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Related Experiment Video

Updated: Jan 7, 2026

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
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Identifying Hidden Disability in Migraine Patients Using the Migraine Interictal Burden Scale-4.

Norichika Hashimoto1,2, Hatsuji Uno2, Tetsurou Tsuji2

  • 1Department of Neurosurgery, University of Fukui, Fukui, JPN.

Cureus
|January 2, 2026
PubMed
Summary

The Migraine Interictal Burden Scale-4 (MIBS-4) effectively measures hidden migraine disability in Japanese patients, independent of attack frequency. Higher scores correlate with greater headache impact and longer disease duration, aiding treatment strategies.

Keywords:
cgrp antibody therapyhit-6interictal burdenmibs-4patient-reported outcomes

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Area of Science:

  • Neurology
  • Psychosomatic Medicine

Background:

  • Migraine presents a significant burden beyond acute attacks, impacting interictal periods.
  • This interictal disability is often underassessed due to focus on acute symptoms and patient underreporting.
  • The Migraine Interictal Burden Scale-4 (MIBS-4) assesses this hidden burden, but its utility in Japanese populations needed investigation.

Purpose of the Study:

  • To evaluate the clinical utility of the MIBS-4 in Japanese migraine outpatients.
  • To identify predictors of interictal burden using the MIBS-4.
  • To examine associations between MIBS-4, ictal disability (HIT-6), and clinical variables.

Main Methods:

  • A cross-sectional study of 81 Japanese migraine patients.
  • Assessment of interictal burden using MIBS-4.
  • Evaluation of ictal disability with Headache Impact Test-6 (HIT-6).
  • Multiple regression analyses to identify MIBS-4 predictors (migraine subtype, MMD, disease duration, sex, age, HIT-6).

Main Results:

  • Higher MIBS-4 scores significantly correlated with increased HIT-6 scores (β = 0.26, p < 0.001).
  • Female sex showed a trend towards lower MIBS-4 scores (β = -1.49, p = 0.057); longer disease duration showed a trend (p = 0.096).
  • Higher HIT-6 scores (OR = 1.33, p = 0.001) and longer disease duration (OR = 1.01, p = 0.016) predicted clinically high interictal burden (MIBS-4 ≥5).

Conclusions:

  • MIBS-4 scores associate with HIT-6 and disease duration, but not monthly migraine days.
  • MIBS-4 effectively captures interictal disability independently of migraine attack frequency.
  • Routine MIBS-4 use can reveal hidden burdens and guide preventive strategies, especially for long-standing migraine or high disability.