Author: "Jacob Stovner" - Searchworks@Jio Institute Digital Library Search Results

305 results on '"Jacob Stovner"'

1. GBD2021: headache disorders and global lost health – a focus on children, and a view forward

Author: Timothy J Steiner, Andreas Husøy, and Lars Jacob Stovner
Subjects: Global Burden of Disease study, Headache disorders, Migraine, Tension-type headache, Children, Epidemiology, Medicine
Published: 2024
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2. The HARDSHIP databases: a forthcoming free good from the Global Campaign against Headache

Author: Timothy J. Steiner, Andreas Husøy, Hallie Thomas, and Lars Jacob Stovner
Subjects: HARDSHIP questionnaire, Headache, Prevalence, Burden, Big data, Health policy, Medicine
Abstract: Abstract In order to pursue its purpose of reducing the global burden of headache, the Global Campaign against Headache has gathered data on headache-attributed burden from countries worldwide. These data, from the individual participants in adult population-based studies and child and adolescent schools-based studies, are being collated in two databases, which will be powerful resources for research and teaching and rich information sources for health policy. Here we briefly describe the structure and content of these databases, and announce the intention to make them available in due course as a free good.
Published: 2023
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3. The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates

Author: Lars Jacob Stovner, Knut Hagen, Mattias Linde, and Timothy J. Steiner
Subjects: Headache, Methodology, Migraine, Prevalence, Narrative review, Tension-type headache, Medicine
Abstract: Abstract Background According to the Global Burden of Disease (GBD) study, headache disorders are among the most prevalent and disabling conditions worldwide. GBD builds on epidemiological studies (published and unpublished) which are notable for wide variations in both their methodologies and their prevalence estimates. Our first aim was to update the documentation of headache epidemiological studies, summarizing global prevalence estimates for all headache, migraine, tension-type headache (TTH) and headache on ≥15 days/month (H15+), comparing these with GBD estimates and exploring time trends and geographical variations. Our second aim was to analyse how methodological factors influenced prevalence estimates. Methods In a narrative review, all prevalence studies published until 2020, excluding those of clinic populations, were identified through a literature search. Prevalence data were extracted, along with those related to methodology, world region and publication year. Bivariate analyses (correlations or comparisons of means) and multiple linear regression (MLR) analyses were performed. Results From 357 publications, the vast majority from high-income countries, the estimated global prevalence of active headache disorder was 52.0% (95%CI 48.9–55.4), of migraine 14.0% (12.9–15.2), of TTH 26.0% (22.7–29.5) and of H15+ 4.6% (3.9–5.5). These estimates were comparable with those of migraine and TTH in GBD2019, the most recent iteration, but higher for headache overall. Each day, 15.8% of the world’s population had headache. MLR analyses explained less than 30% of the variation. Methodological factors contributing to variation, were publication year, sample size, inclusion of probable diagnoses, sub-population sampling (e.g., of health-care personnel), sampling method (random or not), screening question (neutral, or qualified in severity or presumed cause) and scope of enquiry (headache disorders only or multiple other conditions). With these taken into account, migraine prevalence estimates increased over the years, while estimates for all headache types varied between world regions. Conclusion The review confirms GBD in finding that headache disorders remain highly prevalent worldwide, and it identifies methodological factors explaining some of the large variation between study findings. These variations render uncertain both the increase in migraine prevalence estimates over time, and the geographical differences. More and better studies are needed in low- and middle-income countries.
Published: 2022
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4. The Global Campaign turns 18: a brief review of its activities and achievements

Author: Timothy J. Steiner, Gretchen L. Birbeck, Rigmor H. Jensen, Paolo Martelletti, Lars Jacob Stovner, Derya Uluduz, Matilde Leonardi, Jes Olesen, and Zaza Katsarava
Subjects: Headache, Burden, Health care, Structured headache services, Public health, Change management, Medicine
Abstract: Abstract The Global Campaign against Headache, as a collaborative activity with the World Health Organization (WHO), was formally launched in Copenhagen in March 2004. In the month it turns 18, we review its activities and achievements, from initial determination of its strategic objectives, through partnerships and project management, knowledge acquisition and awareness generation, to evidence-based proposals for change justified by cost-effectiveness analysis.
Published: 2022
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5. Structured Q1 headache services as the solution to the ill-health burden of headache: 1. Rationale and description

Author: Timothy J. Steiner, Rigmor Jensen, Zaza Katsarava, Lars Jacob Stovner, Derya Uluduz, Latifa Adarmouch, Mohammed Al Jumah, Ali M. Al Khathaami, Messoud Ashina, Mark Braschinsky, Susan Broner, Jon H. Eliasson, Raquel Gil-Gouveia, Juan B. Gómez-Galván, Larus S. Gudmundsson, Akbar A. Herekar, Nfwama Kawatu, Najib Kissani, Girish Baburao Kulkarni, Elena R. Lebedeva, Matilde Leonardi, Mattias Linde, Otgonbayar Luvsannorov, Youssoufa Maiga, Ivan Milanov, Dimos D. Mitsikostas, Teymur Musayev, Jes Olesen, Vera Osipova, Koen Paemeleire, Mario F. P. Peres, Guiovanna Quispe, Girish N. Rao, Ajay Risal, Elena Ruiz de la Torre, Deanna Saylor, Mansoureh Togha, Sheng-Yuan Yu, Mehila Zebenigus, Yared Zenebe Zewde, Jasna Zidverc-Trajković, Michela Tinelli, and on behalf of Lifting The Burden: the Global Campaign against Headache
Subjects: Headache disorders, Public health, Health policy, Barriers to care, Needs assessment, Health-technology assessment, Medicine
Abstract: Abstract In countries where headache services exist at all, their focus is usually on specialist (tertiary) care. This is clinically and economically inappropriate: most headache disorders can effectively and more efficiently (and at lower cost) be treated in educationally supported primary care. At the same time, compartmentalizing divisions between primary, secondary and tertiary care in many health-care systems create multiple inefficiencies, confronting patients attempting to navigate these levels (the “patient journey”) with perplexing obstacles. High demand for headache care, estimated here in a needs-assessment exercise, is the biggest of the challenges to reform. It is also the principal reason why reform is necessary. The structured headache services model presented here by experts from all world regions on behalf of the Global Campaign against Headache is the suggested health-care solution to headache. It develops and refines previous proposals, responding to the challenge of high demand by basing headache services in primary care, with two supporting arguments. First, only primary care can deliver headache services equitably to the large numbers of people needing it. Second, with educational supports, they can do so effectively to most of these people. The model calls for vertical integration between care levels (primary, secondary and tertiary), and protection of the more advanced levels for the minority of patients who need them. At the same time, it is amenable to horizontal integration with other care services. It is adaptable according to the broader national or regional health services in which headache services should be embedded. It is, according to evidence and argument presented, an efficient and cost-effective model, but these are claims to be tested in formal economic analyses.
Published: 2021
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6. High sensitivity C-reactive protein and risk of migraine in a 11-year follow-up with data from the Nord-Trøndelag health surveys 2006–2008 and 2017–2019

Author: Knut Hagen, Lars Jacob Stovner, and John-Anker Zwart
Subjects: Migraine, Epidemiology, General population, Follow-up, Inflammation, Medicine
Abstract: Abstract Background Several previous studies have reported a cross-sectional association between elevated high sensitivity C-reactive protein (hs-CRP) and migraine. The aim of this population-based follow-up study was to investigate the influence of hs-CRP at baseline on the risk of developing migraine 11 years later. Methods Data from the Nord-Trøndelag Health Study performed in 2006–2008 (baseline) and 2017–2019 were used. A total of 19,574 participants without migraine at baseline were divided into three groups based on hs-CRP levels (
Published: 2020
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7. Time trends of major headache diagnoses and predictive factors. Data from three Nord-Trøndelag health surveys

Author: Knut Hagen, Lars Jacob Stovner, and John-Anker Zwart
Subjects: Migraine, Tension-type headache, Epidemiology, General population, Follow-up, Medicine
Abstract: Abstract Aims The primary aim of this study was to investigate time trends of major headache diagnoses using cross-sectional data from two population-based health surveys. In addition, we aimed to perform a longitudinal assessment of baseline characteristics and subsequent risk for having headache at 22-years’ follow-up among those participating in three health surveys. Methods Data from the Nord-Trøndelag Health Study (HUNT) performed in 1995–1997 (HUNT2), 2006–2008 (HUNT3) and 2017–2019 (HUNT4) were used. The 1-year prevalence time trends of major headache diagnoses were estimated among 41,460 participants in HUNT4 and among 39,697 participants in HUNT3, two surveys with identical headache questions. 16,118 persons participated in all three surveys, and among these, a Poisson regression was used to evaluate health-related baseline information in HUNT2 and the risk ratios (RRs) with 95% confidence interval (CIs) of consistently reporting headache during follow-up. Results Compared with the 1-year prevalence in HUNT3, a higher proportion of participants in HUNT4 had tension-type headache (20.7% vs. 15.9%, p
Published: 2020
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8. The crossover design for migraine preventives: an analyses of four randomized placebo-controlled trials

Author: Astrid Bjørke Jenssen, Lars Jacob Stovner, Erling Tronvik, Trond Sand, Grethe Helde, Gøril Bruvik Gravdahl, and Knut Hagen
Subjects: Headache, Preventive treatment, Carryover effect, Loss of follow-up, Medicine
Abstract: Abstract Aims To evaluate the crossover design in migraine preventive treatment trials by assessing dropout rate, and potential period and carryover effect in four placebo-controlled randomized controlled trials (RCTs). Methods In order to increase statistical power, the study combined data from four different RCTs performed from 1998 to 2015 at St. Olavs Hospital, Norway. Among 264 randomized patients, 120 received placebo treatment before and 144 after active treatment. Results Only 26 (10%) dropped out during the follow-up period of 30–48 weeks, the majority (n = 19) in the first 12 weeks. No period effect was found, since the treatment sequence did not influence the responder rate after placebo treatment, being respectively for migraine 30.5% vs. 27.4% (p = 0.59) and for headache 25.0% vs. 24.8% (p = 0.97, Chi-square test) when placebo occurred early or late. Furthermore, no carryover effect was identified, since the treatment sequence did not influence the treatment effect (difference between placebo and active treatment). There was no significant difference between those who received active treatment first and those who received placebo first with respect to change in number of days per 4 week of headache (− 0.9 vs. -1.3, p = 0.46) and migraine (− 1.2 vs. -0.9, p = 0.35, Student’s t-test). Conclusions Summary data from four crossover trials evaluating preventive treatment in adult migraine showed that few dropped out after the first period. No period or carryover effect was found. RCT studies with crossover design can be recommended as an efficient and cost-saving way to evaluate potential new preventive medicines for migraine in adults.
Published: 2019
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9. The impact of C-reactive protein levels on headache frequency in the HUNT study 2006–2008

