Headache and Pain Research

Original Article

Natural Diagnostic Classes of Headache Disorders: Latent Class Analysis of a Population-Based Study: Wonwoo Lee, Seok-Jae Heo, Jungyon Yum, Min Kyung Chu; Headache Pain Res. 2026;27(1):30-42. Published online February 26, 2026; DOI: https://doi.org/10.62087/hpr.2026.0004

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Abstract PDF Supplementary Material: Purpose: The International Classification of Headache Disorders, 3rd edition (ICHD-3), defines headache diagnoses based on combinations of clinical symptoms. Diagnostic overlap is common, and symptom variability complicates diagnostic classification. We evaluated natural classes of headache disorders using a statistical approach and compared these classes with ICHD-3 diagnostic categories.
Methods
Data from a nationwide, population-based web survey on headache and sleep conducted in South Korea (n=3,030) were analyzed. Participants who reported headache within the past year (n=1,938) were included. Latent class analysis was performed using categorical ICHD-3 diagnostic criteria to identify distinct classes. The characteristics of each class and the distribution of ICHD-3 primary headache diagnoses were examined.
Results
Nine classes were identified, comprising 626, 54, 248, 148, 187, 143, 79, 61, and 392 individuals. Three classes were tension-type headache (TTH)–like: Class 1 was male-dominant mild bilateral TTH, Class 8 represented classic, severe TTH, and Class 9 was mild unilateral TTH. Class 4 showed a typical migraine phenotype and contained most migraine cases. Classes 5 and 6 were dominated by probable migraine (PM) and differed mainly in sensory sensitivity and disability, which were higher in Class 6. Classes 2, 3, and 7 were categorized as “other headache.” Class 2 had the highest prevalence of medication-overuse headache (MOH), whereas Class 3 was characterized by mild headache with nausea. Class 7 showed a mixed-type profile with prominent photophobia. Severity and central sensitization markers were key classifiers.
Conclusion
Latent class analysis identified nine clinically distinct headache classes. PM was clearly distinct from both TTH and migraine. One subtype within the “other headache” class showed the highest MOH burden.

Review Article

Update on Tension-type Headache: Hye Jeong Lee, Soo-Jin Cho, Jong-Geun Seo, Henrik Winther Schytz; Headache Pain Res. 2025;26(1):38-47. Published online December 30, 2024; DOI: https://doi.org/10.62087/hpr.2024.0025

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Tension-type headache (TTH) is the most common type of headache, characterized by mild to moderate intensity, bilateral, with a pressing or tightening (non-pulsating) quality. Migraine and TTH can occur in the same person, and their risk factors and treatments can overlap. However, TTH receives less attention than migraine. Furthermore, despite the expanding market for migraine treatments targeting calcitonin gene-related peptide (CGRP) mechanisms, the lack of evidence regarding mechanisms related to CGRP-related mechanisms in TTH continues to be neglected. There remains a need to develop effective preventive treatments for chronic TTH, which imposes a very high burden of disease. From this perspective, this review aims to provide the latest evidence on TTH.

