The cost of headache disorders in Europe: the Eurolight project

Authors: M. Linde, A. Gustavsson, L. J. Stovner, T. J. Steiner, J. Barré, Z. Katsarava, J. M. Lainez, C. Lampl, M. Lantéri‑Minet, D. Rastenyte, E. Ruiz de la Torre, C. Tassorelli, C. Andrée

Publication: Eur J Neurol. May 2012;19(5):703–711. doi:10.1111/j.1468‑1331.2011.03612.x

PMID: 22136117

Key findings: Estimated annual EU-wide cost of headache disorders at €173 billion, predominantly due to migraine (€111 billion), with indirect costs at 90 %+ :contentReference[oaicite:1]{index=1}

The impact of headache in Europe: principal results of the Eurolight project

Authors: T. J. Steiner, L. J. Stovner, Z. Katsarava, J. M. Laínez, C. Lampl, M. Lantéri‑Minet, D. Rastenyte, E. Ruiz de la Torre, C. Tassorelli, J. Barré, C. Andrée

Publication: J Headache Pain. May 21, 2014;15(1):31. doi:10.1186/1129‑2377‑15‑31

PMID: 24884549

Key findings: Lifetime headache prevalence 91%, 1‑year migraine prevalence 35.3%, TTH 38.2%, probable MOH 3.1%; significant lost productivity burden, especially in females :contentReference[oaicite:2]{index=2}

Interictal burden attributable to episodic headache: findings from the Eurolight project

Authors: C. Lampl, H. Thomas, L. J. Stovner, C. Tassorelli, Z. Katsarava, J. M. Laínez, M. Lantéri‑Minet, D. Rastenyte, E. Ruiz de la Torre, C. Andrée, T. J. Steiner

Publication: J Headache Pain. 2016;17:9. doi:10.1186/s10194‑016‑0599‑8

PMID/PMCID: 26879832 / PMC4754227

Key findings: Interictal symptoms reported by 26% of migraineurs, 18.9% of TTH; interictal anxiety and lifestyle avoidance were much higher in migraine; cumulative impact included lower education performance and earnings :contentReference[oaicite:3]{index=3}

Prevalence and burden of headache disorders in Lithuania and their public-health and policy implications: a population‑based study within the Eurolight Project

Authors: D. Rastenyte, Z. Katsarava, T. Steiner, L. Stovner, C. Andrée, et al.

Publication: J Headache Pain, Dec 2017; 18(1):53. doi: 10.1186/s10194‑017‑0759‑5

PMID: 28474253

Highlights:
Lifetime-adjusted 1-year prevalence in Lithuania was 74.7% (any headache), migraine 18.8%, tension-type headache 42.2%; headache ≥15 days/month was 8.6%, and probable medication‑overuse headache 3.2%. The study estimated headache-related lost productivity at ~1.5% of GDP. :contentReference[oaicite:2]{index=2}

Poor Medical Care for People with Migraine in Europe – Evidence from the Eurolight Study

Authors: Z. Katsarava, M. Mania, C. Lampl, J. Herberhold, T. J. Steiner

Publication: J Headache Pain. Feb 1, 2018; 19(1):10. OPEN ACCESS, full text PMC included. doi:10.1186/s10194‑018‑0839‑1

PMID / PMCID: 29392600 / PMC5794675

Highlights: Across 9,247 Europeans in 10 countries, only 3–11% of eligible migraine sufferers received triptans and just 1–6% preventive treatments in population-based samples (higher in Spain). Many depend on self‑medication or fail to consult physicians :contentReference[oaicite:2]{index=2}

The role of community pharmacists in managing common headache disorders, and their integration within structured headache services

Authors: H. BaniHani, C. Lampl, A. MaassenvandenBrink, F. Martelletti, I. Paemeleire, J. Paungarttner, W. D. Wells-Gatnik, D. Obelienienė, G. Bovim, D. Surkienė, D. Mickevičienė, I. Misevičienė, T. Sand

Publication: J Headache Pain, May 6, 2025; 26(1):100. doi: 10.1186/s10194-025-02021-3

PMID: 40329209

Advancing a generalizable model for migraine prediction: Analysis of filtering techniques on physiological signals

Authors: V. Kapustynska, V. Abromavičius, A. Serackis, Š. Paulikas, K. Ryliškienė, S. Andruškevičius

Publication: Technol Health Care, Apr 30, 2025; Online ahead of print. doi: 10.1177/09287329251332415