Author: Knut Hagen, Lars Jacob Stovner, Kristian Bernhard Nilsen, Espen Saxhaug Kristoffersen, and Bendik Slagsvold Winsvold
Subjects: Neurology. Diseases of the nervous system, RC346-429
Abstract: Abstract Background Increased high sensitivity C- reactive protein (hs-CRP) levels have been found in many earlier studies on migraine, and recently also in persons with migraine and insomnia. The aim of this study was to see whether these findings could be reproduced in a large-scale population-based study. Methods A total of 50,807 (54%) out of 94,194 invited aged ≥20 years or older participated in the third wave of the Nord-Trøndelag Health Study study performed in 2006–2008. Among these, 38,807 (41%) had valid measures of hs-CRP and answered questions on headache and insomnia. Elevated hs-CRP was defined as > 3.0 mg/L. The cross-sectional association with headache was estimated by multivariate analyses using multiple logistic regression. The precision of the odds ratio (OR) was assessed with 95% confidence interval (CI). Results In the fully adjusted model, elevated hs-CRP was associated with migraine (OR 1.14, 95% CI 1.04–1.25) and migraine with aura (OR 1.15, 95% CI 1.03–1.29). The association was strongest among individuals with headache ≥15 days/month for any headache (OR 1.26, 95% CI 1.08–1.48), migraine (OR 1.62, 95% CI 1.21–2.17), and migraine with aura (OR 1.84, 95% CI 1.27–2.67). No clear relationship was found between elevated hs-CRP and headache less than 7 days/month or with insomnia. Conclusions Cross-sectional data from this large-scale population-based study showed that elevated hs-CRP was associated with headache ≥7 days/month, especially evident for migraine with aura.
Published: 2019
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10. Diffusion tensor imaging in middle-aged headache sufferers in the general population: a cross-sectional population-based imaging study in the Nord-Trøndelag health study (HUNT-MRI)

Author: Andreas Kattem Husøy, Live Eikenes, Asta K. Håberg, Knut Hagen, and Lars Jacob Stovner
Subjects: Medicine
Abstract: Abstract Background Several studies have investigated white matter with diffusion tensor imaging (DTI) in those suffering from headache, but so far only in clinic based samples and with conflicting results. Methods In the present study, 1006 individuals (50–66 years) from the general population (Nord-Trøndelag Health Study) participated in an imaging study of the head at 1.5 T (HUNT-MRI). Hundred and ninety-six individuals were excluded because of errors in the data acquisition or brain pathology. Two hundred and forty-six of the remaining participants reported suffering from headache (69 from migraine and 76 from tension-type headache) the year prior to the scanning. DTI data were analysed with Tract-Based Spatial Statistics and automated tractography. Type of headache, frequency of attacks and evolution of headache were investigated for an association with white matter fractional anisotropy (FA), mean diffusivity (MD), axonal diffusivity (AD), radial diffusivity (RD) and tract volume. Correction for various demographical and clinical variables were performed. Results Headache sufferers had widespread higher white matter MD, AD and RD compared to headache free individuals (n = 277). The effect sizes were mostly small with the largest seen in those with middle-age onset headache, who also had lower white matter FA. There were no associations between white matter microstructure and attack frequency or type of headache. Conclusion Middle-age onset headache may be related to a widespread process in the white matter leading to altered microstructure.
Published: 2019
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11. The burden of headache disorders in the Eastern Mediterranean Region, 1990-2016: findings from the Global Burden of Disease study 2016

Author: Kia Vosoughi, Lars Jacob Stovner, Timothy J. Steiner, Maziar Moradi-Lakeh, Seyed-Mohammad Fereshtehnejad, Farshad Farzadfar, Pouria Heydarpour, Reza Malekzadeh, Mohsen Naghavi, Mohammad Ali Sahraian, Sadaf G. Sepanlou, Arash Tehrani-Banihashemi, Reza Majdzadeh, Valery L. Feigin, Theo Vos, Ali H. Mokdad, and Christopher J. L. Murray
Subjects: Primary headache, Migraine, Tension-type headache, Burden, Prevalence, Years lived with disability (YLDs), Medicine
Abstract: Abstract Objectives Using the findings of the Global Burden of Disease Study (GBD), we report the burden of primary headache disorders in the Eastern Mediterranean Region (EMR) from 1990 to 2016. Methods We modelled headache disorders using DisMod-MR 2.1 Bayesian meta-regression tool to ensure consistency between prevalence, incidence, and remission. Years lived with disability (YLDs) were calculated by multiplying prevalence and disability weight (DW) of migraine and tension-type headache (TTH). We assumed primary headache disorders as non-fatal, so their YLD is equal to disability-adjusted life years (DALYs). Results Migraine and TTH were the second and twentieth leading causes of YLDs in EMR. Between 1990 and 2016, the absolute YLD numbers of migraine and TTH increased from 2.3 million (95% uncertainty interval (UI): 1.5–3.2) to 4.7 million (95%UI: 3–6.5) and from 383 thousand (95%UI: 240–562) to 816 thousand (95%UI: 516–1221), respectively. During the same period, age-standardised YLD rates of migraine and TTH in EMR increased by 0.7% and 2.5%, respectively, in comparison to a small decrease in the global rates (0.2% decrease in migraine and TTH). The bulk of burden due to headache occurred in the 30–49 year age group, with a peak at ages 35–44 years. The age-standardised YLD rates of both headache disorders were higher in women with female to male ratio of 1.69 for migraine and 1.38 for TTH. All countries of the EMR except for Somalia and Djibouti had higher age-standardised YLD rates for migraine and TTH in compare to the global rates. Libya and Saudi Arabia had the highest increase in age-standardised YLD rates of migraine and TTH, respectively. Conclusion The findings of this study show that primary headache disorders are a major and a growing cause of disability in EMR. Since 1990, burden of primary headache disorders has constantly been higher in EMR compared to rest of the world, which indicates that health systems in EMR must focus further on developing and implementing preventive and management strategies to control headache.
Published: 2019
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12. Global epidemiology of migraine and its implications for public health and health policy

Author: Timothy J. Steiner and Lars Jacob Stovner
Subjects: Cellular and Molecular Neuroscience, Neurology (clinical)
Published: 2023

13. Clinical and vascular responses to propranolol and candesartan in migraine patients: A randomized controlled clinical trial

Author: Aros Dlawer Barzenje, Knut Gjesdal, Bendik Slagsvold Winsvold, Milada Cvancarova Småstuen, Lars Jacob Stovner, Gøril Bruvik Gravdahl, and Kristian Bernhard Nilsen
Subjects: Therapeutics. Pharmacology, RM1-950, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract: Background: Both propranolol and candesartan are prophylactic drugs for migraine, but with unknown mechanisms of action. The objectives of the present study were to investigate these drugs’ effects on arterial wall dynamics and the potential relation between their vascular and clinical effect. Methods: The study was based on data from a previously published randomized, placebo-controlled, triple-blinded, double crossover clinical trial comparing the prophylactic effects of candesartan and propranolol in 72 patients. Finapres noninvasive blood pressure curves were analyzed. On the descending limb of the pulse curve, a notch is produced by pulse wave reflection, and its relative height compared to the top of the curve (the notch ratio) was used as a marker of arterial wall stiffness. Results: Candesartan decreased the notch ratio from baseline ( p = 0.005), reflecting more compliant arteries and vasodilation, whereas propranolol increased the notch ratio ( p = 0.005), reflecting less compliant arteries and vasoconstriction. There was no difference in baseline notch ratio between clinical responders and nonresponders. Conclusion: The drugs are both efficient prophylactic medications, yet they have opposite effects on arterial wall dynamics. This suggests that drug effects other than those on arterial compliance must be responsible for their prophylactic effect in migraine.
Published: 2020
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14. Headache following head injury: a population-based longitudinal cohort study (HUNT)

Author: Lena Hoem Nordhaug, Knut Hagen, Anne Vik, Lars Jacob Stovner, Turid Follestad, Torunn Pedersen, Gøril Bruvik Gravdahl, and Mattias Linde
Subjects: Headache attributed to head injury, Head injury, Traumatic brain injury, Secondary headache disorders, Post-traumatic headache, Population-based, Medicine
Abstract: Abstract Background Headache is the most frequent symptom following head injury, but long-term follow-up of headache after head injury entails methodological challenges. In a population-based cohort study, we explored whether subjects hospitalized due to a head injury more often developed a new headache or experienced exacerbation of previously reported headache compared to the surrounding population. Methods This population-based historical cohort study included headache data from two large epidemiological surveys performed with an 11-year interval. This was linked with data from hospital records on exposure to head injury occurring between the health surveys. Participants in the surveys who had not been hospitalized because of a head injury comprised the control group. The head injuries were classified according to the Head Injury Severity Scale (HISS). Multinomial logistic regression was performed to investigate the association between head injury and new headache or exacerbation of pre-existing headache in a population with known pre-injury headache status, controlling for potential confounders. Results The exposed group consisted of 294 individuals and the control group of 25,662 individuals. In multivariate analyses, adjusting for age, sex, anxiety, depression, education level, smoking and alcohol use, mild head injury increased the risk of new onset headache suffering (OR 1.74, 95% CI 1.05–2.87), stable headache suffering (OR 1.70, 95% CI 1.15–2.50) and exacerbation of previously reported headache (OR 1.93, 95% CI 1.24–3.02). The reference category was participants without headache in both surveys. Conclusion Individuals hospitalized due to a head injury were more likely to have new onset and worsening of pre-existing headache and persistent headache, compared to the surrounding general population. The results support the entity of the ICHD-3 beta diagnosis “persistent headache attributed to traumatic injury to the head”.
Published: 2018
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15. Prevalence and burden of headache disorders in Lithuania and their public-health and policy implications: a population-based study within the Eurolight Project

Author: Daiva Rastenytė, Dalia Mickevičienė, Lars Jacob Stovner, Hallie Thomas, Colette Andrée, and Timothy J Steiner
Subjects: Migraine, Tension-type headache, Medication-overuse headache, Burden, Disability, Lost productivity, Medicine
Abstract: Abstract Background The Eurolight project assessed the impact of headache disorders in ten EU countries, using the same structured questionnaire but varying sampling methods. In Lithuania, sample selection employed methods in line with consensus recommendations for population-based burden-of-headache studies. Methods The survey was cross-sectional. We identified, from the Residents’ Register Service, a sample of inhabitants of Kaunas city and surrounding Kaunas region reflecting age (in the range 18–65 years), gender and rural/urban distributions of Lithuania. Medical students called unannounced at their homes and conducted face-to-face interviews employing a structured questionnaire. Results Of 1137 people in the pre-identified sample, 573 (male 237 [41.4%], female 336 [58.6%]; mean age 40.9 ± 13.8 years) completed interviews (participation proportion: 50.4%). Gender-adjusted 1-year prevalences were: any headache 74.7%; migraine 18.8%; tension-type headache (TTH) 42.2%; all headache on ≥15 days/month 8.6%; probable medication-overuse headache (pMOH) 3.2%. Migraine (OR: 3.6) and pMOH (OR: 2.9) were associated with female gender. All headache types except TTH were associated with significantly diminished quality of life. Migraine caused a mean 4.5% loss in paid worktime per affected male and 3.5% per affected female. Lost per-person times due to TTH were much less, but to pMOH and other headache on ≥15 days/month much higher. Among the entire workforce, lost productivity to migraine was estimated at 0.7%, to TTH 0.3% and to pMOH or other headache on ≥15 days/month 0.5%. The total of 1.5% may translate directly into lost GDP. Alternative calculations based on headache yesterday (with little recall error) produced, for all headache, a corroborating 1.7%. Similar losses from household work would also drain the nation’s economy. Our findings were comparable to those from earlier studies using similar methods in Russia and Georgia. Conclusions The multiple burdens from headache in Lithuania indicate substantial ill-health and unmet need for health care. The heavy burdens on individuals are matched by heavy economic burden. Of particular concern is the high prevalence of headache on ≥15 days/month, seen also in Russia and Georgia. Health policy in Lithuania must heed WHO’s advice that effective treatment of headache, clearly desirable for its health benefits, is also expected to be cost-saving.
Published: 2017
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16. Continuous positive airway pressure in cluster headache: A randomized, placebo-controlled, triple-blind, crossover study

