et al.

Patients with migraine undergoing surgery are at increased risk of 30-day hospital readmission due to pain, a recent study found. This hospital registry study examined 150,710 patients, aged 18 years or older, who underwent surgery with general anesthesia and mechanical ventilation between 2007 and 2015 at a tertiary care center and 2 affiliated community hospitals in Massachusetts. Researchers found:

• Migraine was associated with an increased risk of 30-day pain-related readmission after surgery (adjusted odds ratio [OR] 1.42).
• The association was stronger for migraine with aura (compared to migraine without aura: adjusted OR 1.69; compared to no migraine: adjusted OR 2.20).
• The predicted adjusted risk of pain-related 30-day readmissions was 9.1 in 1000 surgical patients with migraine with aura and 5.4 in 1,000 patients with migraine without aura, compared to 4.2 in 1000 patients with no migraine.
• Furthermore, migraine was associated with an increased risk of postsurgical 30-day readmission due to a priori defined migraine-related pain (headache or abdominal pain) (adjusted OR 1.55).

Platzbecker K, Zhang MB, Kurth T, et al. The association between migraine and hospital readmission due to pain after surgery: A hospital registry study. [Published online ahead of print July 8, 2018]. Cephalalgia. doi:10.1177/0333102418786457.

Patients with migraine undergoing surgery are at increased risk of 30-day hospital readmission due to pain, a recent study found. This hospital registry study examined 150,710 patients, aged 18 years or older, who underwent surgery with general anesthesia and mechanical ventilation between 2007 and 2015 at a tertiary care center and 2 affiliated community hospitals in Massachusetts. Researchers found:

• Migraine was associated with an increased risk of 30-day pain-related readmission after surgery (adjusted odds ratio [OR] 1.42).
• The association was stronger for migraine with aura (compared to migraine without aura: adjusted OR 1.69; compared to no migraine: adjusted OR 2.20).
• The predicted adjusted risk of pain-related 30-day readmissions was 9.1 in 1000 surgical patients with migraine with aura and 5.4 in 1,000 patients with migraine without aura, compared to 4.2 in 1000 patients with no migraine.
• Furthermore, migraine was associated with an increased risk of postsurgical 30-day readmission due to a priori defined migraine-related pain (headache or abdominal pain) (adjusted OR 1.55).

Platzbecker K, Zhang MB, Kurth T, et al. The association between migraine and hospital readmission due to pain after surgery: A hospital registry study. [Published online ahead of print July 8, 2018]. Cephalalgia. doi:10.1177/0333102418786457.

Patients with migraine undergoing surgery are at increased risk of 30-day hospital readmission due to pain, a recent study found. This hospital registry study examined 150,710 patients, aged 18 years or older, who underwent surgery with general anesthesia and mechanical ventilation between 2007 and 2015 at a tertiary care center and 2 affiliated community hospitals in Massachusetts. Researchers found:

• Migraine was associated with an increased risk of 30-day pain-related readmission after surgery (adjusted odds ratio [OR] 1.42).
• The association was stronger for migraine with aura (compared to migraine without aura: adjusted OR 1.69; compared to no migraine: adjusted OR 2.20).
• The predicted adjusted risk of pain-related 30-day readmissions was 9.1 in 1000 surgical patients with migraine with aura and 5.4 in 1,000 patients with migraine without aura, compared to 4.2 in 1000 patients with no migraine.
• Furthermore, migraine was associated with an increased risk of postsurgical 30-day readmission due to a priori defined migraine-related pain (headache or abdominal pain) (adjusted OR 1.55).

Platzbecker K, Zhang MB, Kurth T, et al. The association between migraine and hospital readmission due to pain after surgery: A hospital registry study. [Published online ahead of print July 8, 2018]. Cephalalgia. doi:10.1177/0333102418786457.

A ketogenic diet appears to be effective for children with refractory status epilepticus (RSE) suggests a small trial that included 14 patients.

