, Todd J. Schwedt3
1Department of Neurology, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
2Institute of Medical Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
3Headache Division, Department of Neurology, Mayo Clinic, Phoenix, AZ, USA
© 2025 The Korean Headache Society
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
AVAILABILITY OF DATA AND MATERIAL
The data presented in this study are available upon reasonable request from the corresponding author.
AUTHOR CONTRIBUTIONS
Conceptualization: SKK, TJS; Data curation: SKK; Formal analysis: SKK; Investigation: SKK; Methodology: SKK; Supervision: TJS; Writing–original draft: SKK; Writing–review & editing: SKK, TJS.
CONFLICT OF INTEREST
Soo-Kyoung Kim is the Deputy Editor of Headache and Pain Research and was not involved in the review process of this article.
Todd J. Schwedt has received personal compensation for consulting with AbbVie, Linpharma, Lundbeck, and Salvia, and royalties from UpToDate, within the prior 24 months. He holds stock options in Allevalux and Nocira. His institution has received research grants on his behalf from American Heart Association, Flinn Foundation, Henry Jackson Foundation, National Headache Foundation, National Institutes of Health, Patient Centered Outcomes Research Institute, Pfizer, Spark Neuro, and the United States Department of Defense.
FUNDING STATEMENT
Not applicable.
ACKNOWLEDGMENTS
Not applicable.
| Domain | Description | Symptoms |
|---|---|---|
| Cognitive dysfunction | Cognitive inefficiency persisting between attacks | “Brain fog,” poor concentration, reduced attention, impaired memory, executive dysfunction |
| Psychological distress | Anticipatory anxiety and emotional comorbidities | Anxiety, depression, avoidance behaviors, fear of next attack |
| Sensory symptoms | Persistent sensory hypersensitivity outside ictal periods | Allodynia, photophobia, phonophobia, osmophobia, vestibular disturbance |
| Social stigma & isolation | Impact of misunderstanding migraine as “just a headache” | Concealment, social withdrawal, delayed diagnosis, underreporting |
| Work productivity loss | Limitations in occupational performance between attacks | Presenteeism, reduced efficiency, economic cost |
| Family burden | Effect on family functioning and relationships | Reduced participation in family activities, parental strain, adolescent stress |
| Purpose | Domains | Limitations | |
|---|---|---|---|
| MIBS-4 | Specific IIB | Emotional distress, planning difficulty, social disruption, work/school impairment | Brief, easy to use, but limited scope |
| MSQ v2.1 | Migraine-specific QoL | Role Function–Restrictive, Preventive, and Emotional | Sensitive to functional changes, but partial interictal coverage |
| HIT-6 | Headache impact and disability | Pain, fatigue, cognitive impairment, role limitation | Not interictal-specific, indirect measure |
| MIDAS | Headache-related productivity loss | Absenteeism, reduced productivity, overall disability | Mixed ictal/interictal contributions |
| Purpose | Domains | Application in migraine research | |
|---|---|---|---|
| CFQ | Cognitive performance in daily activities | Memory, attention, executive failures | Elevated in both ictal and interictal periods |
| HADS | Emotional well-being | Anxiety (HADS-A), depression (HADS-D) | Identifies anticipatory anxiety, emotional distress |
| WPAI | Work productivity and activity impairment | Presenteeism, absenteeism, total activity loss | Estimates economic and occupational impact |
| WHODAS 2.0, SF-36, EQ-5D | General health-related quality of life | Physical, psychological, and social functioning | Assesses vitality, role function, social participation |
IIB, interictal burden; MIBS-4, Migraine Interictal Burden Scale; MSQ, Migraine-Specific Quality of Life Questionnaire; QoL, quality of life; HIT-6, Headache Impact Test; MIDAS, Migraine Disability Assessment.
CFQ, Cognitive Failures Questionnaire; HADS, Hospital Anxiety and Depression Scale; WPAI, Work Productivity and Activity Impairment questionnaire; WHODAS 2.0, World Health Organization Disability Assessment Schedule 2.0; SF-36, 36-item short-form; EQ-5D, EuroQol-5 Dimensions.