Author: Gøril Bruvik Gravdahl, Lars Aakerøy, Lars Jacob Stovner, Morten Engstrøm, Kai Ivar Müller, Marte Helene Bjørk, and Erling Tronvik
Subjects: Neurology (clinical), General Medicine
Abstract: Background Oxygen inhalation aborts cluster headache attacks, and case reports show the effect of continuous positive airway pressure. The aim of this study was to investigate the prophylactic effect of continuous positive airway pressure in chronic cluster headache. Methods This was a randomized placebo-controlled triple-blind crossover study using active and sham continuous positive airway pressure treatment for chronic cluster headache. Patients entered a one month’s baseline period before randomly being assigned to two months’ active continuous positive airway pressure treatment followed by a four weeks’ washout period and two months’ sham continuous positive airway pressure or vice versa. Primary outcome measure was number of cluster headache attacks/week. Results Of the 30 included participants (12 males, median age 49.5 years, min-max 20–66 years), 25 completed both treatment/sham cycles (two discontinued, three lost to follow-up). The median number of cluster headache attacks per week was reduced from 8.25 (0.75–89.75) attacks to 6.25 (0–56.00) attacks for active continuous positive airway pressure and to 7.50 (0.50–43.75) attacks for sham continuous positive airway pressure, but there was no difference in active versus sham (p = 0.904). One patient had a serious adverse event during active treatment, none occurred during sham treatment. Conclusions Continuous positive airway pressure treatment did not reduce the number of cluster headache attacks compared to sham treatment in chronic cluster headache patients. Trial registration Clinicaltrials.gov NCT03397563
Published: 2023

17. Obituary for Ottar Sjaastad, founding editor of Cephalalgia

Author: Lars Jacob Stovner, Torbjørn Fredriksen, and Trond Sand
Subjects: Neurology (clinical), General Medicine
Published: 2022

18. Ottar Sjaastad

Author: Linda White, Trond Sand, Torbjørn Fredriksen, Eylert Brodtkorb, Gunnar Bovim, and Lars Jacob Stovner
Subjects: General Medicine
Published: 2022

19. Do incident musculoskeletal complaints influence mortality? The Nord-Trøndelag Health study.

Author: Anders Nikolai Åsberg, Knut Hagen, Lars Jacob Stovner, Ingrid Heuch, John-Anker Zwart, and Bendik Slagsvold Winsvold
Subjects: Medicine, Science
Abstract: BACKGROUND:Musculoskeletal complaints (MSC) are common in the general population, causing a major disease burden to the individual and society. The association between MSC and mortality is still unclear. To our knowledge, no study has hitherto evaluated the association between MSC onset within the last month (incident MSC) on the one hand, and all-cause and cause-specific mortality on the other. METHODS:This prospective population-based cohort study was done using data from the second Nord-Trøndelag Health Study (HUNT2) linked with data from a comprehensive national registry of cause of death. A total of 25,931 participants at risk for incident MSC were included. Hazard ratios (HR) of mortality were estimated for participants with incident MSC using Cox regression based on a mean of 14.1 years of follow-up. RESULTS:Participants who reported incident MSC did not have an excess mortality compared to those with no MSC in the analyses of all-cause mortality (HR 0.99, 95% CI 0.89-1.10) and cause specific mortality. This was true also after adjustment for several potential confounding factors. No clear association between the number of MSC body sites and mortality was found. CONCLUSION:Incident MSC were not associated with an increased mortality, neither for all-cause mortality, nor cause-specific mortality.
Published: 2018
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20. Lifting The Burden: The Global Campaign Against Headache

Author: Steiner, Timothy J., Jacob Stovner, Lars, Katsarava, Zaza, Jensen, Rigmor, Birbeck, Gretchen L., Martelletti, Paolo, Martelletti, Paolo, editor, and Steiner, Timothy J., editor
Published: 2011
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21. Insufficient sleep may alter cortical excitability near the migraine attack: A blinded TMS crossover study

Author: Martin Syvertsen Mykland, Martin Uglem, Lars Jacob Stovner, Eiliv Brenner, Mari Storli Snoen, Gøril Bruvik Gravdahl, Trond Sand, and Petter Moe Omland
Subjects: Neurology (clinical), General Medicine
Abstract: Background Migraine is a brain disorder with a multifaceted and unexplained association to sleep. Brain excitability likely changes periodically throughout the migraine cycle. In this study we examine the effect of insufficient sleep on neuronal excitability during the course of the migraine cycle. Methods We examined 54 migraine patients after two nights of eight-hour habitual sleep and two nights of four-hour restricted sleep in a randomised, blinded crossover study. We performed transcranial magnetic stimulation and measured cortical silent period, short- and long-interval intracortical inhibition, intracortical facilitation and short-latency afferent inhibition. We analysed how responses changed before and after attacks with linear mixed models. Results Short- interval intracortical inhibition was more reduced after sleep restriction compared to habitual sleep the shorter the time that had elapsed since the attack ( p = 0.041), and specifically in the postictal phase ( p = 0.013). Long-interval intracortical inhibition was more increased after sleep restriction with time closer before the attack ( p = 0.006), and specifically in the preictal phase ( p = 0.034). Short-latency afferent inhibition was more decreased after sleep restriction with time closer to the start of the attack ( p = 0.026). Conclusion Insufficient sleep in the period leading up to a migraine attack may cause dysfunction in cortical GABAergic inhibition. The results also suggest that migraine patients may have increased need for sufficient sleep during a migraine attack to maintain normal neurological function after the attack.
Published: 2023

22. Incidental Intracranial Findings and Their Clinical Impact; The HUNT MRI Study in a General Population of 1006 Participants between 50-66 Years.

Author: Asta Kristine Håberg, Tommy Arild Hammer, Kjell Arne Kvistad, Jana Rydland, Tomm B Müller, Live Eikenes, Mari Gårseth, and Lars Jacob Stovner
Subjects: Medicine, Science
Abstract: Evaluate types and prevalence of all, incidental, and clinically relevant incidental intracranial findings, i.e. those referred to primary physician or clinical specialist, in a cohort between 50 and 66 years from the Nord-Trøndelag Health (HUNT) study. Types of follow-up, outcome of repeated neuroimaging and neurosurgical treatment were assessed.1006 participants (530 women) underwent MRI of the head at 1.5T consisting of T1 weighted sagittal IR-FSPGR volume, axial T2 weighted, gradient echo T2* weighted and FLAIR sequences plus time of flight cerebral angiography covering the circle of Willis. The nature of a finding and if it was incidental were determined from previous radiological examinations, patient records, phone interview, and/or additional neuroimaging. Handling and outcome of the clinically relevant incidental findings were prospectively recorded. True and false positives were estimated from the repeated neuroimaging.Prevalence of any intracranial finding was 32.7%. Incidental intracranial findings were present in 27.1% and clinically relevant findings in 15.1% of the participants in the HUNT MRI cohort. 185 individuals (18.4%) were contacted by phone about their findings. 40 participants (6.2%) underwent ≥ 1 additional neuroimaging session to establish etiology. Most false positives were linked to an initial diagnosis of suspected glioma, and overall positive predictive value of initial MRI was 0.90 across different diagnoses. 90.8% of the clinically relevant incidental findings were developmental and acquired cerebrovascular pathologies, the remaining 9.2% were intracranial tumors, of which extra-axial tumors predominated. In total, 3.9% of the participants were referred to a clinical specialist, and 11.7% to their primary physician. 1.4% underwent neurosurgery/radiotherapy, and 1 (0.1%) experienced a procedure related postoperative deficit.In a general population between 50 and 66 years most intracranial findings on MRI were incidental, and >15% of the cohort was referred to clinical-follow up. Hence good routines for handling of findings need to be in place to ensure timely and appropriate handling.
Published: 2016
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23. The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates

Author: Lars Jacob Stovner, Knut Hagen, Mattias Linde, and Timothy J. Steiner
Subjects: Anesthesiology and Pain Medicine, Headache Disorders, Migraine Disorders, Tension-Type Headache, Headache, Prevalence, Humans, Neurology (clinical), General Medicine
Abstract: Background According to the Global Burden of Disease (GBD) study, headache disorders are among the most prevalent and disabling conditions worldwide. GBD builds on epidemiological studies (published and unpublished) which are notable for wide variations in both their methodologies and their prevalence estimates. Our first aim was to update the documentation of headache epidemiological studies, summarizing global prevalence estimates for all headache, migraine, tension-type headache (TTH) and headache on ≥15 days/month (H15+), comparing these with GBD estimates and exploring time trends and geographical variations. Our second aim was to analyse how methodological factors influenced prevalence estimates. Methods In a narrative review, all prevalence studies published until 2020, excluding those of clinic populations, were identified through a literature search. Prevalence data were extracted, along with those related to methodology, world region and publication year. Bivariate analyses (correlations or comparisons of means) and multiple linear regression (MLR) analyses were performed. Results From 357 publications, the vast majority from high-income countries, the estimated global prevalence of active headache disorder was 52.0% (95%CI 48.9–55.4), of migraine 14.0% (12.9–15.2), of TTH 26.0% (22.7–29.5) and of H15+ 4.6% (3.9–5.5). These estimates were comparable with those of migraine and TTH in GBD2019, the most recent iteration, but higher for headache overall. Each day, 15.8% of the world’s population had headache. MLR analyses explained less than 30% of the variation. Methodological factors contributing to variation, were publication year, sample size, inclusion of probable diagnoses, sub-population sampling (e.g., of health-care personnel), sampling method (random or not), screening question (neutral, or qualified in severity or presumed cause) and scope of enquiry (headache disorders only or multiple other conditions). With these taken into account, migraine prevalence estimates increased over the years, while estimates for all headache types varied between world regions. Conclusion The review confirms GBD in finding that headache disorders remain highly prevalent worldwide, and it identifies methodological factors explaining some of the large variation between study findings. These variations render uncertain both the increase in migraine prevalence estimates over time, and the geographical differences. More and better studies are needed in low- and middle-income countries.
Published: 2021

24. Pain thresholds and suprathreshold pain after sleep restriction in migraine - A blinded crossover study

Author: Morten Engstrøm, Petter Moe Omland, Dagfinn Matre, Jan Petter Neverdahl, Martin Uglem, Trond Sand, Johannes Orvin Hansen, Lars Jacob Stovner, and Erling Tronvik
Subjects: Pain Threshold, Cross-Over Studies, Photophobia, business.industry, Migraine Disorders, Pain, General Medicine, medicine.disease, Crossover study, Sleep in non-human animals, medicine.anatomical_structure, Allodynia, Migraine, Forearm, Anesthesia, medicine, Humans, Ictal, Neurology (clinical), medicine.symptom, business, Sleep, Sleep restriction
Abstract: Objective There is an unexplained association between disturbed sleep and migraine. In this blinded crossover study, we investigate if experimental sleep restriction has a different effect on pain thresholds and suprathreshold pain in interictal migraineurs and controls. Methods Forearm heat pain thresholds and tolerance thresholds, and trapezius pressure pain thresholds and suprathreshold pain were measured in 39 interictal migraineurs and 31 healthy controls after two consecutive nights of partial sleep restriction and after habitual sleep. Results The effect of sleep restriction was not significantly different between interictal migraineurs and controls in the primary analyses. Pressure pain thresholds tended to be lower (i.e., increased pain sensitivity) after sleep restriction in interictal migraineurs compared to controls with a 48-hour preictal-interictal cut-off (p = 0.061). We found decreased pain thresholds after sleep restriction in two of seven migraine subgroup comparisons: heat pain thresholds decreased in migraineurs with lower pain intensity during attacks (p = 0.005) and pressure pain thresholds decreased in migraineurs with higher severity of photophobia during attacks (p = 0.031). Heat pain thresholds tended to decrease after sleep restriction in sleep-related migraine (p = 0.060). Sleep restriction did not affect suprathreshold pain measurements in either group. Conclusion This study could not provide strong evidence for an increased effect of sleep restriction on pain sensitivity in migraineurs compared to healthy controls. There might be a slightly increased effect of sleep restriction in migraineurs, detectable using large samples or more pronounced in certain migraine subgroups.
Published: 2021

25. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Sorin Hostiuc, Shaun Wen Huey Lee, Jorge R. Ledesma, Carsten Flohr, Masoumeh Sadeghi, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Cyrus Alinia, Mehdi Bohluli, Félix Carvalho, Yun Jin Kim, Catalina Liliana Andrei, Seyyed Meysam Mousavi, Bernhard T. Baune, Ehsan Ahmadpour, Dinh-Toi Chu, Beatrix Haddock, Gianfranco Alicandro, Vasily Vlassov, Mohammad Taghi Khodayari, Gianna Gayle Herrera Amul, Arash Tehrani-Banihashemi, Govinda Prasad Dhungana, Fereshteh Ansari, Michael K. Hole, Azeem Majeed, Iman Halvaei, Saqib Ali, Arianna Maever L. Amit, Tomas Y. Yeheyis, John S. Ji, Martin McKee, Jamileh Shadid, Leonardo Roever, Peng Jia, Ettore Beghi, Pablo M. Lavados, Young Eun Kim, Vahid Alipour, Sowmya J. Rao, Ahmad Daryani, Cathleen Keller, Ibrahim Abdollahpour, Nicole K. DeCleene, Ebrahim Babaee, Saman Esmaeilnejad, Boris Bikbov, William M. Gardner, Lydia M. Haile, Luca Ronfani, Azalea M. Thomson, Irena Ilic, Ruth W. Kimokoti, Yingxi Zhao, Guoqing Hu, Mehran Shams-Beyranvand, Ilais Moreno Velásquez, Nathaniel J. Henry, Brijesh Sathian, Daniel Kim, Peter Memiah, Mohammad Hadi Abbasi, Andrea Farioli, Zahra Kamiab, Bolajoko O. Olusanya, Matthew C. Doxey, Tommi Vasankari, Hamideh Salimzadeh, Luisa Sorio Flor, Priya Rathi, Shanshan Li, Tanvir M. Huda, Dillon O Sylte, Rosario Cárdenas, Agegnehu Bante, Helen Ippolito, Alyssa Acebedo, Jeffrey D. Stanaway, Anwar Faraj, João Pedro Silva, Amin Mousavi Khaneghah, Pushpendra Kumar, Sangram Kishor Patel, Josephine W. Ngunjiri, Holly E. Erskine, Eugene Sobngwi, Filippo Ariani, Shane D. Morrison, Mohammad Aghaali, Meghan D. Mooney, Vera Marisa Costa, Palash Chandra Banik, Rupak Desai, Ken Takahashi, Maigeng Zhou, Morteza Oladnabi, Bogdan Oancea, Daniela Ribeiro, Mohammad Farahmand, Irmina Maria Michalek, Yetunde O. John-Akinola, Khem Narayan Pokhrel, Emilie R Maddison, Syed Mohamed Aljunid, Damian G. Hoy, Hosni Salem, V. 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A., Yeheyis, T. Y., Yeshitila, Y. G., Yip, P., Yonemoto, N., Yoon, S. -J., Yoosefi Lebni, J., Younis, M. Z., Younker, T. P., Yousefi, Z., Yousefifard, M., Yousefinezhadi, T., Yousuf, A. Y., Yu, C., Yusefzadeh, H., Zahirian Moghadam, T., Zaki, L., Zaman, S. B., Zamani, M., Zamanian, M., Zandian, H., Zangeneh, A., Zastrozhin, M. S., Zewdie, K. A., Zhang, Y., Zhang, Z. -J., Zhao, J. T., Zhao, Y., Zheng, P., Zhou, M., Ziapour, A., Zimsen, S. R. M., Naghavi, M., Murray, C. J. L., Department of Public Health, Clinicum, Department of Neurosciences, HUS Comprehensive Cancer Center, Environmental Sciences, Public Health, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Sálfræðideild (HR), Department of Psychology (RU), Samfélagssvið (HR), School of Social Sciences (RU), Háskólinn í Reykjavík, Reykjavik University, GBD 2019 Diseases and Injuries Collaborator, Violante FS, Department of Earth Observation Science, Faculty of Geo-Information Science and Earth Observation, and UT-I-ITC-ACQUAL
Subjects: Male, Life expectancy, Disability-Adjusted Life Year, Diseases, Disease, communicable disease, systematic analysis, Global Burden of Disease, 0302 clinical medicine, 80 and over, Medicine, 10. No inequality, Child, 11 Medical and Health Sciences, injuries, Aged, 80 and over, education.field_of_study, Sjúkdómar, DEMENTIA, FALLS, General Medicine, Forvarnir, 3. Good health, Child, Preschool, Human, GBD, Population health, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Humans, Global Burden of Disease Study, education, Aged, Spatial Analysis, Global burden, Disability, Prevention, DISABILITY, Infant, Spatial Analysi, Mortality rate, Global Burden of Disease, Diseases, Injuries, Systematic analysis, PREVENTION, Years of potential life lost, Risk factors, Disease study, ITC-ISI-JOURNAL-ARTICLE, RISK-FACTORS, Clinical Medicine, RA, Demography, Fötlun, Dánartíðni, Áhættuþættir, 030204 cardiovascular system & hematology, Risk Factors, Cause of Death, Global health, 030212 general & internal medicine, 1. No poverty, Disability-Adjusted Life Years, Public Health, Global Health, Social Medicine and Epidemiology, Middle Aged, 3142 Public health care science, environmental and occupational health, Adolescent, Adult, Age Distribution, Female, Infant, Newborn, Young Adult, Lýðheilsa, CLINICAL-TRIALS, Population, Settore MED/01 - Statistica Medica, diseases, ITC-HYBRID, Heilbrigðisvísindi, General & Internal Medicine, Mortality, Preschool, Disease burden, business.industry, Risk Factor, Klinisk medicin, Newborn, purl.org/pe-repo/ocde/ford#3.02.00 [https], Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Áverkar, Systematic analysis, NA, business
Abstract: Publisher's version (útgefin grein), Background In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990-2010 time period, with the greatest annualised rate of decline occurring in the 0-9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10-24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10-24 years were also in the top ten in the 25-49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50-74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd., Research reported in this publication was supported by the Bill & Melinda Gates Foundation; the University of Melbourne; Queensland Department of Health, Australia; the National Health and Medical Research Council, Australia; Public Health England; the Norwegian Institute of Public Health; St Jude Children's Research Hospital; the Cardiovascular Medical Research and Education Fund; the National Institute on Ageing of the National Institutes of Health (award P30AG047845); and the National Institute of Mental Health of the National Institutes of Health (award R01MH110163). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders. The authors alone are responsible for the views expressed in this Article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated, the National Health Service (NHS), the National Institute for Health Research (NIHR), the UK Department of Health and Social Care, or Public Health England; the United States Agency for International Development (USAID), the US Government, or MEASURE Evaluation; or the European Centre for Disease Prevention and Control (ECDC). This research used data from the Chile National Health Survey 2003, 2009-10, and 2016-17. The authors are grateful to the Ministry of Health, the survey copyright owner, for allowing them to have the database. All results of the study are those of the authors and in no way committed to the Ministry. The Costa Rican Longevity and Healthy Aging Study project is a longitudinal study by the University of Costa Rica's Centro Centroamericano de Poblacion and Instituto de Investigaciones en Salud, in collaboration with the University of California at Berkeley. The original pre-1945 cohort was funded by the Wellcome Trust (grant 072406), and the 1945-55 Retirement Cohort was funded by the US National Institute on Aging (grant R01AG031716). The principal investigators are Luis Rosero-Bixby and William H Dow and co-principal investigators are Xinia Fernandez and Gilbert Brenes. The accuracy of the authors' statistical analysis and the findings they report are not the responsibility of ECDC. ECDC is not responsible for conclusions or opinions drawn from the data provided. ECDC is not responsible for the correctness of the data and for data management, data merging and data collation after provision of the data. ECDC shall not be held liable for improper or incorrect use of the data. The Health Behaviour in School-Aged Children (HBSC) study is an international study carried out in collaboration with WHO/EURO. The international coordinator of the 1997-98, 2001-02, 2005-06, and 2009-10 surveys was Candace Currie and the databank manager for the 1997-98 survey was Bente Wold, whereas for the following surveys Oddrun Samdal was the databank manager. A list of principal investigators in each country can be found on the HBSC website. Data used in this paper come from the 2009-10 Ghana Socioeconomic Panel Study Survey, which is a nationally representative survey of more than 5000 households in Ghana. The survey is a joint effort undertaken by the Institute of Statistical, Social and Economic Research (ISSER) at the University of Ghana and the Economic Growth Centre (EGC) at Yale University. It was funded by EGC. ISSER and the EGC are not responsible for the estimations reported by the analysts. The Palestinian Central Bureau of Statistics granted the researchers access to relevant data in accordance with license number SLN2014-3-170, after subjecting data to processing aiming to preserve the confidentiality of individual data in accordance with the General Statistics Law, 2000. The researchers are solely responsible for the conclusions and inferences drawn upon available data. Data for this research was provided by MEASURE Evaluation, funded by USAID. The authors thank the Russia Longitudinal Monitoring Survey, conducted by the National Research University Higher School of Economics and ZAO Demoscope together with Carolina Population Center, University of North Carolina at Chapel Hill and the Institute of Sociology, Russia Academy of Sciences for making data available. This paper uses data from the Bhutan 2014 STEPS survey, implemented by the Ministry of Health with the support of WHO; the Kuwait 2006 and 2014 STEPS surveys, implemented by the Ministry of Health with the support of WHO; the Libya 2009 STEPS survey, implemented by the Secretariat of Health and Environment with the support of WHO; the Malawi 2009 STEPS survey, implemented by Ministry of Health with the support of WHO; and the Moldova 2013 STEPS survey, implemented by the Ministry of Health, the National Bureau of Statistics, and the National Center of Public Health with the support of WHO. This paper uses data from Survey of Health, Ageing and Retirement in Europe (SHARE) Waves 1 (DOI:10.6103/SHARE. w1.700), 2 (10.6103/SHARE.w2.700), 3 (10.6103/SHARE.w3.700), 4 (10.6103/SHARE.w4.700), 5 (10.6103/SHARE.w5.700), 6 (10.6103/SHARE.w6.700), and 7 (10.6103/SHARE.w7.700); see Borsch-Supan and colleagues (2013) for methodological details. The SHARE data collection has been funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812), FP7 (SHARE-PREP: GA N degrees 211909, SHARE-LEAP: GA N degrees 227822, SHARE M4: GA N degrees 261982) and Horizon 2020 (SHARE-DEV3: GA N degrees 676536, SERISS: GA N degrees 654221) and by DG Employment, Social Affairs & Inclusion. Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the US National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C), and from various national funding sources is gratefully acknowledged. This study has been realised using the data collected by the Swiss Household Panel, which is based at the Swiss Centre of Expertise in the Social Sciences. The project is financed by the Swiss National Science Foundation. The United States Aging, Demographics, and Memory Study is a supplement to the Health and Retirement Study (HRS), which is sponsored by the National Institute of Aging (grant number NIA U01AG009740). It was conducted jointly by Duke University and the University of Michigan. The HRS is sponsored by the National Institute on Aging (grant number NIA U01AG009740) and is conducted by the University of Michigan. This paper uses data from Add Health, a program project designed by J Richard Udry, Peter S Bearman, and Kathleen Mullan Harris, and funded by a grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 17 other agencies. Special acknowledgment is due to Ronald R Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website. No direct support was received from grant P01-HD31921 for this analysis. The data reported here have been supplied by the United States Renal Data System. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the US Government. Collection of data for the Mozambique National Survey on the Causes of Death 2007-08 was made possible by USAID under the terms of cooperative agreement GPO-A-00-08-000_D3-00. This manuscript is based on data collected and shared by the International Vaccine Institute (IVI) from an original study IVI conducted. L G Abreu acknowledges support from Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (Brazil; finance code 001) and Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq, a Brazilian funding agency). I N Ackerman was supported by a Victorian Health and Medical Research Fellowship awarded by the Victorian Government. O O Adetokunboh acknowledges the South African Department of Science and Innovation and the National Research Foundation. A Agrawal acknowledges the Wellcome Trust DBT India Alliance Senior Fellowship. S M Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. M Ausloos, C Herteliu, and A Pana acknowledge partial support by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. A Badawi is supported by the Public Health Agency of Canada. D A Bennett was supported by the NIHR Oxford Biomedical Research Centre. R Bourne acknowledges the Brien Holden Vision Institute, University of Heidelberg, Sightsavers, Fred Hollows Foundation, and Thea Foundation. G B Britton and I Moreno Velasquez were supported by the Sistema Nacional de Investigacion, SNI-SENACYT, Panama. R Buchbinder was supported by an Australian National Health and Medical Research Council (NHMRC) Senior Principal Research Fellowship. J J Carrero was supported by the Swedish Research Council (2019-01059). F Carvalho acknowledges UID/MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/MCTES through national funds. A R Chang was supported by National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases grant K23 DK106515. V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundacao para a Ciencia e Tecnologia, IP, under the Norma Transitaria DL57/2016/CP1334/CT0006. A Douiri acknowledges support and funding from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South London at King's College Hospital NHS Foundation Trust and the Royal College of Physicians, and support from the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. B B Duncan acknowledges grants from the Foundation for the Support of Research of the State of Rio Grande do Sul (IATS and PrInt) and the Brazilian Ministry of Health. H E Erskine is the recipient of an Australian NHMRC Early Career Fellowship grant (APP1137969). A J Ferrari was supported by a NHMRC Early Career Fellowship grant (APP1121516). H E Erskine and A J Ferrari are employed by and A M Mantilla-Herrera and D F Santomauro affiliated with the Queensland Centre for Mental Health Research, which receives core funding from the Queensland Department of Health. M L Ferreira holds an NHMRC Research Fellowship. C Flohr was supported by the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust. M Freitas acknowledges financial support from the EU (European Regional Development Fund [FEDER] funds through COMPETE POCI-01-0145-FEDER-029248) and National Funds (Fundacao para a Ciencia e Tecnologia) through project PTDC/NAN-MAT/29248/2017. A L S Guimaraes acknowledges support from CNPq. C Herteliu was partially supported by a grant co-funded by FEDER through Operational Competitiveness Program (project ID P_40_382). P Hoogar acknowledges Centre for Bio Cultural Studies, Directorate of Research, Manipal Academy of Higher Education and Centre for Holistic Development and Research, Kalaghatagi. F N Hugo acknowledges the Visiting Professorship, PRINT Program, CAPES Foundation, Brazil. B-F Hwang was supported by China Medical University (CMU107-Z-04), Taichung, Taiwan. S M S Islam was funded by a National Heart Foundation Senior Research Fellowship and supported by Deakin University. R Q Ivers was supported by a research fellowship from the National Health and Medical Research Council of Australia. M Jakovljevic acknowledges the Serbian part of this GBD-related contribution was co-funded through Grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. P Jeemon was supported by a Clinical and Public Health intermediate fellowship (grant number IA/CPHI/14/1/501497) from the Wellcome Trust-Department of Biotechnology, India Alliance (2015-20). O John is a recipient of UIPA scholarship from University of New South Wales, Sydney. S V Katikireddi acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_12017/13, MC_UU_12017/15), and the Scottish Government Chief Scientist Office (SPHSU13, SPHSU15). C Kieling is a CNPq researcher and a UK Academy of Medical Sciences Newton Advanced Fellow. Y J Kim was supported by Research Management Office, Xiamen University Malaysia (XMUMRF/2018-C2/ITCM/00010). K Krishan is supported by UGC Centre of Advanced Study awarded to the Department of Anthropology, Panjab University, Chandigarh, India. M Kumar was supported by K43 TW 010716 FIC/NIMH. B Lacey acknowledges support from the NIHR Oxford Biomedical Research Centre and the BHF Centre of Research Excellence, Oxford. J V Lazarus was supported by a Spanish Ministry of Science, Innovation and Universities Miguel Servet grant (Instituto de Salud Carlos III [ISCIII]/ESF, the EU [CP18/00074]). K J Looker thanks the NIHR Health Protection Research Unit in Evaluation of Interventions at the University of Bristol, in partnership with Public Health England, for research support. S Lorkowski was funded by the German Federal Ministry of Education and Research (nutriCARD, grant agreement number 01EA1808A). R A Lyons is supported by Health Data Research UK (HDR-9006), which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, NIHR (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation, and Wellcome Trust. J J McGrath is supported by the Danish National Research Foundation (Niels Bohr Professorship), and the Queensland Health Department (via West Moreton HHS). P T N Memiah acknowledges support from CODESRIA. U O Mueller gratefully acknowledges funding by the German National Cohort Study BMBF grant number 01ER1801D. S Nomura acknowledges the Ministry of Education, Culture, Sports, Science, and Technology of Japan (18K10082). A Ortiz was supported by ISCIII PI19/00815, DTS18/00032, ISCIII-RETIC REDinREN RD016/0009 Fondos FEDER, FRIAT, Comunidad de Madrid B2017/BMD-3686 CIFRA2-CM. These funding sources had no role in the writing of the manuscript or the decision to submit it for publication. S B Patten was supported by the Cuthbertson & Fischer Chair in Pediatric Mental Health at the University of Calgary. G C Patton was supported by an aNHMRC Senior Principal Research Fellowship. M R Phillips was supported in part by the National Natural Science Foundation of China (NSFC, number 81371502 and 81761128031). A Raggi, D Sattin, and S Schiavolin were supported by grants from the Italian Ministry of Health (Ricerca Corrente, Fondazione Istituto Neurologico C Besta, Linea 4-Outcome Research: dagli Indicatori alle Raccomandazioni Cliniche). P Rathi and B Unnikrishnan acknowledge Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal. A L P Ribeiro was supported by Brazilian National Research Council, CNPq, and the Minas Gerais State Research Agency, FAPEMIG. D C Ribeiro was supported by The Sir Charles Hercus Health Research Fellowship (#18/111) Health Research Council of New Zealand. D Ribeiro acknowledges financial support from the EU (FEDER funds through the Operational Competitiveness Program; POCI-01-0145-FEDER-029253). P S Sachdev acknowledges funding from the NHMRC of Australia Program Grant. A M Samy was supported by a fellowship from the Egyptian Fulbright Mission Program. M M Santric-Milicevic acknowledges the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract number 175087). R Sarmiento-Suarez received institutional support from Applied and Environmental Sciences University (Bogota, Colombia) and ISCIII (Madrid, Spain). A E Schutte received support from the South African National Research Foundation SARChI Initiative (GUN 86895) and Medical Research Council. S T S Skou is currently funded by a grant from Region Zealand (Exercise First) and a grant from the European Research Council under the EU's Horizon 2020 research and innovation program (grant agreement number 801790). J B Soriano is funded by Centro de Investigacion en Red de Enfermedades Respiratorias, ISCIII. R Tabares-Seisdedos was supported in part by the national grant PI17/00719 from ISCIII-FEDER. N Taveira was partially supported by the European & Developing Countries Clinical Trials Partnership, the EU (LIFE project, reference RIA2016MC-1615). S Tyrovolas was supported by the Foundation for Education and European Culture, the Sara Borrell postdoctoral programme (reference number CD15/00019 from ISCIII-FEDER). S B Zaman received a scholarship from the Australian Government research training programme in support of his academic career., "Peer Reviewed"
Published: 2020