• A study conducted by the Status Epilepticus Research Group from January 2011 to December 2016 found that 71% of patients with refractory status epilepticus who received a ketogenic diet experienced seizure resolution, verified by EEG findings, within 7 days of starting the regimen.
• 79% of the children with RSE were weaned off enteral infusions of the diet within 14 days.
• Possible adverse effects from the ketogenic diet occurred in 3 of 14 patients, including gastrointestinal paresis and elevated triglyceride levels.
• The regimen produced ketosis within a median of 2 days after it was initiated.
• By 3 months, 4 patients were still seizure free and 3 had fewer seizures.

pediatric Status Epilepticus Research Group (pSERG). Efficacy and safety of ketogenic diet for treatment of pediatric convulsive refractory status epilepticus. Epilepsy Res. 2018;144:1-6.

A ketogenic diet appears to be effective for children with refractory status epilepticus (RSE) suggests a small trial that included 14 patients.

• A study conducted by the Status Epilepticus Research Group from January 2011 to December 2016 found that 71% of patients with refractory status epilepticus who received a ketogenic diet experienced seizure resolution, verified by EEG findings, within 7 days of starting the regimen.
• 79% of the children with RSE were weaned off enteral infusions of the diet within 14 days.
• Possible adverse effects from the ketogenic diet occurred in 3 of 14 patients, including gastrointestinal paresis and elevated triglyceride levels.
• The regimen produced ketosis within a median of 2 days after it was initiated.
• By 3 months, 4 patients were still seizure free and 3 had fewer seizures.

pediatric Status Epilepticus Research Group (pSERG). Efficacy and safety of ketogenic diet for treatment of pediatric convulsive refractory status epilepticus. Epilepsy Res. 2018;144:1-6.

A ketogenic diet appears to be effective for children with refractory status epilepticus (RSE) suggests a small trial that included 14 patients.

• A study conducted by the Status Epilepticus Research Group from January 2011 to December 2016 found that 71% of patients with refractory status epilepticus who received a ketogenic diet experienced seizure resolution, verified by EEG findings, within 7 days of starting the regimen.
• 79% of the children with RSE were weaned off enteral infusions of the diet within 14 days.
• Possible adverse effects from the ketogenic diet occurred in 3 of 14 patients, including gastrointestinal paresis and elevated triglyceride levels.
• The regimen produced ketosis within a median of 2 days after it was initiated.
• By 3 months, 4 patients were still seizure free and 3 had fewer seizures.

pediatric Status Epilepticus Research Group (pSERG). Efficacy and safety of ketogenic diet for treatment of pediatric convulsive refractory status epilepticus. Epilepsy Res. 2018;144:1-6.

The epilepsy associated with focal cortical dysplasia remains a major challenge, but early recognition of the disorder will allow clinicians to consider the possibility of resective surgery, which has been shown to eliminate seizures in some patients.

• A recent review of the medical literature found that most children with focal cortical dysplasia have intractable focal epilepsy.
• The epilepsy observed in patients with focal cortical dysplasia is related to activation of the mTOR pathway and altered receptor neurotransmission.
• The literature review discusses the epidemiology, natural history, and mechanisms that precipitate seizures in children with focal cortical dysplasia.
• Between 25% and 29% of children in a surgical series had focal cortical dysplasia.

Challenges in managing epilepsy associated with focal cortical dysplasia in children. Epilepsy Res. 2018;145:1-17.

The epilepsy associated with focal cortical dysplasia remains a major challenge, but early recognition of the disorder will allow clinicians to consider the possibility of resective surgery, which has been shown to eliminate seizures in some patients.

• A recent review of the medical literature found that most children with focal cortical dysplasia have intractable focal epilepsy.
• The epilepsy observed in patients with focal cortical dysplasia is related to activation of the mTOR pathway and altered receptor neurotransmission.
• The literature review discusses the epidemiology, natural history, and mechanisms that precipitate seizures in children with focal cortical dysplasia.
• Between 25% and 29% of children in a surgical series had focal cortical dysplasia.

Challenges in managing epilepsy associated with focal cortical dysplasia in children. Epilepsy Res. 2018;145:1-17.

The epilepsy associated with focal cortical dysplasia remains a major challenge, but early recognition of the disorder will allow clinicians to consider the possibility of resective surgery, which has been shown to eliminate seizures in some patients.

