Primary headache disorders susceptibility is associated with fasting-related headache: evidence from a multinational study across 14 countries
Frontiers in Neurology, cilt.17, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 17
- Basım Tarihi: 2026
- Doi Numarası: 10.3389/fneur.2026.1859536
- Dergi Adı: Frontiers in Neurology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Psycinfo, Directory of Open Access Journals
- Anahtar Kelimeler: fasting-related headache, migraine, primer headache disorders, Ramadan fasting, risk stratification
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Kütahya Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background – Fasting-related headache has traditionally been attributed to dehydration, caffeine withdrawal, and sleep disruption, but pre-existing primary headache disorders may also play an important role in determining susceptibility. Objectives – To determine the prevalence, clinical characteristics, and predictors of headache during Ramadan fasting and to explore the relative contribution of pre-existing primary headache disorders and the lifestyle-related factors assessed in this study to headache occurrence during fasting. Methods – In this multinational cross-sectional survey across 14 countries, adults (18–65 years) observing Ramadan fasting completed a 17-item questionnaire. Headache during Ramadan was the primary outcome. Classification and regression tree (CRT) modelling were used to identify predictors and characterize fasting related headache. Results – Headache attacks occurred mainly in the afternoon/pre-iftar period and improved after iftar in 54.6% of cases. Pre-existing primary headache disorders, particularly migraine, were more strongly associated with headache occurrence within the exploratory CRT model than the lifestyle variables assessed in this study. Conclusion – Fasting-related headache is highly prevalent and is influenced by both lifestyle-related factors and underlying headache susceptibility. A history of primary headache disorders was strongly associated with headache occurrence during Ramadan fasting, highlighting the importance of considering individual headache history alongside fasting- related exposures when assessing vulnerability.