26. The impact of C-reactive protein levels on headache frequency in the HUNT study 2006–2008

Author: Lars Jacob Stovner, Knut Hagen, Espen Saxhaug Kristoffersen, Bendik S. Winsvold, and Kristian Bernhard Nilsen
Subjects: Adult, Male, medicine.medical_specialty, Cross-sectional study, Migraine Disorders, Population, Comorbidity, Logistic regression, lcsh:RC346-429, Young Adult, Sleep Initiation and Maintenance Disorders, Internal medicine, medicine, Humans, education, lcsh:Neurology. Diseases of the nervous system, Aged, education.field_of_study, Norway, business.industry, General Medicine, Odds ratio, Middle Aged, medicine.disease, Confidence interval, Migraine with aura, C-Reactive Protein, Cross-Sectional Studies, Migraine, Female, Neurology (clinical), medicine.symptom, business, Research Article
Abstract: Background Increased high sensitivity C- reactive protein (hs-CRP) levels have been found in many earlier studies on migraine, and recently also in persons with migraine and insomnia. The aim of this study was to see whether these findings could be reproduced in a large-scale population-based study. Methods A total of 50,807 (54%) out of 94,194 invited aged ≥20 years or older participated in the third wave of the Nord-Trøndelag Health Study study performed in 2006–2008. Among these, 38,807 (41%) had valid measures of hs-CRP and answered questions on headache and insomnia. Elevated hs-CRP was defined as > 3.0 mg/L. The cross-sectional association with headache was estimated by multivariate analyses using multiple logistic regression. The precision of the odds ratio (OR) was assessed with 95% confidence interval (CI). Results In the fully adjusted model, elevated hs-CRP was associated with migraine (OR 1.14, 95% CI 1.04–1.25) and migraine with aura (OR 1.15, 95% CI 1.03–1.29). The association was strongest among individuals with headache ≥15 days/month for any headache (OR 1.26, 95% CI 1.08–1.48), migraine (OR 1.62, 95% CI 1.21–2.17), and migraine with aura (OR 1.84, 95% CI 1.27–2.67). No clear relationship was found between elevated hs-CRP and headache less than 7 days/month or with insomnia. Conclusions Cross-sectional data from this large-scale population-based study showed that elevated hs-CRP was associated with headache ≥7 days/month, especially evident for migraine with aura.
Published: 2019

27. Structured headache services as the solution to the ill-health burden of headache: 1. Rationale and description

Author: Zaza Katsarava, Jon H. Eliasson, Akbar A. Herekar, Mohammed Al Jumah, Yared Zenebe Zewde, Girish Baburao Kulkarni, Koen Paemeleire, Susan W. Broner, Mehila Zebenigus, Mattias Linde, Rigmor Jensen, Girish N Rao, Deanna Saylor, Raquel Gil-Gouveia, Shengyuan Yu, Timothy J. Steiner, Najib Kissani, Otgonbayar Luvsannorov, Youssoufa Maiga, Guiovanna Quispe, V. V. Osipova, Ajay Risal, Ali M. Al Khathaami, Larus S. Gudmundsson, Jasna Zidverc-Trajkovic, Jes Olesen, Matilde Leonardi, Teymur Musayev, Michela Tinelli, Ivan Milanov, Mark Braschinsky, Latifa Adarmouch, Derya Uluduz, Elena R. Lebedeva, Elena Ruiz de la Torre, Mansoureh Togha, Messoud Ashina, Nfwama Kawatu, Lars Jacob Stovner, Mario Fernando Prieto Peres, Dimos D. Mitsikostas, and Juan B. Gómez-Galván
Subjects: medicine.medical_specialty, Headache Disorders, Pain medicine, 03 medical and health sciences, 0302 clinical medicine, Argument, Medicine, Humans, 030212 general & internal medicine, Health policy, Public health, Horizontal integration, Primary Health Care, Global Campaign against Headache, business.industry, Health-technology assessment, Principal (computer security), Headache, General Medicine, medicine.disease, Primary care, Needs assessment, Consensus Article, Anesthesiology and Pain Medicine, Migraine, Barriers to care, Service organization and delivery, Structured headache services, RA Public aspects of medicine, RC Internal medicine, Neurology (clinical), Medical emergency, business, Delivery of Health Care, 030217 neurology & neurosurgery
Abstract: In countries where headache services exist at all, their focus is usually on specialist (tertiary) care. This is clinically and economically inappropriate: most headache disorders can effectively and more efficiently (and at lower cost) be treated in educationally supported primary care. At the same time, compartmentalizing divisions between primary, secondary and tertiary care in many health-care systems create multiple inefficiencies, confronting patients attempting to navigate these levels (the “patient journey”) with perplexing obstacles.High demand for headache care, estimated here in a needs-assessment exercise, is the biggest of the challenges to reform. It is also the principal reason why reform is necessary.The structured headache services model presented here by experts from all world regions on behalf of the Global Campaign against Headache is the suggested health-care solution to headache. It develops and refines previous proposals, responding to the challenge of high demand by basing headache services in primary care, with two supporting arguments. First, only primary care can deliver headache services equitably to the large numbers of people needing it. Second, with educational supports, they can do so effectively to most of these people. The model calls for vertical integration between care levels (primary, secondary and tertiary), and protection of the more advanced levels for the minority of patients who need them. At the same time, it is amenable to horizontal integration with other care services. It is adaptable according to the broader national or regional health services in which headache services should be embedded.It is, according to evidence and argument presented, an efficient and cost-effective model, but these are claims to be tested in formal economic analyses.
Published: 2021

