Headache Disorders in the Real World: Overcoming Resistance and Advancing Reliable Care

Headache disorders, such as migraine and cluster headache, are major contributors to global disability and often challenge both patients and clinicians with their persistence and complexity. Despite advances in scientific understanding and therapy development, many individuals do not achieve adequate or sustained symptom control due to drug resistance, fluctuating symptom severity, and frequent coexisting conditions like depression, sleep problems, and chronic pain. Recent studies highlight that gaps remain between promising interventions tested in controlled settings and the outcomes realized in routine care, in part due to diagnostic uncertainties and real-world limitations. Ongoing debates involve how best to classify headache types, manage refractory cases, and ensure treatment safety over the long term. These challenges underscore an urgent need for improved diagnostic approaches, individualized and precise treatment strategies, and robust systems to track patient outcomes in order to meet the diverse needs encountered in headache medicine.This Research Topic aims to clarify the complex landscape of headache disorders as encountered in routine clinical settings, with a focus on overcoming therapeutic resistance, accommodating patient and disease heterogeneity, and developing reproducible strategies for reliable diagnosis, monitoring, and evaluation. It seeks to advance understanding by connecting evidence-based clinical knowledge with practical, scalable interventions that can be implemented across different healthcare systems and patient populations.To gather further insights into the real-world challenges and solutions for complex headache disorders, we welcome submissions across a diverse range of manuscript types supported by the journal—including Original Research, Brief Research Reports, Perspectives, Protocols, Mini-Reviews, and more—exploring, but not limited to, the following themes:- Predictors and definitions of drug resistance and refractoriness- Impact of comorbidities and multimorbidity on diagnosis, prognosis, and treatment selection- Complications such as medication-overuse headache, chronification, adverse events, and disability progression- Clinical complexities across demographic groups, including sex and gender differences, hormonal influences, pediatrics, aging, pregnancy, and underserved populations- Diagnostic dilemmas: mixed phenotypes, imaging advances, biomarker identification, red-flag pathways, and delays in care- Therapeutic optimization, polypharmacy management, non-pharmacological and multidisciplinary approaches, treatment adherence, and access barriers- Innovations in monitoring: harmonized outcomes, patient-reported measures, digital tools, sensor technology, longitudinal assessment, and reproducibility in analyticsArticles will be published online as soon as they are accepted after peer review and approved for publication.Sign up now to participate in this exciting Research Topic.Topic Editor Dimos-Dimitrios Mitsikostas has served as principal investigator in clinical trials funded by Lundbeck, Pfizer, Swixx, and Teva Pharmaceuticals and has received honoraria for advisory board participation and lectures from AbbVie, Amgen, AstraZeneca, Bennett, Bristol-Meyers Squibb, Eli Lilly, Cross, ELPEN, Haleon, Intermed, Genesis Pharma, Lundbeck, Merck, Mylan, Orion Pharma, Novartis, Pfizer, Roche, and Teva Pharmaceuticals. Topic Editor Addolorata Maria Pia Prudenzano occasionally serves as a consultant and advisory board member for AbbVie, Idorsia, Laborest, Lilly, Lundbeck, Novartis, Orion Pharma, Organon, Pfizer, and Teva Pharmaceuticals. Topic Editor Dr. Lars Neeb has served as an advisory board member for Lundbeck, Perfood, Teva Pharmaceuticals, and AbbVie, and received speaking fees from AbbVie, Hormosan, Lundbeck, Novartis, and Teva Pharmaceuticals. Topic editors: Lars Neeb, Addolorata Maria Pia Prudenzano, DIMOS-DIMITRIOS D MITSIKOSTAS Source: https://www.frontiersin.org/research-topics/81463/headache-disorders-in-the-real-world-overcoming-resistance-and-advancing-reliable-care