Background: Interictal photophobia and sleep disturbances are common in migraine patients and may contribute to migraine chronicity. However, the interplay between these symptoms and their role in the progression from episodic migraine (EM) to chronic migraine (CM) is not fully understood. This study investigates the association of ictal and interictal photophobia and sleep disturbances with CM. Methods: We conducted a retrospective analysis of 500 patients diagnosed with migraine based on the International Classification of Headache Disorders (ICHD‐3) criteria. Patients were classified into EM and CM groups. Data on photophobia, sleep disturbances, and clinical characteristics were collected. Logistic regression and network analyses were performed to identify predictors and explore symptom interconnections. Results: Among 500 participants (mean age: 41.03 ± 11.06 years; 84.2% female), 311 had EM, and 189 had CM. Ictal photophobia was present in 89.8% and interictal photophobia in 93.4% of patients, with 61.0% reporting severe interictal photophobia. Sleep disturbances were common, with 44.9% reporting difficulty falling asleep. Logistic regression identified medication overuse (OR: 5.007, 95% CI: 3.01–8.31, p < 0.001) and aura (OR: 0.226, 95% CI: 0.07–0.71, p = 0.012) as significant predictors of CM. Network analysis revealed stronger associations between interictal photophobia, daytime sleepiness, and medication overuse in CM compared to EM. Conclusions: Interictal photophobia and sleep disturbances are significant factors in the chronicity of migraine. These findings suggest that managing these symptoms may reduce migraine progression. Further research is needed to explore targeted interventions for CM patients.

Neurosteroids (NSs) are endogenous steroid hormones, which are synthesised and metabolised within the central nervous system (CNS). NSs aid myelination and glial differentiation and modulate cognitive functions. Herein, we aim to investigate the relationship between NS levels, 5-alpha-dihydroxyprogesterone (5-α-DHP) and allopregnanolone (ALPG), and their relationship with cognitive changes in relapsing remitting MS patients.A total of 43 cases with well controlled, relapsing remitting MS composed the study group. The control group included 21 age and gender matched healthy controls (HC). MS patients were assessed by calculating Expanded Disability Status Scale (EDSS) scores, and the Brief Repeatable Battery of Neuropsychological Tests (BRBNT) was performed in both MS group and HC. Levels of 5-α-DHP and ALPG levels were also evaluated for each participant.The median level of 5-α-DHP was 48 [IQR: 39.2-144.2] pg/mcgL in the MS group and 68.4 [IQR: 57.1-365.9] pg/mcgL in HC (p = 0.02). The median ALPG level was found to be 56.5 [IQR: 37.7-75.4] pg/mcgL in the MS group and 43.9 [IQR: 29.4-70.2] pg/mcgL in HC (p = 0.1). In both groups 5-α-DHP levels were positively correlated with Symbol Digit Modalities Test (SDMT) scores (HC: p = 0.01, r = 0.3 and MS: p = 0.03, r = 0.3). In the MS group, higher EDSS scores were associated with lower scores on Spatial Recall Test (SPART)-Delayed (p = 0.009, r= -0.4) and SDMT (p = 0.01, r= -0.4). The disease duration was negatively correlated with the scores on SPART-Immediate, SPART-Delayed and SDMT (p = 0.02, r= -0.4; p = 0.005, r= -0.4 and p = 0.05, r= -0.3).5-α-DHP may be lower even in well-controlled cases. 5-α-DHP may contribute to better perceptual processing and attention in cases with MS.

Background: Migraine, including vestibular migraine (VM), is a complex neurological disorder with diverse symptoms. VM is primarily characterized by vertigo attacks, while episodic migraine (EM) is more associated with headache features. This study aims to identify the distinguishing characteristics and comorbidities of VM and EM. Methods: A retrospective analysis was conducted using databases from Mersin University and Brain 360 Integrative Brain Health Center, encompassing 333 patients (248 EM, 85 VM) diagnosed according to the International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria between 2021 and 2023 to examine various migraine features and comorbidities. Results: Both EM and VM were predominantly observed in women with similar age distributions. EM patients exhibited significantly longer symptom duration and higher frequencies of nausea, photophobia, and phonophobia (p<0.05). No significant differences were found in vomiting, osmophobia and allodynia rates (p=0.147, p=0.109, p=0.822), while motion sickness was more prevalent in EM (p<0.05). EM patients also showed greater prevalence of migraine family history, menstrual associations, metabolic syndromes, and fibromyalgia (p<0.05). Although headache severity was similar, EM attacks lasted longer. Sleep disorders and medication overuses were more common among EM patients (p<0.05). EM patients reported more sleep disorders, medication overuse, and emotional stress, while dizziness was more common in VM patients (p<0.05). Conclusions: Migraine-like features and comorbidities are generally more prevalent and diverse in EM patients, revealing a distinct pattern compared to VM patients. These findings suggest a broader spectrum of VM symptoms beyond current diagnostic criteria, highlighting the need for more comprehensive longitudinal studies.

Introduction: Migraine is a highly disabling neurological condition with substantial variability in its clinical presentation. This study aimed to explore the influence of familial transmission of comorbid medical conditions on the phenotype of chronic and episodic migraine. Methods: A total of 500 patients who presented to a private tertiary headache clinic were categorized into episodic and chronic migraine groups based on the International Classification of Headache Disorders-3 criteria. Data on demographics, clinical symptoms, and familial medical history were collected. Statistical analysis included chi-square and independent sample t-tests to evaluate the impact of familial comorbidities on migraine phenotypes. Results: Of the participants, 63% were diagnosed with episodic migraine and 37% with chronic migraine. Significant findings included higher rates of medication overuse (63.31%) and allodynia (58.82%) in patients with chronic migraine. Notably, patients with a maternal history of hypercholesterolemia showed a higher prevalence of chronic migraine (78.6%), whereas those with both parents affected tended to have episodic migraine. Educational levels are inversely correlated with the prevalence of chronic migraine, suggesting a socioeconomic influence on migraine chronification. Discussion: This study highlights significant associations between familial health conditions and migraine phenotypes. The findings suggest that the maternal transmission of comorbidities, particularly hypercholesterolemia, may influence the development of chronic migraine. These results underscore the importance of considering familial medical history in the management and understanding of migraine.