28. OnabotulinumtoxinA injection towards the SPG for treating symptoms of refractory chronic rhinosinusitis with nasal polyposis: a pilot study

Author: Daniel Fossum Bratbak, Irina Aschehoug, Lars Jacob Stovner, Erling Tronvik, Wenche Moe Thorstensen, Joan Vidal Crespi, and Kent Are Jamtøy
Subjects: Male, medicine.medical_specialty, Rhinorrhea, Chronic rhinosinusitis, Pilot Projects, Injections, Nasal Polyps, Refractory, medicine, Humans, Vidian nerve, Prospective Studies, Botulinum Toxins, Type A, Sinusitis, Rhinitis, business.industry, General Medicine, Middle Aged, Botulinum toxin, Dermatology, Ganglion, medicine.anatomical_structure, Neuromuscular Agents, Otorhinolaryngology, Chronic Disease, Female, Pterygopalatine ganglion, Nasal Obstruction, business, medicine.drug
Abstract: Background and objective The main objective of this prospective, open, uncontrolled pilot study was to investigate the safety of administering onabotulinumtoxinA (BTA) towards the sphenopalatine ganglion (SPG) in 10 patients with refractory chronic rhinosinusitis with nasal polyposis (CRSwNP) using a novel injection tool, the MultiGuide®. Material and methods A one-month baseline period was followed by bilateral injections of 25 U BTA in the SPG and a follow-up of 12 weeks. The primary outcome was adverse events (AE), and the main efficacy outcome was a 50% reduction in visual analogue scale (VAS) symptoms for nasal obstruction and rhinorrhea in months 2 and 3 post-treatment compared to baseline. Results We registered 13 AEs, none of which were serious, however, one patient experienced diplopia which moderately affected his daily activities. The symptoms slowly improved and resolved 4 weeks after injection. Five patients were treatment responders with at least 50% median reduction in the nasal obstruction, and four were treatment responders concerning rhinorrhea. Conclusions Injection of BTA toward the SPG using the MultiGuide® in patients with CRSwNP appears to be safe but with a potential for moderately disabling side effects. The study indicates a beneficial effect on nasal obstruction.
Published: 2021

29. Harald Schrader

Author: Ralf Peter Michler, Lars Jacob Stovner, and Geir Bråthen
Subjects: General Medicine
Published: 2021

30. Migraine remains second among the world's causes of disability, and first among young women: findings from GBD2019

Author: Lars Jacob Stovner, RH Jensen, Derya Uluduz, Timothy J. Steiner, and Zaza Katsarava
Subjects: medicine.medical_specialty, Neurology, Pain medicine, MEDLINE, Clinical Neurology, lcsh:Medicine, HEADACHE, medicine, Psychiatry, Lifting The Burden: the Global Campaign against Headache, 0604 Genetics, Science & Technology, Neurology & Neurosurgery, business.industry, lcsh:R, Neurosciences, 1103 Clinical Sciences, General Medicine, medicine.disease, Editorial, Anesthesiology and Pain Medicine, Migraine, Neurology (clinical), Neurosciences & Neurology, business, Life Sciences & Biomedicine
Published: 2020

31. Burden of Neurological Disorders Across the US From 1990-2017: A Global Burden of Disease Study

Author: Veeresh Kumar N. Shivamurthy, Simona Giampaoli, Rupak Desai, Mahya Beheshti, Theo Vos, Timothy J. Steiner, E. Ray Dorsey, Maziar Moradi-Lakeh, Giancarlo Logroscino, Gregory A. Roth, Arianna Maever L. Amit, Shane D. Morrison, Michael K. Hole, Joseph R. Zunt, Takayoshi Ikeda, Lars Jacob Stovner, Mohsen Naghavi, Emma Nichols, Daniel Kim, Azadeh Shafieesabet, George A. Mensah, Ali H. Mokdad, Ted R. Miller, Warren D. Lo, Michael H. Criqui, Khaled Khatab, Walter J. Koroshetz, Fares Alahdab, Amir Radfar, Prachi Chavan, Ettore Beghi, Sara Sheikhbahaei, Giorgia Giussani, Samath D Dharmaratne, Jordan Weiss, Till Bärnighausen, Aziz Sheikh, Jae Il Shin, Vijay Krishnamoorthy, Catherine O. Johnson, Christopher M Odell, Mitchell T. Wallin, Jaimie D. Adelson, Valery L. Feigin, Xuefeng Liu, Islam Y. Elgendy, Christopher J L Murray, Jagdish Khubchandani, Irina Filip, Bo Norrving, Salahuddin Mohammed, Rita Krishnamurthi, Elisabetta Pupillo, Arielle Wilder Eagan, Nima Hafezi-Nejad, Rizwan Kalani, Chenkai Wu, and Jasvinder A. Singh
Subjects: medicine.medical_specialty, Pediatrics, Neurology, Population, Disease, Global Health, Global Burden of Disease, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Cost of Illness, medicine, Dementia, Humans, Online First, 030212 general & internal medicine, education, Stroke, Original Investigation, education.field_of_study, business.industry, Incidence (epidemiology), Research, Disability-Adjusted Life Years, medicine.disease, United States, Featured, Migraine, Neurology (clinical), Nervous System Diseases, business, 030217 neurology & neurosurgery, Comments
Abstract: Key Points Question What is the current burden of neurological disorders in the US by states, and what are the temporal trends (from 1990 to 2017)? Findings Systematic analysis of the Global Burden of Disease study shows that, in 2017, the 3 most burdensome neurological disorders in the US were stroke, Alzheimer disease and other dementias, and migraine. The burden of individual neurological disorders varied moderately to widely by states (a 1.2-fold to 7.5-fold difference), and the absolute numbers of incident, prevalent, and fatal cases and disability-adjusted life-years of neurological disorders (except for traumatic brain injury incidence; spinal cord injury prevalence; meningitis prevalence, deaths, and disability-adjusted life-years; and encephalitis disability-adjusted life-years) across all US states increased from 1990 to 2017. Meaning A large and increasing number of people have various neurological disorders in the US, with significant variation in the burden of and trends in neurological disorders across the US states, and the reasons for these geographic variations need to be explored further., This analysis of the Global Burden of Disease 2017 study presents burden estimates of major neurological disorders in the US states by age and sex from 1990 to 2017., Importance Accurate and up-to-date estimates on incidence, prevalence, mortality, and disability-adjusted life-years (burden) of neurological disorders are the backbone of evidence-based health care planning and resource allocation for these disorders. It appears that no such estimates have been reported at the state level for the US. Objective To present burden estimates of major neurological disorders in the US states by age and sex from 1990 to 2017. Design, Setting, and Participants This is a systematic analysis of the Global Burden of Disease (GBD) 2017 study. Data on incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) of major neurological disorders were derived from the GBD 2017 study of the 48 contiguous US states, Alaska, and Hawaii. Fourteen major neurological disorders were analyzed: stroke, Alzheimer disease and other dementias, Parkinson disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, traumatic brain injury, spinal cord injuries, brain and other nervous system cancers, meningitis, encephalitis, and tetanus. Exposures Any of the 14 listed neurological diseases. Main Outcome and Measure Absolute numbers in detail by age and sex and age-standardized rates (with 95% uncertainty intervals) were calculated. Results The 3 most burdensome neurological disorders in the US in terms of absolute number of DALYs were stroke (3.58 [95% uncertainty interval [UI], 3.25-3.92] million DALYs), Alzheimer disease and other dementias (2.55 [95% UI, 2.43-2.68] million DALYs), and migraine (2.40 [95% UI, 1.53-3.44] million DALYs). The burden of almost all neurological disorders (in terms of absolute number of incident, prevalent, and fatal cases, as well as DALYs) increased from 1990 to 2017, largely because of the aging of the population. Exceptions for this trend included traumatic brain injury incidence (−29.1% [95% UI, −32.4% to −25.8%]); spinal cord injury prevalence (−38.5% [95% UI, −43.1% to −34.0%]); meningitis prevalence (−44.8% [95% UI, −47.3% to −42.3%]), deaths (−64.4% [95% UI, −67.7% to −50.3%]), and DALYs (−66.9% [95% UI, −70.1% to −55.9%]); and encephalitis DALYs (−25.8% [95% UI, −30.7% to −5.8%]). The different metrics of age-standardized rates varied between the US states from a 1.2-fold difference for tension-type headache to 7.5-fold for tetanus; southeastern states and Arkansas had a relatively higher burden for stroke, while northern states had a relatively higher burden of multiple sclerosis and eastern states had higher rates of Parkinson disease, idiopathic epilepsy, migraine and tension-type headache, and meningitis, encephalitis, and tetanus. Conclusions and Relevance There is a large and increasing burden of noncommunicable neurological disorders in the US, with up to a 5-fold variation in the burden of and trends in particular neurological disorders across the US states. The information reported in this article can be used by health care professionals and policy makers at the national and state levels to advance their health care planning and resource allocation to prevent and reduce the burden of neurological disorders.
Published: 2020

32. Do ACE inhibitors and angiotensin receptor antagonists increase the risk of severe COVID-19?

Author: Anne Hege, Aamodt, Marte H, Bjørk, Erling A, Tronvik, Eirik Alnes, Buanes, Lars Jacob, Stovner, and Dan, Atar
Subjects: Angiotensin Receptor Antagonists, Betacoronavirus, SARS-CoV-2, Pneumonia, Viral, COVID-19, Humans, Angiotensin-Converting Enzyme Inhibitors, Coronavirus Infections, Pandemics, Severity of Illness Index
Published: 2020

33. Gir ACE-hemmere og angiotensinreseptorantagonister økt risiko for alvorlig covid-19?

Author: Lars Jacob Stovner, Erling Tronvik, Anne Hege Aamodt, Eirik Alnes Buanes, Marte-Helene Bjørk, and Dan Atar
Subjects: medicine.medical_specialty, biology, business.industry, MEDLINE, General Medicine, biology.organism_classification, medicine.disease, Pneumonia, Internal medicine, Severity of illness, Pandemic, medicine, business, Betacoronavirus
Published: 2020

34. High sensitivity C-reactive protein and risk of migraine in a 11-year follow-up with data from the Nord-Trøndelag health surveys 2006–2008 and 2017–2019