• A recent review of the medical literature found that most children with focal cortical dysplasia have intractable focal epilepsy.
• The epilepsy observed in patients with focal cortical dysplasia is related to activation of the mTOR pathway and altered receptor neurotransmission.
• The literature review discusses the epidemiology, natural history, and mechanisms that precipitate seizures in children with focal cortical dysplasia.
• Between 25% and 29% of children in a surgical series had focal cortical dysplasia.

Challenges in managing epilepsy associated with focal cortical dysplasia in children. Epilepsy Res. 2018;145:1-17.

Drug therapy for pregnant women with epilepsy has changed markedly in recent years according to analysis of data from the Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study.

• MONEAD, an NIH-funded, observational, multicenter study that looked at pregnancy outcomes in mothers and their children, included women ages 14-45 years and up to 20 weeks pregnant.
• Among 351 pregnant women with epilepsy enrolled in the study, 73.8% (259) were on monotherapy and 21.9% (77) on polytherapy; 4% were not taking an antiepileptic drug.
• Lamotrigine was the most popular drug in women on monotherapy, followed by levetiracetam, carbamazepine, zonisamide, oxcarbazepine, and topiramate.
• The most common polypharmacy regimen included  lamotrigine and levetiracetam.

The researchers point out that these percentages only reflect drug usage in US tertiary epilepsy centers and may not indicate usage in community practice.

MONEAD Investigator Group. Changes in antiepileptic drug-prescribing patterns in pregnant women with epilepsy. Epilepsy Behav. 2018;84:10-14.

Drug therapy for pregnant women with epilepsy has changed markedly in recent years according to analysis of data from the Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study.

• MONEAD, an NIH-funded, observational, multicenter study that looked at pregnancy outcomes in mothers and their children, included women ages 14-45 years and up to 20 weeks pregnant.
• Among 351 pregnant women with epilepsy enrolled in the study, 73.8% (259) were on monotherapy and 21.9% (77) on polytherapy; 4% were not taking an antiepileptic drug.
• Lamotrigine was the most popular drug in women on monotherapy, followed by levetiracetam, carbamazepine, zonisamide, oxcarbazepine, and topiramate.
• The most common polypharmacy regimen included  lamotrigine and levetiracetam.

The researchers point out that these percentages only reflect drug usage in US tertiary epilepsy centers and may not indicate usage in community practice.

MONEAD Investigator Group. Changes in antiepileptic drug-prescribing patterns in pregnant women with epilepsy. Epilepsy Behav. 2018;84:10-14.

Drug therapy for pregnant women with epilepsy has changed markedly in recent years according to analysis of data from the Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study.

• MONEAD, an NIH-funded, observational, multicenter study that looked at pregnancy outcomes in mothers and their children, included women ages 14-45 years and up to 20 weeks pregnant.
• Among 351 pregnant women with epilepsy enrolled in the study, 73.8% (259) were on monotherapy and 21.9% (77) on polytherapy; 4% were not taking an antiepileptic drug.
• Lamotrigine was the most popular drug in women on monotherapy, followed by levetiracetam, carbamazepine, zonisamide, oxcarbazepine, and topiramate.
• The most common polypharmacy regimen included  lamotrigine and levetiracetam.

The researchers point out that these percentages only reflect drug usage in US tertiary epilepsy centers and may not indicate usage in community practice.

MONEAD Investigator Group. Changes in antiepileptic drug-prescribing patterns in pregnant women with epilepsy. Epilepsy Behav. 2018;84:10-14.

Visual quality of life (QOL) is significantly adversely affected in migraine sufferers, according to a recent study. In fact, patients with chronic migraine may have visual QOL impacts that are as significant as those associated with other common neuro‐ophthalmic disorders. In this cross‐sectional quantitative survey, visual QOL in individuals with chronic and episodic migraine was assessed using the National Eye Institute Visual Function Questionnaire‐25, and the 10‐item National Eye Institute Visual Function Questionnaire‐25 Neuro‐Ophthalmic Supplement. Overall headache severity and impact was assessed using the Migraine‐specific Quality of Life Questionnaire and the Headache Impact Test‐6. Researchers found:

• Among 29 participants with chronic migraine, vision‐specific QOL scores were all statistically significantly decreased compared to disease‐free controls.
• Among 37 participants with episodic migraine, vision‐specific QOL scores were also decreased compared to disease‐free controls.
• Chronic migraineurs had decreased visual QOL scores compared to those with episodic migraines.
• Participants with chronic migraine had visual QOL scores that were as poor as those previously published for patients with other neuro‐ophthalmic disorders, such as multiple sclerosis, myasthenia gravis, and ischemic optic neuropathy.
   

