BRIDGING NEUROPHYSIOLOGY AND IMMUNOLOGY IN CHRONIC HEADACHE: INSIGHTS FROM A CLINICAL COHORT STUDY

Abstract

Chronic headache disorders, particularly chronic migraine, pose substantial diagnostic and therapeutic challenges due to their multifaceted neurobiological mechanisms. The present study investigates the clinical, neurophysiological, and neuroimmunological profiles of major chronic headache forms and develops individualized, optimization-oriented treatment strategies. A cohort of patients with chronic migraine and other persistent cephalalgic syndromes underwent an integrated assessment protocol comprising EEG-based neurophysiological evaluation, autonomic function testing, and detailed immunological profiling. The analysis identified distinct neurophysiological signaturesincluding disrupted cortical excitability patterns and autonomic dysregulationthat differentiated chronic migraine from other chronic headache subtypes. Concurrently, immunological assessments revealed characteristic cytokine patterns correlating with headache frequency, intensity, and chronicity, reinforcing the role of neuroinflammatory mechanisms in sustaining the disorder. Implementation of tailored therapeutic regimens, combining pharmacological therapy with neuromodulatory and lifestyle-based interventions, resulted in markedly superior clinical outcomes compared with standard treatment approaches. These findings underscore the clinical necessity of a multimodal, biologically informed diagnostic and therapeutic framework for the effective management of chronic headaches.