Author: John-Anker Zwart, Lars Jacob Stovner, and Knut Hagen
Subjects: Male, Time Factors, Epidemiology, lcsh:Medicine, Cohort Studies, 0302 clinical medicine, Chronic Migraine, Risk Factors, Medicine, 030212 general & internal medicine, education.field_of_study, biology, Norway, Follow-up, General population, General Medicine, Middle Aged, C-Reactive Protein, symbols, Female, Research Article, Adult, medicine.medical_specialty, Migraine Disorders, Population, 03 medical and health sciences, symbols.namesake, Internal medicine, Humans, Poisson regression, education, Migraine, Aged, Inflammation, business.industry, C-reactive protein, lcsh:R, medicine.disease, Health Surveys, Confidence interval, Anesthesiology and Pain Medicine, Cross-Sectional Studies, Relative risk, biology.protein, Neurology (clinical), business, 030217 neurology & neurosurgery, Biomarkers, Follow-Up Studies
Abstract: Background Several previous studies have reported a cross-sectional association between elevated high sensitivity C-reactive protein (hs-CRP) and migraine. The aim of this population-based follow-up study was to investigate the influence of hs-CRP at baseline on the risk of developing migraine 11 years later. Methods Data from the Nord-Trøndelag Health Study performed in 2006–2008 (baseline) and 2017–2019 were used. A total of 19,574 participants without migraine at baseline were divided into three groups based on hs-CRP levels (
Published: 2020

35. White matter hyperintensities and headache: A population-based imaging study (HUNT MRI)

Author: Mattias Linde, Asta Håberg, Lasse-Marius Honningsvåg, Kjell Arne Kvistad, Knut Hagen, and Lars Jacob Stovner
Subjects: Adult, Male, Pediatrics, medicine.medical_specialty, Population, Population based, Fluid-attenuated inversion recovery, New onset, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, 030212 general & internal medicine, education, Aged, education.field_of_study, business.industry, Headache, Leukoaraiosis, Imaging study, General Medicine, Middle Aged, medicine.disease, Magnetic Resonance Imaging, White Matter, Hyperintensity, Migraine, Female, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract: Objective To examine the relationship between white matter hyperintensities and headache. Methods White matter hyperintensities burden was assessed semi-quantitatively using Fazekas and Scheltens scales, and by manual and automated volumetry of MRI in a sub-study of the general population-based Nord-Trøndelag Health Study (HUNT MRI). Using validated questionnaires, participants were categorized into four cross-sectional headache groups: Headache-free (n = 551), tension-type headache (n = 94), migraine (n = 91), and unclassified headache (n = 126). Prospective questionnaire data was used to further categorize participants into groups according to the evolution of headache during the last 12 years: Stable headache-free, past headache, new onset headache, and persistent headache. White matter hyperintensities burden was compared across headache groups using adjusted multivariate regression models. Results Individuals with tension-type headache were more likely to have extensive white matter hyperintensities than headache-free subjects, with this being the case across all methods of white matter hyperintensities assessment (Scheltens scale: Odds ratio, 2.46; 95% CI, 1.44–4.20). Migraine or unclassified headache did not influence the odds of having extensive white matter hyperintensities. Those with new onset headache were more likely to have extensive white matter hyperintensities than those who were stable headache-free (Scheltens scale: Odds ratio, 2.24; 95% CI, 1.13–4.44). Conclusions Having tension-type headache or developing headache in middle age was linked to extensive white matter hyperintensities. These results were similar across all methods of assessing white matter hyperintensities. If white matter hyperintensities treatment strategies emerge in the future, this association should be taken into consideration.
Published: 2018

36. Depicting the pterygopalatine ganglion on 3 Tesla magnetic resonance images

Author: Manjit Matharu, Erling Tronvik, David W. Dodick, Ståle Nordgård, Daniel Fossum Bratbak, Mari Folvik, and Lars Jacob Stovner
Subjects: Adult, Male, Pterygopalatine Fossa, 030218 nuclear medicine & medical imaging, Pathology and Forensic Medicine, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Image guidance, Aged, Pterygopalatine fossa, Clinical Trials as Topic, medicine.diagnostic_test, business.industry, Reproducibility of Results, Magnetic resonance imaging, Anatomy, Middle Aged, Magnetic Resonance Imaging, Mr imaging, medicine.anatomical_structure, Female, Surgery, Pterygopalatine ganglion, sense organs, Mr images, business, 030217 neurology & neurosurgery
Abstract: The pterygopalatine ganglion has yet not been identified on medical images in living humans. The primary aim of this study was to evaluate whether the pterygopalatine ganglion could be identified on 3 T MR imaging. This study was performed on medical images of 20 Caucasian subjects on both sides (n = 40 ganglia) with an exploratory design. 3 T MR images were assessed by two physicians for the presence and size of the pterygopalatine ganglion. The distance from the pterygopalatine ganglion to four bony landmarks was registered from fused MR and CT images. In an equivalence analysis, the distances were compared to those obtained in an anatomical cadaveric study serving as historical controls (n = 50). A structure assumed to be the pterygopalatine ganglion was identified on MR images in all patients on both sides by both physicians. The mean size was depth 2.1 ± 0.5 mm, width 4.2 ± 1.1 mm and height 5.1 ± 1.4 mm, which is in accordance with formerly published data. Equivalence of the measurements on MR images and the historical controls was established, suggesting that the structure identified on the MR images is the pterygopalatine ganglion. Our findings suggest that the pterygopalatine ganglion can be detected on 3 T MR images. Identification of the pterygopalatine ganglion may be important for image-guided interventions targeting the pterygopalatine ganglion, and has the potential to increase the efficacy, safety and reliability for these treatments.
Published: 2017

37. Migraine and Other Pain Disorders

Author: Jacob Stovner, Lars, primary, Hagen, Knut, additional, and Burstein, Rami, additional
Published: 2011
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38. Inverse relationship between type 1 diabetes mellitus and migraine. Data from the Nord-Trøndelag Health Surveys 1995–1997 and 2006–2008

Author: John-Anker Zwart, Kristian Midthjell, Bjørn Olav Åsvold, Lars Jacob Stovner, Knut Hagen, and Mattias Linde
Subjects: Adult, Male, medicine.medical_specialty, Migraine Disorders, Population, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, Internal medicine, Epidemiology, Odds Ratio, Prevalence, Humans, Medicine, 030212 general & internal medicine, education, Aged, Aged, 80 and over, Type 1 diabetes, education.field_of_study, Norway, business.industry, Type 2 Diabetes Mellitus, General Medicine, Middle Aged, medicine.disease, Health Surveys, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Migraine, Female, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract: Aims The aim of this cross-sectional population-based study was to investigate the associations between migraine and type 1 and type 2 diabetes mellitus (DM). Methods We used data from the second (1995–1997) and third survey (2006–2008) in the Nord-Trøndelag Health Study. Analyses were made for the 26,121 participants (30–97 years of age, median 58.3 years) with known headache and DM status in both surveys, and for the 39,584 participants in the third survey (20–97 years, median 54.1 years). The diagnosis of migraine was given to those who fulfilled the questionnaire-based migraine diagnosis in the second and/or third survey. Associations were assessed using multiple logistic regression, estimating prevalence odds ratio (OR) with 95% confidence intervals (CIs). Results In the multivariate analysis of the 26,121 participants in both surveys, adjusting for age, gender, years of education, and smoking, classical type 1 DM (n = 81) was associated with a lower prevalence of any headache (OR = 0.55, 95% CI 0.34–0.88),and migraine (OR = 0.47, 95% CI 0.26–0.96) compared to those without DM (n = 24,779). Correspondingly, the merged group of classical type 1 DM and latent autoimmune diabetes of adults (LADA) (n = 153) were less likely to have migraine (OR = 0.53, 95% CI 0.31–0.91). Similarly, an inverse relationship between type 1 DM and migraine was found in analyses of 39,584 participants in the third survey. No clear association was found between headache and type 2 DM. Conclusions In this cross-sectional population-based study of mainly middle-aged participants, type 1 DM was inversely associated with headache, in particular migraine.
Published: 2017

39. Does pain sensitivity change by migraine phase? A blinded longitudinal study

Author: Lars Jacob Stovner, Mattias Linde, Kristian Bernhard Nilsen, Erling Tronvik, Petter Moe Omland, Martin Uglem, Trond Sand, and Knut Hagen
Subjects: Adult, Male, Pain Threshold, medicine.medical_specialty, Longitudinal study, Hot Temperature, Migraine Disorders, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Threshold of pain, medicine, Humans, Single-Blind Method, Longitudinal Studies, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Pain Measurement, business.industry, Follow up studies, General Medicine, Middle Aged, medicine.disease, Cold Temperature, Allodynia, Migraine, Physical therapy, Female, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract: Objective Studies suggest that pain thresholds may be altered before and during migraine headaches, but it is still debated if a central or peripheral dysfunction is responsible for the onset of pain in migraine. The present blinded longitudinal study explores alterations in thermal pain thresholds and suprathreshold heat pain scores before, during, and after headache. Methods We measured pain thresholds to cold and heat, and pain scores to 30 seconds of suprathreshold heat four times in 49 migraineurs and once in 31 controls. Sessions in migraineurs were categorized by migraine diaries as interictal, preictal (≤one day before attack), ictal or postictal (≤one day after attack). Results Trigeminal cold pain thresholds were decreased ( p = 0.014) and pain scores increased ( p = 0.031) in the ictal compared to the interictal phase. Initial pain scores were decreased ( p Conclusion Preictal heat hypoalgesia and reduced adaptation was followed by ictal trigeminal cold suballodynia and heat hyperalgesia. Our results support that cyclic alterations of pain perception occur late in the prodromal phase before headache. Further longitudinal investigation of how pain physiology changes within the migraine cycle is important to gain a more complete understanding of the pathogenic mechanisms behind the migraine attack.
Published: 2016

40. COMT genotypes and use of antipsychotic medication: linking population-based prescription database to the HUNT study†

Author: Hagen, Knut, Jacob Stovner, Lars, Skorpen, Frank, Pettersen, Elin, and Zwart, John-Anker
Published: 2008
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41. The impact of C-reactive protein levels on headache frequency. The HUNT Study 2006-2008

Author: Knut Hagen, Lars Jacob Stovner, Kristian Bernhard Nilsen, Espen Saxhaug Kristoffersen, and Bendik Slagsvold Winsvold
Abstract: Background Increased high sensitivity C- reactive protein (hs-CRP) levels have been found in many earlier studies on migraine, and recently also in persons with migraine and insomnia. The aim of this study was to see whether these findings could be reproduced in a large-scale population-based study. Methods A total of 50,807 (54%) out of 94,194 invited aged ≥ 20 years or older participated in the third wave of the Nord-Trøndelag Health Study study performed in 2006-2008. Among these, 38,807 (41%) had valid measures of hs-CRP and answered questions on headache and insomnia. Elevated hs-CRP was defined as >3.0 mg/L. The cross-sectional association with headache was estimated by multivariate analyses using multiple logistic regression. The precision of the odds ratio (OR) was assessed with 95% confidence interval (CI). Results In the fully adjusted model, elevated hs-CRP was associated with migraine (OR 1.14, 95% CI 1.04-1.25) and migraine with aura (OR 1.15, 95% CI 1.03-1.29). The association was strongest among individuals with headache ≥ 15 days/month for any headache (OR 1.26, 95% CI 1.08-1.48), migraine (OR 1.62, 95% CI 1.21-2.17), and migraine with aura (OR 1.84, 95% CI 1.27-2.67). No clear relationship was found between elevated hs-CRP and headache less than 7 days/month or with insomnia. Conclusions Cross-sectional data from this large-scale population-based study showed that elevated hs-CRP was associated with headache ≥ 7 days/month, especially evident for migraine with aura.
Published: 2019