Patients with migraine have substantial reductions in measures of visual quality of life. [Published online ahead of print June 7, 2018]. Headache. doi:10.1111/head.13330.

Visual quality of life (QOL) is significantly adversely affected in migraine sufferers, according to a recent study. In fact, patients with chronic migraine may have visual QOL impacts that are as significant as those associated with other common neuro‐ophthalmic disorders. In this cross‐sectional quantitative survey, visual QOL in individuals with chronic and episodic migraine was assessed using the National Eye Institute Visual Function Questionnaire‐25, and the 10‐item National Eye Institute Visual Function Questionnaire‐25 Neuro‐Ophthalmic Supplement. Overall headache severity and impact was assessed using the Migraine‐specific Quality of Life Questionnaire and the Headache Impact Test‐6. Researchers found:

• Among 29 participants with chronic migraine, vision‐specific QOL scores were all statistically significantly decreased compared to disease‐free controls.
• Among 37 participants with episodic migraine, vision‐specific QOL scores were also decreased compared to disease‐free controls.
• Chronic migraineurs had decreased visual QOL scores compared to those with episodic migraines.
• Participants with chronic migraine had visual QOL scores that were as poor as those previously published for patients with other neuro‐ophthalmic disorders, such as multiple sclerosis, myasthenia gravis, and ischemic optic neuropathy.
   

Patients with migraine have substantial reductions in measures of visual quality of life. [Published online ahead of print June 7, 2018]. Headache. doi:10.1111/head.13330.

Visual quality of life (QOL) is significantly adversely affected in migraine sufferers, according to a recent study. In fact, patients with chronic migraine may have visual QOL impacts that are as significant as those associated with other common neuro‐ophthalmic disorders. In this cross‐sectional quantitative survey, visual QOL in individuals with chronic and episodic migraine was assessed using the National Eye Institute Visual Function Questionnaire‐25, and the 10‐item National Eye Institute Visual Function Questionnaire‐25 Neuro‐Ophthalmic Supplement. Overall headache severity and impact was assessed using the Migraine‐specific Quality of Life Questionnaire and the Headache Impact Test‐6. Researchers found:

• Among 29 participants with chronic migraine, vision‐specific QOL scores were all statistically significantly decreased compared to disease‐free controls.
• Among 37 participants with episodic migraine, vision‐specific QOL scores were also decreased compared to disease‐free controls.
• Chronic migraineurs had decreased visual QOL scores compared to those with episodic migraines.
• Participants with chronic migraine had visual QOL scores that were as poor as those previously published for patients with other neuro‐ophthalmic disorders, such as multiple sclerosis, myasthenia gravis, and ischemic optic neuropathy.
   

Patients with migraine have substantial reductions in measures of visual quality of life. [Published online ahead of print June 7, 2018]. Headache. doi:10.1111/head.13330.

Less than one-third of eligible migraineurs were referred for behavioral treatment and only about half initiated behavioral migraine treatment in a recent prospective cohort study. Researchers compared patients who initiated behavioral migraine treatment following a provider recommendation with those who did not (demographics, migraine characteristics, and locus of control) with analysis of variance and chi-square tests. They found:

• Of the 234 eligible patients, 69 (29.5%) were referred for behavioral treatment.
• 53 (76.8%) patients referred for behavioral treatment were reached by phone.
• The mean duration from time of referral to follow-up was 76 (median 76, SD=45) days.
• 30 (56.6%) patients initiated behavioral migraine treatment.
• There was no difference in initiation of behavioral migraine treatment with regard to sex, age, age of diagnosis, years suffered with headaches, health care utilization visits, Migraine Disability Assessment Screen, and locus of control.
• Patients who had previously seen a psychologist for migraine were more likely to initiate behavioral migraine treatment than patients who had not.
• Time constraints were the most common barrier cited for not initiating behavioral migraine treatment.

