Clinical characteristics of 2,378 patients presenting with headache disorders to headache clinics in Japan: A clinic-based multicenter study

Abstract

Abstract Background There are single-center reports regarding patients visiting headache clinics; however, few multicenter studies have been conducted in Japan. This study aims to fill the aforementioned gaps by providing a detailed analysis of the clinical characteristics, headache types, severity, and psychiatric comorbidities of patients presenting to headache clinics across three distinct healthcare settings in Japan: a university hospital, regional headache center, and private headache clinic. Methods We prospectively evaluated the clinical characteristics of 2,378 patients with headache disorders visiting three Japanese Headache Society–accredited headache educational facilities between March 2021 and March 2022. Baseline demographics, such as the visual analog scale (VAS), and psychiatric assessments, such as the Japanese versions of the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9), were evaluated. Headache types were classified as migraine, tension-type headache (TTH), trigeminal autonomic cephalalgias (TACs), other primary headache disorders (OPHDs), and secondary headache. Parameters were compared between headache types using the Kruskal–Wallis test. Results The most common headache type was migraine (78.8%), followed by TTH (12.2%), secondary headache (5.5%), OPHDs (2.1%), and TACs (1.6%). Patients with migraine were significantly younger at first consultation (median age 32.0) than those with other headache types (TTH; 47.0, TACs; 39.0, OPHDs; 49.5, and secondary headache; 47.0). Patients with TACs exhibited the highest severity and psychiatric symptoms, with VAS (median 90.0), GAD-7 (7.0), and PHQ-9 (7.5) scores significantly higher than those of other headache type (migraine; 70.0, 5.0, 5.0, TTH; 50.0, 4.0, 4.0, OPHDs; 65.0, 4.0, 3.5, and secondary headache; 60.0, 3.0, 3.5: p < 0.001, p = 0.032, p < 0.001). Conclusion Most patients visiting headache clinics had migraine; patients with TACs showed significantly higher headache severity and psychiatric symptoms than those with other headache types.