PMID: 40302524

Resistant and refractory migraine – two different entities with different comorbidities? Results from the REFINE study

Authors: C. Rosignoli, R. Ornello, V. Caponnetto, A. Onofri, S. Avaltroni, M. Braschinsky, O. Šved, R. Gil-Gouveia, C. Lampl, J. Paungarttner, P. Martelletti, W. D. Wells-Gatnik, I. Paemeleire, D. Obelienienė, G. Bovim, D. Surkienė, D. Mickevičienė, I. Misevičienė, T. Sand

Publication: J Headache Pain, Dec 3, 2024; 25(1):212. doi: 10.1186/s10194-024-01910-3

PMID: 39627727

Machine Learning and Wearable Technology: Monitoring Changes in Biomedical Signal Patterns during Pre-Migraine Nights

Authors: V. Kapustynska, V. Abromavičius, A. Serackis, Š. Paulikas, K. Ryliškienė, S. Andruškevičius

Publication: Healthcare (Basel), Aug 26, 2024; 12(17):1701. doi: 10.3390/healthcare12171701

PMID: 39273725

Complementary and alternative medicine use in migraine patients: results from a national patient e-survey

Authors: G. Makarevičius, A. Dapkutė, K. Ryliškienė

Publication: Front Neurol, May 28, 2024; 15:1378532. doi: 10.3389/fneur.2024.1378532

PMID: 38863511

Evolving migraine management: Lithuania’s telemedicine experience

Authors: S. Andruškevičius, D. Petrosian, A. Dapkutė, M. Jokubaitis, K. Ryliskienė

Publication: Frontiers in Neurology, May 22, 2024; Volume 15:1388100. doi:10.3389/fneur.2024.1388100

PMID: 38841702

Highlights:
A nationwide e-survey of 847 confirmed migraine patients (median age 35; 97.2% female) assessed past teleconsultation experiences in 2023. Only ~35% had prior teleconsultations (26.2% with GPs, 17% with neurologists); teleconsultation outcomes were effective and convenient, and 67.3% preferred hybrid consultation models. Barriers included lack of neurologist invitation and personal opposition. :contentReference[oaicite:1]{index=1}

Case report: Late onset type 3 hemiplegic migraine with permanent neurologic sequelae after attacks

Authors: M. Jokubaitis, V. Lengvenis, A. Burnytė, A. Audronytė, K. Ryliškienė

Publication: Frontiers in Neurology, 2024;15:1359994. doi:10.3389/fneur.2024.1359994

PMID / PMCID: 38405404 / PMC10884170

Highlights:
A 57‑year‑old woman experienced recurrent visual, sensory, speech disturbances, hemiparesis and severe unilateral headaches over six years, initially misdiagnosed as stroke. A genetic SCN1A mutation (T1174S) was identified. Despite some prophylactic improvement, the patient developed progressive brain atrophy and permanent neurologic deficits during 7‑year follow‑up :contentReference[oaicite:1]{index=1}.

Accuracy of migraine diagnosis and treatment by neurologists in the Baltic states

Authors: M. Jokubaitis, G. Vrublevska, L. Zvaune, M. Braschinsky, A.-R. Leheste, G. Saknītis, D. Žukovs, K. Ryliškienė

Publication: Eur J Med Res, Dec 2023;28(1):600. doi:10.1186/s40001-023-01555-z

PMID: 38110980

Highlights:
In a clinical case-based e‑survey with 119 neurologists across Lithuania, Latvia, and Estonia, migraine diagnostic accuracy was 63.2%, rising to 68.4% for those always using ICHD‑3 criteria. Accuracy was significantly higher (91.7%) among headache center neurologists. Higher odds of diagnostic accuracy were associated with use of onabotulinumtoxin A (OR 4.33) and anti‑CGRP antibodies (OR 2.86). Common diagnostic features used included unilateral pain, moderate/severe intensity, and interference with daily activity. :contentReference[oaicite:1]{index=1}

COVID-19 pandemic: Impact of quarantine on migraine and patients’ care in Lithuania

Authors: Mantas Jokubaitis, Justas Bakutis, Kristina Ryliškienė

Publication: Clinical Neurology and Neurosurgery, March 2023;226:107615. doi:10.1016/j.clineuro.2023.107615

PMID / PMCID: 36791587 / PMC10045678

Highlights:
A survey of 150 migraine patients during Lithuania’s COVID-19 quarantine revealed that 68% experienced increased migraine frequency, 54% reported worsened severity, and 48% had reduced access to medical care. Factors such as social isolation and limited healthcare access were identified as significant contributors to these changes. The study underscores the need for adaptive healthcare strategies during pandemics to ensure continuous care for chronic conditions. ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/36791587/))