Factors related to migraine patients’ decisions to initiate behavioral migraine treatment following a headache specialist’s recommendation: A prospective observational study. [Published online ahead of print June 5, 2018]. Pain Medicine. doi:10.1093/pm/pny028.

Less than one-third of eligible migraineurs were referred for behavioral treatment and only about half initiated behavioral migraine treatment in a recent prospective cohort study. Researchers compared patients who initiated behavioral migraine treatment following a provider recommendation with those who did not (demographics, migraine characteristics, and locus of control) with analysis of variance and chi-square tests. They found:

• Of the 234 eligible patients, 69 (29.5%) were referred for behavioral treatment.
• 53 (76.8%) patients referred for behavioral treatment were reached by phone.
• The mean duration from time of referral to follow-up was 76 (median 76, SD=45) days.
• 30 (56.6%) patients initiated behavioral migraine treatment.
• There was no difference in initiation of behavioral migraine treatment with regard to sex, age, age of diagnosis, years suffered with headaches, health care utilization visits, Migraine Disability Assessment Screen, and locus of control.
• Patients who had previously seen a psychologist for migraine were more likely to initiate behavioral migraine treatment than patients who had not.
• Time constraints were the most common barrier cited for not initiating behavioral migraine treatment.

Factors related to migraine patients’ decisions to initiate behavioral migraine treatment following a headache specialist’s recommendation: A prospective observational study. [Published online ahead of print June 5, 2018]. Pain Medicine. doi:10.1093/pm/pny028.

Less than one-third of eligible migraineurs were referred for behavioral treatment and only about half initiated behavioral migraine treatment in a recent prospective cohort study. Researchers compared patients who initiated behavioral migraine treatment following a provider recommendation with those who did not (demographics, migraine characteristics, and locus of control) with analysis of variance and chi-square tests. They found:

• Of the 234 eligible patients, 69 (29.5%) were referred for behavioral treatment.
• 53 (76.8%) patients referred for behavioral treatment were reached by phone.
• The mean duration from time of referral to follow-up was 76 (median 76, SD=45) days.
• 30 (56.6%) patients initiated behavioral migraine treatment.
• There was no difference in initiation of behavioral migraine treatment with regard to sex, age, age of diagnosis, years suffered with headaches, health care utilization visits, Migraine Disability Assessment Screen, and locus of control.
• Patients who had previously seen a psychologist for migraine were more likely to initiate behavioral migraine treatment than patients who had not.
• Time constraints were the most common barrier cited for not initiating behavioral migraine treatment.

Factors related to migraine patients’ decisions to initiate behavioral migraine treatment following a headache specialist’s recommendation: A prospective observational study. [Published online ahead of print June 5, 2018]. Pain Medicine. doi:10.1093/pm/pny028.

Athletes with a pre-injury migraine history may be at an elevated risk for a protracted return to school after concussion, especially girls and women, according to a recent study. High school and collegiate athletes (n=1265; 42% female) who sustained a sport-related concussion were monitored by athletic trainers using a web-based surveillance system that collects information about concussion recovery. Researchers found:

• There were 117 athletes (9.2%) who reported a pre-injury migraine history.
• Athletes with a history of migraine took a median of 6 days to return to academics and 15.5 days to return to athletics, while those with no migraine history took a median of 5 days to return to academics and 14 days to return to athletics.
• There were no statistically significant differences in days to return to school or athletics between the groups.
• However, a lower percentage of athletes with a history of migraine had returned to school after 7 days, 14 days, and 21 days post-injury.
• Stratifying the analyses by sex showed that this effect was significant in girls and women with pre-existing migraines, but not boys and men with pre-existing migraines.

Pre-injury migraine history as a risk factor for prolonged return to school and sports following concussion. [Published online ahead of print May 5, 2018]. J Neurotrauma. doi:10.1089/neu.2017.5443.

