Background: Tension-type headache (TTH) is a prevalent primary headache disorder significantly impacting quality of life and healthcare resource utilization, with females typically bearing a higher disease burden. However, comprehensive analyses and predictive studies on the global TTH burden stratified by gender are currently lacking. Aim: This study utilized data from the Global Burden of Disease (GBD) Study to analyze the global burden of tension - type headache by sex from 1990 to 2021 and conducted a 15 - year projection (up to 2036). Methods: We conducted a systematic review of GBD 2021 data, employing Joinpoint regression analysis and decomposition analysis to assess TTH incidence, prevalence, YLDs, and DALYs. Additionally, we used the ARIMA model for a 15-year predictive analysis of TTH burden trends. Results: From 1990 to 2021, global female TTH cases rose from 669.54 million (95% UI: 586.2-751.8 million) to 1.04 billion (95% UI: 923.0-1.1 billion), with incidence increasing from 242.9 million (95% UI: 218.8-267.0 million) to 369.86 million (95% UI: 332.5-407.2 million). Male cases grew from 616.82 million (95% UI: 537.2-696.4 million) to 970 million (95% UI: 851.0-1.0 billion). Decomposition analysis indicated population growth was the primary driver of the increase in female TTH prevalence. Projections suggest that by 2036, the incidence will reach 9,174.84 per 100,000 females (95% UI: 8,854.8-9,494.9), prevalence will be 25,135.1 per 100,000 females (95% UI: 23,977.2-26,283.0), YLD rate will be 62.76 per 100,000 females (95% UI: 58.8-66.7), and DALY rate will be 60.97 per 100,000 females (95% UI: 56.7-65.2). Conclusion: This study highlights the significance of gender in TTH burden, particularly the heightened risk for females. Through temporal trend analysis and predictive modeling, we provide insights into future TTH disease trajectories, aiding global public health policy formulation and healthcare resource allocation.

Introduction: This study aimed to assess the safety and effectiveness of peripheral neurostimulation of the sphenopalatine ganglion (SPG) in the treatment of refractory chronic cluster headache. Development: Various medical databases were used to perform a systematic review of the scientific literature. The search for articles continued until 31 October 2016, and included clinical trials, systematic reviews and/or meta-analyses, health technology assessment reports, and clinical practice guidelines that included measurements of efficiency/effectiveness or adverse effects associated with the treatment. The review excluded cohort studies, case-control studies, case series, literature reviews, letters to the editor, opinion pieces, editorials, and studies that had been duplicated or outdated by later publications from the same institution. Regarding effectiveness, we found that SPG stimulation had positive results for pain relief, attack frequency, medication use, and patients' quality of life. In the results regarding safety, we found a significant number of adverse events in the first 30 days following the intervention. Removal of the device was necessary in some patients. Little follow-up data, and no long-term data, is available. Conclusions: These results are promising, despite the limited evidence available. We consider it essential for research to continue into the safety and efficacy of SPG stimulation for patients with refractory chronic cluster headache. In cases where this intervention may be indicated, treatment should be closely monitored. (C) 2017 Sociedad Espanola de Neurologia. Published by Elsevier Espana, S.L.U.

Headache is one of the most common clinical complaints and is listed as one of the top 10 disability disorders by the World Health Organization (WHO). For standardizing the diagnosis and treatment of headache and improve the level of clinical diagnosis and treatment of traditional Chinese medicine (TCM), on 30 January 2019, China Association of Chinese Medicine officially issued the Guidelines for Diagnosis and Treatment of Common Internal Diseases in Chinese Medicine-Headache (T/CACM 1271–2019). The Guidelines were developed following the method process recommended by Technical Requirements for the Revision of TCM Clinical Diagnosis and Treatment Guidelines (pilot edition), and also referring to WHO Handbook for Guideline Development. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was also followed. The protocol was formulated by the guideline project team, which comprised of specialists of TCM encephalopathy, guideline methodologist, patient representative, etc. Question regarding the treatment of headaches in TCM were formulated and 18 most important ones were chosen as PICOs (population, intervention, comparison, outcomes). Comprehensive search and review of the literature were performed and the quality of the evidence was assessed and rated based on certain criteria. Twenty-five recommendations were put forward in the Guidelines through three rounds of expert consensus based on their quality of evidence, in addition to the balance of pros and cons of these interventions, patient preferences and values, and economic factors. It is the first and the only clinical practice guide for Chinese medicine accepted by National Guidelines Clearinghouse in the world.

OBJECTIVES: To assess the effect of non-pharmacological self-management interventions against usual care, and to explore di ff erent components and delivery methods within those interventions PARTICIPANTS: People living with migraine and/or tension-type headache INTERVENTIONS: Non-pharmacological educational or psychological self-management interventions; excluding biofeedback and physical therapy.We assessed the overall effectiveness against usual care on headache frequency, pain intensity, mood, headache-related disability, quality of life and medication consumption in meta-analysis.We also provide preliminary evidence on the effectiveness of intervention components and delivery methods. RESULTS: We found a small overall effect for the superiority of self-management interventions over usual care, with a standardised mean di ff erence (SMD) of -0.36 (-0.45 to -0.26) for pain intensity; -0.32 (-0.42 to -0.22) for headache-related disability, 0.32 (0.20 to 0.45) for quality of life and a moderate effect on mood (SMD=0.53 (-0.66 to -0.40)). We did not find an effect on headache frequency (SMD=-0.07 (-0.22 to 0.08)).Assessment of components and characteristics suggests a larger effect on pain intensity in interventions that included explicit educational components (-0.51 (-0.68 to -0.34) vs -0.28 (-0.40 to -0.16)); mindfulness components (-0.50 (-0.82 to -0.18) vs 0.34 (-0.44 to -0.24)) and in interventions delivered in groups vs one-to-one delivery (0.56 (-0.72 to -0.40) vs -0.39 (-0.52 to -0.27)) and larger effects on mood in interventions including a cognitive-behavioural therapy (CBT) component with an SMD of -0.72 (-0.93 to -0.51) compared with those without CBT -0.41 (-0.58 to -0.24). CONCLUSION: Overall we found that self-management interventions for migraine and tension-type headache are more effective than usual care in reducing pain intensity, mood and headache-related disability, but have no effect on headache frequency. Preliminary findings also suggest that including CBT, mindfulness and educational components in interventions, and delivery in groups may increase effectiveness.