We conducted an observational study of 4926 university students from all over Italy and different university courses, including health areas. Students were contacted through the most popular social networks and some student’s course representatives also acted as intermediaries, from June 1 to August 31, 2021. A questionnaire has been carried out using “Google Forms” and MIDAS. The study confirmed how the headache was widespreaded among the student population and how much it was underestimated (only one-fifth of the interviewees had been to a specialist/headache center). The negative impact of habitual headache on school performance was confirmed by the attendance on courses and the overall study performance. The clinical phenomenon might have been impacted by the pandemic period and its changes in lifestyle, in the study methodology, and due to the stress increase. Finally, the means used in the study were very satisfactory: the use of peers of the interviewees and the social networks, obtaining a broad acceptance of the study and possibly offering a method which is likely to be used in the future. Students presenting habitual headaches must be aware of their condition and the need to search for an appropriate diagnosis and treatment.

Background/Objectives: Studying the second exteroceptive suppression period (ES2) of the temporalis muscle may well shed some light on the brainstem neural circuits involved in migraine pathophysiology. It is known that allodynia is related to an increased sensitization of second-/third-order neurons both in the trigeminal nucleus caudalis and sensory thalamus. This pilot, observational study was carried out in the interictal period on female migraineurs with/without allodynia to assess the ES2 of the temporalis muscle compared to controls. Methods: Forty-nine non-consecutive female patients were enrolled, as they met the diagnostic criteria for migraine (26 episodic and 23 chronic), alongside 23 healthy controls. The inclusion criteria encompassed no ongoing pharmacological prophylactic treatment, and the exclusion criteria included any relevant comorbidities. In line with international standards, the exteroceptive suppression of the temporalis muscle activity was registered on the left side, assessing ES2 latency and duration in the interictal period. Results: Allodynia was observed in 24 patients (50%), and 16/24 (67%) were chronic migraineurs. No statistically significant differences in ES2 latency or its duration between the migraine patients and controls were detected. However, there was a significantly longer ES2 duration in allodynic migraineurs than in the controls (p = 0.04; effect size: 0.71) and in allodynic compared to non-allodynic migraineurs (p = 0.04; effect size: 0.63). Conclusions: The increased duration of ES2 observed in allodynic migraineurs might be related to the impaired activity of brainstem circuits and, in our opinion, it seems reasonable to hypothesize that this change may be a neurophysiological correlate of central sensitization in migraine allodynic patients.

Background/Objectives The study of the second exteroceptive suppression period (ES2) of the temporalis muscle could provide information as to the brainstem neural circuits involved in migraine pathophysiology. Allodynia is known to be related to the sensitization of second/third order neurons in the trigeminal nucleus caudalis and sensory thalamus, respectively. The aim of this observational, pilot study was to investigate the ES2 of the temporalis muscle in female migraineurs, with and without allodynia, in the interictal period, compared to controls. Methods A total of 49 non-consecutive female patients fulfilling the diagnostic criteria for migraine (13 with aura, 26 episodic 23 chronic), naïve from any pharmacological prophylactic treatment, without relevant comorbidities and 19 healthy controls were enrolled. The exteroceptive suppression of the temporalis muscle activity was registered, according to international standards, in the interictal period. The presence of allodynia was assessed by the Allodynia Symptom Checklist. Results Twenty-four patients (50%) had allodynia, 16/24 (67%) were chronic migraineurs. The ES2 latency and duration between the groups were compared by the Student’s t-test. There were no statistically significant differences in the ES2 latency or its duration between the migraine patients and controls. Conversely, the ES2 duration was significantly longer in allodynic migraineurs than in controls (p=0.04) and in allodynic than in non-allodynic migraineurs (p=0.04). Conclusions This study suggests that the increased duration of ES2 observed in allodynic migraineurs may reflect an impaired activity of brainstem circuits. Indeed, we suppose that this alteration in ES2 may be a neurophysiological correlate of central sensitization in migraine patients with allodynia.

Background: Menstrual migraine (MM), including pure menstrual migraine (PMM) and menstrually related migraine (MRM), is characterized by attacks occurring in close temporal association with menstruation and is often more severe, longer lasting, and less responsive to treatment than non-menstrual migraine. Prostaglandin-mediated inflammation and calcitonin gene-related peptide (CGRP) release play a key role in MM pathophysiology. Phycocyanin (PC) and palmitoylethanolamide (PEA) are nutraceutical compounds with anti-inflammatory, analgesic, and neuroprotective properties that may be beneficial as short-term perimenstrual prophylaxis. Objectives: To evaluate the effectiveness of an oral supplementation combining phycocyanin and palmitoylethanolamide as a short-term prophylaxis for menstrual migraine in a real-world clinical setting, a retrospective observational study without a control group was conducted in five Italian centers between May 2023 and June 2025. Methods: Clinical records of 800 women were reviewed, and 220 patients receiving perimenstrual supplementation with phycocyanin and palmitoylethanolamide were screened. Sixty-one women diagnosed with migraine without aura, according to the International Classification of Headache Disorders, met all inclusion criteria and were analyzed. Phycocyanin and palmitoylethanolamide were taken at a dosage of two capsules daily from five days before to five days after the onset of menstruation for three consecutive months. Outcomes during the perimenstrual window were compared with a three-month period without supplementation. Primary outcomes included migraine severity, frequency, and duration of the attacks; secondary outcomes included analgesic consumption and menstrual migraine-associated symptoms. Results: Among the 61 included patients, phycocyanin and palmitoylethanolamide supplementation was associated with a significant reduction in migraine severity across all monitored perimenstrual days (p < 0.0001). While the overall monthly frequency of migraine attacks did not change, the number of migraine days during the perimenstrual window significantly decreased from the first month of supplementation (p < 0.05). Moreover, migraine duration during the perimenstrual window was significantly reduced at one, two, and three months of phycocyanin and palmitoylethanolamide supplementation compared with baseline. Analgesic use and the number of days with migraine-associated symptoms (nausea, vomiting, photophobia/phonophobia) were also significantly reduced. Treatment was well tolerated. Conclusions: In this real-world retrospective study, perimenstrual supplementation with phycocyanin and palmitoylethanolamide was associated with reduced severity, duration, and perimenstrual frequency of menstrual migraine attacks, along with decreased analgesic use, suggesting a safe and potentially beneficial short-term prophylactic strategy for women with menstrual migraine.