Athletes with a pre-injury migraine history may be at an elevated risk for a protracted return to school after concussion, especially girls and women, according to a recent study. High school and collegiate athletes (n=1265; 42% female) who sustained a sport-related concussion were monitored by athletic trainers using a web-based surveillance system that collects information about concussion recovery. Researchers found:

• There were 117 athletes (9.2%) who reported a pre-injury migraine history.
• Athletes with a history of migraine took a median of 6 days to return to academics and 15.5 days to return to athletics, while those with no migraine history took a median of 5 days to return to academics and 14 days to return to athletics.
• There were no statistically significant differences in days to return to school or athletics between the groups.
• However, a lower percentage of athletes with a history of migraine had returned to school after 7 days, 14 days, and 21 days post-injury.
• Stratifying the analyses by sex showed that this effect was significant in girls and women with pre-existing migraines, but not boys and men with pre-existing migraines.

Pre-injury migraine history as a risk factor for prolonged return to school and sports following concussion. [Published online ahead of print May 5, 2018]. J Neurotrauma. doi:10.1089/neu.2017.5443.

Athletes with a pre-injury migraine history may be at an elevated risk for a protracted return to school after concussion, especially girls and women, according to a recent study. High school and collegiate athletes (n=1265; 42% female) who sustained a sport-related concussion were monitored by athletic trainers using a web-based surveillance system that collects information about concussion recovery. Researchers found:

• There were 117 athletes (9.2%) who reported a pre-injury migraine history.
• Athletes with a history of migraine took a median of 6 days to return to academics and 15.5 days to return to athletics, while those with no migraine history took a median of 5 days to return to academics and 14 days to return to athletics.
• There were no statistically significant differences in days to return to school or athletics between the groups.
• However, a lower percentage of athletes with a history of migraine had returned to school after 7 days, 14 days, and 21 days post-injury.
• Stratifying the analyses by sex showed that this effect was significant in girls and women with pre-existing migraines, but not boys and men with pre-existing migraines.

Pre-injury migraine history as a risk factor for prolonged return to school and sports following concussion. [Published online ahead of print May 5, 2018]. J Neurotrauma. doi:10.1089/neu.2017.5443.

Circadian misalignment and delayed sleep timing are associated with higher migraine frequency and severity that was not better accounted for by the amount of sleep, according to a recent study. Twenty women with chronic migraine (CM) and 20 age‐matched healthy controls (HC) completed a protocol that included a 7-day sleep assessment at home using wrist actigraphy followed by a circadian phase assessment using salivary melatonin. Researchers compared CM vs HC on sleep parameters and circadian factors. Subsequently, they examined associations between dim‐light melatonin onset (DLMO), the midpoint of the sleep episode, and the phase angle (time from DLMO to sleep midpoint) with the number of migraine days per month and the migraine disability assessment scale (MIDAS). They found:

• CM and HC did not differ on measures of sleep or circadian phase.
• Within the CM group, more frequent migraine days per month was significantly correlated with DLMO (r = .49) and later sleep episode (r = .47).
• In addition, a greater phase angle (ie, circadian misalignment) was significantly correlated with more severe migraine‐related disability (r = .48).
• These relationships remained significant after adjusting for total sleep time.

Can Circadian dysregulation exacerbate migraines? [Published online ahead of print May 4, 2018]. Headache. doi:10.1111/head.13310.

Circadian misalignment and delayed sleep timing are associated with higher migraine frequency and severity that was not better accounted for by the amount of sleep, according to a recent study. Twenty women with chronic migraine (CM) and 20 age‐matched healthy controls (HC) completed a protocol that included a 7-day sleep assessment at home using wrist actigraphy followed by a circadian phase assessment using salivary melatonin. Researchers compared CM vs HC on sleep parameters and circadian factors. Subsequently, they examined associations between dim‐light melatonin onset (DLMO), the midpoint of the sleep episode, and the phase angle (time from DLMO to sleep midpoint) with the number of migraine days per month and the migraine disability assessment scale (MIDAS). They found:

• CM and HC did not differ on measures of sleep or circadian phase.
• Within the CM group, more frequent migraine days per month was significantly correlated with DLMO (r = .49) and later sleep episode (r = .47).
• In addition, a greater phase angle (ie, circadian misalignment) was significantly correlated with more severe migraine‐related disability (r = .48).
• These relationships remained significant after adjusting for total sleep time.

Can Circadian dysregulation exacerbate migraines? [Published online ahead of print May 4, 2018]. Headache. doi:10.1111/head.13310.