42. Increased C-reactive protein levels in participants with frequent headache. The HUNT Study 2006-2008

Author: Knut Hagen, Lars Jacob Stovner, Kristian Bernhard Nilsen, and Bendik Slagsvold Winsvold
Abstract: Background Increased high sensitivity C- reactive protein (hs-CRP) levels have been found in many earlier studies on migraine, and recently also in persons with migraine and insomnia. The aim of this study was to see whether these findings could be reproduced in a large-scale population-based study. Methods A total of 50,807 (54%) out of 94,194 invited aged ≥ 20 years or older participated in the third wave of the Nord-Trøndelag Health Study study performed in 2006-2008. Among these, 38,807 (41%) had valid measures of hs-CRP and answered questions on headache and insomnia. Elevated hs-CRP was defined as >3.0 mg/L. The cross-sectional association with headache was estimated by multivariate analyses using multiple logistic regression. The precision of the odds ratio (OR) was assessed with 95% confidence interval (CI). Results In the fully adjusted model, elevated hs-CRP was associated with migraine (OR 1.14, 95% CI 1.04-1.25) and migraine with aura (OR 1.15, 95% CI 1.03-1.29). The association was stronger among individuals with headache ≥ 7 days/month for any headache (OR 1.19, 95% CI 1.08-1.31), migraine (OR 1.30, 95% CI 1.10-1.54), migraine with aura (OR 1.47, 95% CI 1.20-1.80), and other headaches (OR 1.16, 95% CI 1.03-1.30). No clear relationship was found between elevated hs-CRP and headache less than 7 days/month or with insomnia. Conclusions Cross-sectional data from a large-scale population-based study showed that elevated hs-CRP was associated with headache ≥ 7 days/month, especially frequent migraine with aura.
Published: 2019

43. Cerebral cortical dimensions in headache sufferers aged 50 to 66 years: a population-based imaging study in the Nord-Trøndelag Health Study (HUNT-MRI)

Author: Torgil Riise Vangberg, Lars Jacob Stovner, Andreas Kattem Husøy, Knut Hagen, Asta Håberg, and Lars M. Rimol
Subjects: Male, medicine.medical_specialty, Migraine Disorders, Population, Audiology, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Nevrologi: 752, Brain mapping, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Imaging, Three-Dimensional, 030202 anesthesiology, Surveys and Questionnaires, medicine, Humans, education, Prefrontal cortex, Anterior cingulate cortex, Aged, Cerebral Cortex, education.field_of_study, Brain Mapping, medicine.diagnostic_test, business.industry, Tension-Type Headache, Headache, Magnetic resonance imaging, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Anesthesiology and Pain Medicine, medicine.anatomical_structure, Neurology, Migraine, Cerebral cortex, VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Neurology: 752, Female, Neurology (clinical), business, Insula, 030217 neurology & neurosurgery
Abstract: Based on previous clinic-based magnetic resonance imaging studies showing regional differences in the cerebral cortex between those with and without headache, we hypothesized that headache sufferers have a decrease in volume, thickness, or surface area in the anterior cingulate cortex, prefrontal cortex, and insula. In addition, exploratory analyses on volume, thickness, and surface area across the cerebral cortical mantle were performed. A total of 1006 participants (aged 50-66 years) from the general population were selected to an imaging study of the head at 1.5 T (HUNT-MRI). Two hundred eighty-three individuals suffered from headache, 80 with migraine, and 87 with tension-type headache, whereas 309 individuals did not suffer from headache and were used as controls. T1-weighted 3D scans of the brain were analysed with voxel-based morphometry and FreeSurfer. The association between cortical volume, thickness, and surface area and questionnaire-based headache diagnoses was evaluated, taking into consideration evolution of headache and frequency of attacks. There were no significant differences in cortical volume, thickness, or surface area between headache sufferers and nonsufferers in the anterior cingulate cortex, prefrontal cortex, or insula. Similarly, the exploratory analyses across the cortical mantle demonstrated no significant differences in volume, thickness, or surface area between any of the headache groups and the nonsufferers. Maps of effect sizes showed small differences in the cortical measures between headache sufferers and nonsufferers. Hence, there are probably no or only very small differences in volume, thickness, or surface area of the cerebral cortex between those with and without headache in the general population. © 2019. This is the authors' accepted and refereed manuscript to the chapter. Locked until 31.7.2020 due to copyright restrictions. The final authenticated version is available online at: http://dx.doi.org/10.1097/j.pain.0000000000001550
Published: 2019

44. Headache Disorders and the World Health Organization

Author: Nelly Huynh, Lars Jacob Stovner, and Timothy J. Steiner
Subjects: medicine.medical_specialty, business.industry, Public health, media_common.quotation_subject, World health, Neglect, Epidemiology, medicine, Ill health, Headache Disorders, business, Psychiatry, Health policy, media_common, Healthcare system
Abstract: Our understanding of headache-attributed burden (described in Chap. 4) comes in the main from formal epidemiological studies. This chapter reports a complementary global enquiry by the World Health Organization and Lifting The Burden, not only into the impact of headache in countries around the world but also into how, if at all, healthcare systems in these countries were responding to headache. Depressingly, the enquiry found worldwide neglect of major causes of public ill health, and inadequate responses to them everywhere.
Published: 2019

45. The Way Forward

Author: Timothy J. Steiner and Lars Jacob Stovner
Published: 2019

46. The burden of headache disorders in the Eastern Mediterranean Region, 1990-2016: Findings from the Global Burden of Disease study 2016

Author: Lars Jacob Stovner, Timothy J. Steiner, Reza Majdzadeh, Mohsen Naghavi, Seyed-Mohammad Fereshtehnejad, Kia Vosoughi, Theo Vos, Valery L. Feigin, Ali H. Mokdad, Farshad Farzadfar, Christopher J L Murray, Sadaf G. Sepanlou, Mohammad Ali Sahraian, Maziar Moradi-Lakeh, Pouria Heydarpour, Arash Tehrani-Banihashemi, and Reza Malekzadeh
Subjects: Male, lcsh:Medicine, SCHOOL-CHILDREN, Global Health, Global burden of disease study (GBD), Global Burden of Disease, 0302 clinical medicine, Prevalence, EPIDEMIOLOGY, Medicine, 030212 general & internal medicine, Female to male, Mediterranean Region, Incidence (epidemiology), Disability-adjusted life years (DALYs), General Medicine, Middle Aged, Female, Quality-Adjusted Life Years, Life Sciences & Biomedicine, Research Article, Burden of disease, Adult, Headache Disorders, Uncertainty interval, Clinical Neurology, UNITED-STATES, Burden, MECHANISMS, 03 medical and health sciences, Primary headache, Years lived with disability (YLDs), EPISODIC MIGRAINE, Humans, Disabled Persons, Migraine, 0604 Genetics, Science & Technology, Neurology & Neurosurgery, business.industry, DISABILITY, lcsh:R, Neurosciences, POPULATION-BASED SAMPLE, 1103 Clinical Sciences, Bayes Theorem, medicine.disease, Eastern Mediterranean region (EMR), Tension-type headache, Eastern mediterranean, Anesthesiology and Pain Medicine, MEDICATION OVERUSE HEADACHE, Neurosciences & Neurology, Neurology (clinical), business, 030217 neurology & neurosurgery, Demography, Primary Headache Disorders
Abstract: Objectives Using the findings of the Global Burden of Disease Study (GBD), we report the burden of primary headache disorders in the Eastern Mediterranean Region (EMR) from 1990 to 2016. Methods We modelled headache disorders using DisMod-MR 2.1 Bayesian meta-regression tool to ensure consistency between prevalence, incidence, and remission. Years lived with disability (YLDs) were calculated by multiplying prevalence and disability weight (DW) of migraine and tension-type headache (TTH). We assumed primary headache disorders as non-fatal, so their YLD is equal to disability-adjusted life years (DALYs). Results Migraine and TTH were the second and twentieth leading causes of YLDs in EMR. Between 1990 and 2016, the absolute YLD numbers of migraine and TTH increased from 2.3 million (95% uncertainty interval (UI): 1.5–3.2) to 4.7 million (95%UI: 3–6.5) and from 383 thousand (95%UI: 240–562) to 816 thousand (95%UI: 516–1221), respectively. During the same period, age-standardised YLD rates of migraine and TTH in EMR increased by 0.7% and 2.5%, respectively, in comparison to a small decrease in the global rates (0.2% decrease in migraine and TTH). The bulk of burden due to headache occurred in the 30–49 year age group, with a peak at ages 35–44 years. The age-standardised YLD rates of both headache disorders were higher in women with female to male ratio of 1.69 for migraine and 1.38 for TTH. All countries of the EMR except for Somalia and Djibouti had higher age-standardised YLD rates for migraine and TTH in compare to the global rates. Libya and Saudi Arabia had the highest increase in age-standardised YLD rates of migraine and TTH, respectively. Conclusion The findings of this study show that primary headache disorders are a major and a growing cause of disability in EMR. Since 1990, burden of primary headache disorders has constantly been higher in EMR compared to rest of the world, which indicates that health systems in EMR must focus further on developing and implementing preventive and management strategies to control headache. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Published: 2019

47. Headache in the Global Burden of Disease (GBD) Studies

Author: Lars Jacob Stovner, Timothy J. Steiner, Emma Nichols, and Theo Vos
Subjects: Burden of disease, medicine.medical_specialty, business.industry, parasitic diseases, medicine, Intensive care medicine, business, humanities
Abstract: The significance of the Global Burden of Disease (GBD) studies for recognition of headache as a major public-health concern cannot be overrated.
Published: 2019

48. Headache in the HUNT Study: Analytical Headache Epidemiology as a Source of Added Knowledge

Author: Knut Hagen and Lars Jacob Stovner
Subjects: medicine.medical_specialty, Migraine, Headache epidemiology, business.industry, Hunt study, Epidemiology, medicine, Health survey, Headaches, medicine.symptom, medicine.disease, business, Psychiatry
Abstract: Headache epidemiological studies aiming to detect causes of headaches are quite rare compared with those that measure prevalence and burden. The Nord-Trondelag Health Survey (Helseundersokelsen i Nord-Trondelag: HUNT) is a large health survey of all inhabitants in one county, performed in adults in four waves (HUNT1-4) from 1985 to 2019, and in adolescents (Young-HUNT) from 1995. A wide array of health-related data and risk factors have been collected. Questions about headache (migraine and tension-type headache) have been included since HUNT2 in 1995, allowing estimates of associations between headache and putative risk factors both cross-sectionally (in the same study) and longitudinally (in follow-up studies).
Published: 2019

49. Headache, Functional Impact and Environment

Author: Timothy J. Steiner and Lars Jacob Stovner
Subjects: Burden of disease, medicine.medical_specialty, education.field_of_study, business.industry, Population, medicine, Functional impact, Headache Disorders, Intensive care medicine, education, business
Abstract: Recent improvements in the methodology of population-based studies have led not only to better estimates of prevalence but also to better, more inclusive descriptions of headache-attributed burden. Yet it is still not certain that existing methods even recognize, let alone adequately describe, all the consequences of living with headache.
Published: 2019

50. Dismantling the Barriers

Author: Zaza Katsarava, Lars Jacob Stovner, Rigmor Jensen, Paolo Martelletti, and Timothy J. Steiner
Subjects: medicine.medical_specialty, business.industry, Public health, Change management, Public relations, humanities, Task (project management), Action (philosophy), medicine, Headache Disorders, Psychology, business, health care economics and organizations, Health policy
Abstract: The preceding chapter described the barriers to effective headache care, high as they are, and insurmountable for many. Dismantling them is not an easy task. The Global Campaign against Headache is a response with this purpose. This chapter describes this stepwise action programme and its many activities and partners in more than 35 countries.
Published: 2019

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