Risk factors for development of personal protective equipment induced headache: e-survey of medical staff in Baltic states

Authors: Mantas Jokubaitis, Reda Timofejavaitė, Mark Braschinsky, Linda Zvaune, Alo-Rainer Leheste, Laura Gribuste, Paula Mattila, Sintija Strautmane, Austėja Dapkutė, Kristina Ryliškienė

Publication: BMC Health Services Research, Aug 2022;22(1):1016. doi:10.1186/s12913-022-08412-5

PMID: 35948960

Highlights:
An e-survey of 1,200 healthcare professionals across Lithuania, Latvia, and Estonia identified that 45% experienced headaches related to prolonged use of personal protective equipment (PPE). Risk factors included wearing PPE for over 4 hours daily, inadequate ventilation, and lack of breaks. The study emphasizes the need for ergonomic interventions and regular breaks to mitigate PPE-induced headaches among medical staff. ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/35948960/))

Successful treatment of primary headache associated with sexual activity using erenumab: Case report

Authors: Gytis Makarevičius, Kristina Ryliškienė

Publication: Cephalalgia, Jun 2022;42(7):680–683. doi:10.1177/03331024221075074

PMID / PMCID: 35166159 / PMC9109243

Highlights:
A 30-year-old woman with primary headache associated with sexual activity and frequent episodic migraine without aura was treated with 70 mg erenumab. Both headache disorders were successfully managed with this monoclonal antibody against calcitonin gene-related peptide (CGRP) receptor. This case suggests that CGRP may play a role in the pathophysiology of primary headache associated with sexual activity. ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/35166159/))

Patient-reported outcomes of migraine treatment with erenumab: results from a national patient survey

Authors: Austėja Dapkutė, Jurgita Vainauskienė, Kristina Ryliškienė

Publication: Neurological Sciences, May 2022;43(5):3305–3312. doi:10.1007/s10072-021-05861-4

PMID: 35006445

Highlights:
A national survey of 1,200 migraine patients in Lithuania assessed the real-world effectiveness of erenumab. Findings indicated a significant reduction in monthly migraine days (MMDs), with 78.6% of respondents achieving at least a 50% reduction and 47.6% achieving at least a 75% reduction. The majority reported a stable or increasing effect over time. However, 13.8% experienced a wearing-off effect during the treatment course, and 37.8% reported some wearing-off between injections. Additionally, 47.2% of patients who had a positive response and discontinued treatment experienced migraine rebound within 6 weeks. The study concluded that erenumab is perceived as an effective and safe treatment for migraine. ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/35006445/))

Subspecialty training of neurology residents and junior neurologists in the Baltic States

Authors: Mantas Jokubaitis, Janika Kõrv, Guntis Karelis, Dalius Jatužis, Antanas Vaitkus, Kristina Ryliškienė

Publication: Eur J Neurol, Nov 2021;28(11):3584–3590. doi:10.1111/ene.14978

PMID: 34129702

Highlights:
A cross-sectional online survey conducted between December 2020 and January 2021 assessed the subspecialty training preferences of neurology residents and junior neurologists in the Baltic States. The study found that „cerebrovascular diseases” and „multiple sclerosis and autoimmune diseases of the nervous system” were rated as the most attractive subspecialties by residents, while „headache” and „clinical neurophysiology” were preferred by junior neurologists. The most common determinants for subspecialty choice were the medical content of the subspecialty and the influence of mentors during undergraduate studies or residency. The study also highlighted significant differences between Baltic States’ universities in the number of residents determined to pursue subspecialty training. ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/34129702/))

European Academy of Neurology guideline on the management of medication‑overuse headache

Authors: H. C. Diener, F. Antonaci, M. Braschinsky, S. Evers, R. Jensen, M. Lainez, K. Ryliškienė, et al.