Citations

Citations to this article as recorded by

Tension-Type Headache in Brazzaville: Prevalence and Sociodemographic Profile from a Cross-Sectional Population-Based Study
Ghislain Armel Mpandzou, Dinah Happhia Motoula Latou, Amedna Madh Beny Koukat, Prince Eliot Galiéni Sounga Bandzouzi, Josué Euberma Diatewa, Yacouba Kaba, Karen Lise Obondzo Aloba, Paul Macaire Ossou-Nguiet
World Journal of Neuroscience.2026; 16(01): 57. CrossRef
Tension-Type Headache and Primary Stabbing Headache: Primary Headaches Beyond Migraine
Mi-Kyoung Kang
Headache and Pain Research.2025; 26(2): 89. CrossRef
Hallmarks of primary headache: part 2– Tension-type headache
Li-Ling Hope Pan, Yu-Hsiang Ling, Shuu-Jiun Wang, Linda Al-Hassany, Wei-Ta Chen, Chia-Chun Chiang, Soo-Jin Cho, Min Kyung Chu, Gianluca Coppola, Adriana Della Pietra, Zhao Dong, Esme Ekizoglu, Charl Els, Fatemeh Farham, David Garcia-Azorin, Woo-Seok Ha, F
The Journal of Headache and Pain.2025;[Epub] CrossRef
Trends in the Burden of Headache Disorders in Europe, 1990–2021: A Systematic Analysis from the Global Burden of Disease Study 2021
Terry Jung, Yoonkyung Chang, Moon-Kyung Shin, Sohee Wang, Seyedehmahla Hosseini, Joonho Kim, Min Kyung Chu, Tae-Jin Song
Journal of Clinical Medicine.2025; 14(19): 6966. CrossRef
Interoception Accuracy Differences in Patients with Chronic Tension-type Headache
İnan Özdemir, Güllüşah Üstün, Serkan Aksu, Semai Bek, Gülnihal Kutlu
Neurological Sciences and Neurophysiology.2025; 42(3): 116. CrossRef
Results of the observational program CITOTREK (use of the drug CITOflavin in Tablets) in patients with tension headaches against the backgRound of asthenic syndromE taKing into account comorbidity
M.V. Putilina, N.I. Shabalina, I.A. Blinova
S.S. Korsakov Journal of Neurology and Psychiatry.2025; 125(10): 104. CrossRef

Original Article

Associations of Migraine and Tension-type Headache with Glaucoma: Jong-Ho Kim, Young-Suk Kwon, Sang-Hwa Lee, Jong-Hee Sohn; Headache Pain Res. 2024;25(1):54-62. Published online March 29, 2024; DOI: https://doi.org/10.62087/hpr.2024.0002

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4 Citations

Abstract PDF

Purpose: It remains unclear whether primary headaches, particularly migraine, are associated with glaucoma. We investigated potential associations between primary headaches, including migraine and tension-type headache (TTH), and primary glaucoma, including open-angle glaucoma (OAG) and closed-angle glaucoma (CAG).
Methods
We used data from the Clinical Data Warehouse collected between 2008 and 2023 to investigate whether migraine and TTH influence the risk of primary glaucoma. We compared the prevalence of primary glaucoma, including OAG, CAG, other glaucoma, and total glaucoma (TG), among patients with migraine, those with TTH, and controls.
Results
This study analyzed 46,904 patients with migraine, 48,116 patients with TTH, and 455,172 controls. Controls were selected based on propensity score matching (PSM). After adjustment for covariates and PSM, the fully adjusted odds ratios (ORs) for patients with migraine were 1.83 for OAG (95% confidence interval [95% CI], 1.33–2.51; p<0.004) and 1.55 for TG (95% CI, 1.26–1.91; p<0.004) compared to controls. Furthermore, in patients with TTH, the ORs for CAG were 2.20 (95% CI, 1.40–3.47; p<0.004) compared to controls. Additionally, patients with migraine had fully adjusted ORs of 1.71 for OAG (95% CI, 1.24–2.36; p<0.004) and 1.41 for TG (95% CI, 1.15–1.73; p<0.004) compared to those with TTH.
Conclusion
Migraine is associated with primary glaucoma, particularly OAG.

Citations

Citations to this article as recorded by

The association between migraine and glaucoma diseases: A retrospective cohort study
Matan Bar, Ido Peles, Gal Ifergane, Erez Tsumi, Assaf Kratz
Headache: The Journal of Head and Face Pain.2026; 66(1): 144. CrossRef
Exploring Secondary Headaches: Insights from Glaucoma and COVID-19 Infection
Soo-Kyoung Kim
Headache and Pain Research.2025; 26(1): 3. CrossRef
Association between migraine and primary open-angle glaucoma: A two-sample Mendelian randomization study
Dima L Chaar, Aliya Yakubova, Chen Jiang, Thomas J Hoffmann, Alice Pressman, Denis Plotnikov, Hélène Choquet
Cephalalgia Reports.2025;[Epub] CrossRef
Subjective Cognitive Decline Patterns in Patients with Migraine, with or without Depression, versus Non-depressed Older Adults
Sun Hwa Lee, Soo-Jin Cho
Headache and Pain Research.2024; 25(2): 103. CrossRef

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