache. Methods We searched PubMed/Medline, EMBASE, Cochrane, and clinicaltrials.gov until 31 December 2022. We included original research studies with any design with at least five participants with new daily persistent headache. We assessed risk of bias using National Institutes of Health Quality Assessment Tools. We used random-effects meta-analysis where suitable to calculate pooled estimates of proportions. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis compliant study is registered with PROSPERO (registration number CRD42022383561). Results Forty-six studies met inclusion criteria, predominantly case series, including 2155 patients. In 67% (95% CI 57–77) of cases new daily persistent headache has a chronic migraine phenotype, however new daily persistent headache has been found to be less likely than chronic migraine to be associated with a family history of headache, have fewer associated migrainous symptoms, be less vulnerable to medication overuse, and respond less well to injectable and neuromodulatory treatments. Conclusions New daily persistent headache is a well described, recognisable disorder, which requires further research into its pathophysiology and treatment. There is a lack of high-quality evidence and, until this exists, we recommend continuing to consider new daily persistent headache a distinct disorder.

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Section: Discussionmentioning

confidence: 99%

New daily persistent headache: A systematic review and meta-analysis

et al. 2023

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“…3 Kiruddu National Referral Hospital, Kampala, Uganda. 4 The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK. 5 Department of Neurology, Alfred Health, Melbourne, Australia.…”

Section: Abbreviationsmentioning

confidence: 99%

“…The pathophysiology of the primary headache disorders tension-type headache, migraine, cluster headache, and new daily persistent headache (NDPH), and the degree of overlap in pathophysiology between the disorders, is incompletely understood [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

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Cytokines in primary headache disorders: a systematic review and meta-analysis

et al. 2023

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Background The role of inflammation and cytokines in the pathophysiology of primary headache disorders is uncertain. We performed a systematic review and meta-analysis to synthesise the results of studies comparing peripheral blood cytokine levels between patients with migraine, tension-type headache, cluster headache, or new daily persistent headache (NDPH), and healthy controls; and in migraine between the ictal and interictal stages. Methods We searched PubMed/Medline and Embase from inception until July 2022. We included original research studies which measured unstimulated levels of any cytokines in peripheral blood using enzyme-linked immunosorbent assay or similar assay. We assessed risk of bias using the Newcastle–Ottawa Quality Assessment Scale. We used random effects meta-analysis with inverse variance weighted average to calculate standardised mean difference (SMD), 95% confidence intervals, and heterogeneity for each comparison. This study is registered with PROSPERO (registration number CRD42023393363). No funding was received for this study. Results Thirty-eight studies, including 1335 patients with migraine (32 studies), 302 with tension-type headache (nine studies), 42 with cluster headache (two studies), and 1225 healthy controls met inclusion criteria. Meta-analysis showed significantly higher interleukin (IL)-6 (SMD 1.07, 95% CI 0.40–1.73, p = 0.002), tumour necrosis factor (TNF)-α (SMD 0.61, 95% CI 0.14–1.09, p = 0.01), and IL-8 (SMD 1.56, 95% CI 0.03–3.09, p = 0.04), in patients with migraine compared to healthy controls, and significantly higher interleukin-1β (IL-1β) (SMD 0.34, 95% CI 0.06–0.62, p = 0.02) during the ictal phase of migraine compared to the interictal phase. Transforming growth factor (TGF)-β (SMD 0.52, 95% CI 0.18–0.86, p = 0.003) and TNF-α (SMD 0.64, 95% CI 0.33–0.96, p = 0.0001) were both higher in patients with tension-type headache than controls. Conclusions The higher levels of the proinflammatory cytokines IL-6, IL-8 and TNF-α in migraine compared to controls, and IL-1β during the ictal stage, suggest a role for inflammation in the pathophysiology of migraine, however prospective studies are required to confirm causality and investigate the mechanisms for the increase in cytokine levels identified. Cytokines may also have a role in tension-type headache. Due a lack of data, no conclusions can be made regarding cluster headache or NDPH.

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“…The authors also provided an excellent summary of the acute and prophylactic medications for hypnic headache reported so far, although well-designed randomized clinical trials are lacking. Peng and Rozen reviewed NDPH with the most updated findings (7). They provided new insight into pathogenesis- and clinically-driven sub-classification of NDPH (“3Ts model”) and treatment strategies based on the 3Ts model.…”

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confidence: 99%