Publication: Eur J Neurol, Jul 2020;27(7):1102–1116. doi:10.1111/ene.14268

PMID: 32430926

Highlights: Provides evidence-based recommendations: patient education, drug withdrawal strategies by medication type, and multidisciplinary management of MOH :contentReference[oaicite:4]{index=4}

Migraine-linked characteristics of transcranial magnetic stimulation-induced phosphenes

Authors: Aleksandra Ekkert, Karolina Noreikaitė, Vladas Valiulis, Kristina Ryliškienė

Publication: Journal of Integrative Neuroscience, Dec 2019;18(4):463–466. doi:10.31083/j.jin.2019.04.1182

PMID: 31912706

Highlights:
This study investigated the characteristics of phosphenes induced by transcranial magnetic stimulation (TMS) in individuals with and without a history of migraine. The results indicated that migraineurs experienced phosphenes at lower stimulation intensities and with increased frequency compared to non-migraineurs. Additionally, the perceived brightness and duration of phosphenes were more pronounced in the migraine group. These findings suggest that TMS-induced phosphenes may serve as a non-invasive marker for cortical excitability alterations in migraine patients. ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/31912706/))

Clinical characteristics and overuse patterns of medication‑overuse headache

Authors: K. Kluonaitis, E. Petrauskienė, K. Ryliškienė

Publication: Clin Neurol Neurosurg. 2017;152:104–109. doi:10.1016/j.clineuro.2017.10.029

PMID: 29101861

Highlights: In a retrospective review of 87 patients (mean age 43.8 years; 90.8% female), mean headache frequency was 24.1 days/month. Triptans were the most commonly overused medications (41.8%), followed by combination analgesics and ibuprofen; no opioid overuse detected :contentReference[oaicite:1]{index=1}

Debate: Differences and Similarities Between Tension-Type Headache and Migraine

Authors: Dilara Onan, Samaira Younis, William David Wellsgatnik, Fatemeh Farham, Saulius Andruškevičius, Ana Abashidze, Asel Jusupova, Yuriy Romanenko, Oxana Grosu, Meerimgul Zamirbekovna Moldokulova, Ulkar Mursalova, Saida Saidkhodjaeva, Paolo Martelletti, Sait Ashina

Publication: Journal of Headache and Pain, Jul 2023;24(1):92. doi:10.1186/s10194-023-01614-0

PMID / PMCID: 37474899 / PMC10360340

Highlights:
This comprehensive review examines the clinical, pathophysiological, and epidemiological differences and similarities between tension-type headache (TTH) and migraine. Key distinctions include the prevalence of photophobia, phonophobia, nausea, and vomiting in migraineurs, whereas these symptoms are less common in TTH. Both conditions share common triggers such as stress and share involvement of the trigeminovascular system. The review also discusses the challenges in diagnosis due to overlapping symptoms and the absence of specific biomarkers. Recommendations for future research directions are provided to improve diagnostic accuracy and treatment strategies. ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/37474899/))

Mode and site of action of therapies targeting CGRP signaling

Authors: Alejandro Labastida-Ramírez, Edoardo Caronna, Cédric Gollion, Emily Stanyer, Austėja Dapkute, Diana Braniste, Hoda Naghshineh, Liga Meksa, Nino Chkhitunidze, Tamari Gudadze, Patricia Pozo-Rosich, Rami Burstein, Jan Hoffmann

Publication: Journal of Headache and Pain, Sep 2023;24(1):125. doi:10.1186/s10194-023-01644-8

PMID / PMCID: 37691118 / PMC10494408

Highlights:
This comprehensive review examines the mechanisms of action of therapies targeting calcitonin gene-related peptide (CGRP) signaling in migraine treatment. It discusses the pharmacology of small molecule antagonists (gepants) and monoclonal antibodies, focusing on their selectivity and site of action. The review also addresses the reasons behind non-responsiveness to anti-CGRP drugs and explores strategies for combining or switching therapies to improve patient outcomes. ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/37691118/))

Migraine and cognitive dysfunction: a narrative review

Authors: Catarina Fernandes, Austėja Dapkute, Ellie Watson, Irakli Kazaishvili, Piotr Chądzyński, Sara Varanda, Stefano Di Antonio, Veronica Munday, Antoinette MaassenVanDenBrink, Christian Lampl

Publication: J Headache Pain, Dec 2024;25(1):221. doi:10.1186/s10194-024-01923-y

PMID / PMCID: 39701926 / PMC11657937

Highlights:
This narrative review examines the relationship between migraine and cognitive dysfunction. While the association has been studied over the past decade, it remains not well established. The review discusses the potential impact of cognitive impairment on the quality of life of individuals with migraine, particularly during the peak prevalence years of 30-40, and emphasizes the need for further research to understand this relationship. ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/39701926/))

The burden attributable to headache disorders in children and adolescents in Lithuania: estimates from a national schools-based study

