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Migraine and tension-type headache in multiple sclerosis: A two-year, prospective, longitudinal, controlled study
Panagiotis Gklinos1, Maria-Eleftheria Evangelopoulos1, Georgios Velonakis2
1First Neurology Department, Eginition University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Multiple Sclerosis and Related Disorders
|August 10, 2025
Summary
People with multiple sclerosis (MS) have a higher prevalence of primary headache disorders, particularly migraine, compared to healthy individuals. This prospective study highlights the increased burden of migraine in MS patients.
Area of Science:
- Neurology
- Epidemiology
- Headache Medicine
Background:
- Previous studies suggest a higher migraine prevalence in people with MS (pwMS), but often used retrospective designs with potential bias.
- No prospective, longitudinal studies have assessed primary headache disorders in pwMS.
Purpose of the Study:
- To prospectively evaluate the prevalence of primary headache disorders in pwMS versus healthy controls (HCs) over two years.
- To compare headache features and characteristics between pwMS and HCs.
Main Methods:
- A two-year prospective, longitudinal, controlled study involving 96 pwMS and 96 age/sex-matched HCs.
- Participants completed headache diaries every six months to track headache disorders and features.
Main Results:
- The prevalence of any primary headache disorder was significantly higher in pwMS (60.4%) than HCs (41.7%).
- Migraine was more prevalent in pwMS (31.3%) compared to HCs (16.7%), with pwMS experiencing more frequent, longer, and intense attacks.
- Tension-type headache prevalence did not significantly differ between groups.
Conclusions:
- Migraine is more prevalent and burdensome in pwMS than in HCs; tension-type headache prevalence is similar.
- The study's prospective design, use of diaries, and matched controls enhance reliability.
- Further research is needed to understand the mechanisms behind increased migraine prevalence in pwMS.