Circadian misalignment and delayed sleep timing are associated with higher migraine frequency and severity that was not better accounted for by the amount of sleep, according to a recent study. Twenty women with chronic migraine (CM) and 20 age‐matched healthy controls (HC) completed a protocol that included a 7-day sleep assessment at home using wrist actigraphy followed by a circadian phase assessment using salivary melatonin. Researchers compared CM vs HC on sleep parameters and circadian factors. Subsequently, they examined associations between dim‐light melatonin onset (DLMO), the midpoint of the sleep episode, and the phase angle (time from DLMO to sleep midpoint) with the number of migraine days per month and the migraine disability assessment scale (MIDAS). They found:

• CM and HC did not differ on measures of sleep or circadian phase.
• Within the CM group, more frequent migraine days per month was significantly correlated with DLMO (r = .49) and later sleep episode (r = .47).
• In addition, a greater phase angle (ie, circadian misalignment) was significantly correlated with more severe migraine‐related disability (r = .48).
• These relationships remained significant after adjusting for total sleep time.

Can Circadian dysregulation exacerbate migraines? [Published online ahead of print May 4, 2018]. Headache. doi:10.1111/head.13310.

Mobile phone apps have the potential to improve medication adherence and are a promising intervention for adolescent and young adult patients with migraine who have demonstrated low adherence to treatment, according to a recent study. Involving parents in the intervention is also helpful. Thirty-five adolescents and young adults (aged 13 to 21 years) with migraine participated in an AB-design pilot study to assess the use of a mobile phone app and progressive reminder system. Adherence was calculated using electronic monitoring during the baseline period and medication adherence intervention. Researchers found:

• Relative to baseline, adherence significantly improved during the first month of the intervention.
• Specifically, improvements existed for older participants with lower baseline adherence.
• Self-reported app-based adherence rates were significantly lower than electronically monitored adherence rates.
• Participants rated the intervention as acceptable and easy to use.

A pilot investigation of a mobile phone application and progressive reminder system to improve adherence to daily prevention treatment in adolescents and young adults with migraine. [Published online ahead of print April 10, 2018]. Cephalalgia. doi:10.1177/0333102418756864.

Mobile phone apps have the potential to improve medication adherence and are a promising intervention for adolescent and young adult patients with migraine who have demonstrated low adherence to treatment, according to a recent study. Involving parents in the intervention is also helpful. Thirty-five adolescents and young adults (aged 13 to 21 years) with migraine participated in an AB-design pilot study to assess the use of a mobile phone app and progressive reminder system. Adherence was calculated using electronic monitoring during the baseline period and medication adherence intervention. Researchers found:

• Relative to baseline, adherence significantly improved during the first month of the intervention.
• Specifically, improvements existed for older participants with lower baseline adherence.
• Self-reported app-based adherence rates were significantly lower than electronically monitored adherence rates.
• Participants rated the intervention as acceptable and easy to use.

A pilot investigation of a mobile phone application and progressive reminder system to improve adherence to daily prevention treatment in adolescents and young adults with migraine. [Published online ahead of print April 10, 2018]. Cephalalgia. doi:10.1177/0333102418756864.

Mobile phone apps have the potential to improve medication adherence and are a promising intervention for adolescent and young adult patients with migraine who have demonstrated low adherence to treatment, according to a recent study. Involving parents in the intervention is also helpful. Thirty-five adolescents and young adults (aged 13 to 21 years) with migraine participated in an AB-design pilot study to assess the use of a mobile phone app and progressive reminder system. Adherence was calculated using electronic monitoring during the baseline period and medication adherence intervention. Researchers found:

• Relative to baseline, adherence significantly improved during the first month of the intervention.
• Specifically, improvements existed for older participants with lower baseline adherence.
• Self-reported app-based adherence rates were significantly lower than electronically monitored adherence rates.
• Participants rated the intervention as acceptable and easy to use.

A pilot investigation of a mobile phone application and progressive reminder system to improve adherence to daily prevention treatment in adolescents and young adults with migraine. [Published online ahead of print April 10, 2018]. Cephalalgia. doi:10.1177/0333102418756864.