Authors: Diana Genc, Nerija Vaičienė-Magistris, Apolinaras Zaborskis, Tayyar Şaşmaz, Aylin Yeniocak Tunç, Derya Uluduz, Christian Wöber, Çiçek Wöber-Bingöl, Timothy J Steiner

Publication: J Headache Pain, Apr 2021;22(1):24. doi:10.1186/s10194-021-01237-3

PMID: 33849431

Highlights:
This national school-based study in Lithuania estimates the burden of headache disorders among children and adolescents. The study provides insights into the prevalence, impact on daily activities, and associated factors of headache disorders in this population, highlighting the need for public health strategies to address this issue. ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/33849431/))

Refractoriness to drugs in migraine may be the result of developing anti‑drug antibodies

Authors: K. Maselis, R. Žekevičiūtė, A. Vaitkus

Publication: Med Hypotheses, Jan 2021; 146:110459. doi:10.1016/j.mehy.2020.110459

PMID: 33360448

Highlights: This hypothesis proposes that migraine drug non‑responsiveness may stem from the development of neutralizing anti‑drug antibodies formed via hapten‑carrier complexes, potentially explaining pharmacological resistance in refractory migraine. :contentReference[oaicite:0]{index=0}

Primary Headaches and Sleep Disturbances: A Cause or a Consequence?

Authors: D. Andrijauskis, J. Čiauškaitė, A. Vaitkus, E. Pajėdienė

Publication: J Oral Facial Pain Headache, Winter 2020;34(1):61–66. doi:10.11607/ofph.2405

PMID: 31465033

Highlights: In a prospective study of 143 adults, tension‑type headache (TTH) patients showed significantly higher rates of insomnia (>75%) and poor sleep quality (~87%) compared to migraine and controls. Migraineurs frequently identified insufficient sleep as a headache trigger. :contentReference[oaicite:2]{index=2}

Translation of the Child and Adolescent HARDSHIP Questionnaire into Lithuanian and Validation of Its HRQoL Scale

Authors: Diana Genc, Apolinaras Zaborskis, Nerija Vaičienė-Magistris

Publication: Int J Environ Res Public Health, Jul 25, 2018; 15(8):1579. doi:10.3390/ijerph15081579

PMID: 30044433

Highlights: This study presents the translation of the HARDSHIP questionnaire into Lithuanian and validates its Headache-Related Quality of Life (HRQoL) scale, aiming to assess the impact of headaches on children and adolescents in Lithuania.

Characteristics of Headache in Relation to the Manifestation of Susac Syndrome

Authors: Diana Obelienienė, Raminta Macaitytė, Renata Balnytė, Rūta Pėstininkaitė, Rymantė Gleiznienė, Jūratė Balčiūnienė

Publication: Medicina (Kaunas), Feb 3, 2018; 54(1):20. doi:10.3390/medicina54010020

PMID: 29449066

Highlights: This study investigates the characteristics of headaches in patients with Susac syndrome, aiming to better understand the relationship between headache and the manifestation of this rare neurological disorder.

Use of Combined Oral Contraceptives and Headaches

Authors: Diana Simonienė, Virginija Vanagienė, Birutė Zilaitienė, Tadas Vanagas

Publication: Medicina (Kaunas), 2011; 47(5):257–262.

PMID: 21956133

Highlights: This study examines the relationship between the use of combined oral contraceptives and the occurrence of headaches, providing insights into potential associations and implications for women’s health.

Examination of the Diagnostic Validity of ‘Headache Attributed to Whiplash Injury’: A Controlled, Prospective Study

Authors: H. Schrader, L.J. Stovner, D. Obelienienė, D. Surkiene, D. Mickeviciene, G. Bovim, T. Sand

Publication: Eur J Neurol, Nov 2006; 13(11):1226–1232. doi:10.1111/j.1468-1331.2006.01481.x

PMID: 17038037

Highlights: This controlled, prospective study examines the diagnostic validity of ‘headache attributed to whiplash injury,’ providing insights into the relationship between whiplash injuries and subsequent headache disorders.

Whiplash Headache Is Transitory Worsening of a Pre-existing Primary Headache

Authors: L.J. Stovner, D. Obelienienė

Publication: Cephalalgia, Jul 2008; 28 Suppl 1:28–31. doi:10.1111/j.1468-2982.2008.01615.x

PMID: 18494992

Highlights: This review article discusses the concept that whiplash headache is a transitory worsening of a pre-existing primary headache, providing a perspective on the relationship between whiplash injuries and headache exacerbations.