Piero Barbanti, Giulia Fiorentini, Cecilia Camarda, Massimo Autunno, Francesca Pistoia, Cinzia Aurilia, Florindo d’Onofrio, Gabriella Egeo, Antonio Carnevale, Stefano Caproni, Alberto Doretti, A. Cherchi, Roberto De Simone, Maurizio Zucco, Steno Rinalduzzi, B Colombo, Massimo Filippi, Simone Quintana, Marco Russo, Alfonso Coppola, Rosario Grugno, Marco Bartolini, Giovanna Viticchi, Renata Rao, Maria Albanese, Fabrizio Vernieri, Licia Grazzi, Micaela Robotti, Alfonsina Di Summa, Marco Aguggia, Monica Laura Bandettini di Poggio, Cinzia Finocchi, Rossana Terlizzi, Mattia Sansone, Francesca Gragnani, Pietro Querzani, Francesco Perini, Paolo Solla, Valentina Favoni, Ludovica Ferraù, Gennaro Saporito, Elisabetta Iannaccone, Carlo Colosimo, Stefano Messina, Laura Di Clemente, Francesca Cortese, Paola Scatena, Domenico Cosenza, Nicoletta Brunelli, Giacomo Querzola, Annalisa Gai, Sara Cazzulo, Francesco Tazza, Martina Guarinoni, Tommaso Ercoli, Sofia Tavani, Bianca Orlando, Francesco Bono, Pietro Antonio Bruno, Stefania Proietti, Stefano Bonassi, Carlo Tomino, Annamaria Porreca, Paola Torelli, Sabina Cevoli, Italian Migraine Registry (I-GRAINE) study group, Gennaro Alfieri, Vincenzo Andreone, Mariamichela Aquino, L. Borrello, Giulia Bozzo, Simone Braca, Simone Cesarano, Ilaria Cetta, Alessandro Cocuzza, Eleonora Colombo, Vittoria Carla D’Agostino, M. De Luca, Arianna Deidda, Fabio Frediani, I. Pestalozza, Lorenzo Forino, Chiara Gambini, Federica Genovese, Alessandro Gotti, G. Sixt, Alice Laffranchi, Riccardo Lo Presti, Davide Mantica, Marilena Marcosano, Aurora Masia, Davide Mascarella, Nicola Biagio Mercuri, Roberta Messina, Giulia Pierangeli, Barbara Petolicchio, Enrica Maria Puddu, Prabha Cristina Ranchicchio, Angelo Ranieri, Chiara Serafini
BACKGROUND: Although migraine attacks have been precisely characterized over the years - with significant advances in pathophysiology and treatment - the comprehensive identity of the migraine patient remains poorly defined. Real-world data capturing the full sociodemographic and clinical spectrum of individuals with migraine is still limited. The Italian National Migraine Registry (I-GRAINE) was established to address this gap by systematically collecting data on individuals with migraine across Italy's public healthcare system. METHODS: I-GRAINE is an ongoing, nationwide, multicenter, prospective registry involving 43 publicly funded headache centers. Since 19/04/2021, patients diagnosed with episodic migraine (EM) or chronic migraine (CM) have been systematically enrolled. Data were collected through face-to-face interviews conducted by trained neurologists using a dedicated electronic platform. Information included sociodemographic and lifestyle factors, comorbidities, and detailed clinical characteristics. We aimed to define the patient profile, explore the broad clinical phenotype, and compare EM and CM subgroups. RESULTS: ), and high education level. Over 70% were physically inactive, and 32.2% reported sleep disturbances. Headache was typically unilateral (69.1%), pulsating (64.0%), and lasted > 24 h (57.1%). Frequently reported non-ICHD-3 symptoms included osmophobia (41.5%), allodynia (40.5%), dopaminergic symptoms (37.2%), cephalalgiaphobia (34.0%), and dizziness (16.9%). ≥ 1 comorbidity was present in 41.2% of patients. Compared to those with EM, CM patients had higher BMI (24.0 vs. 23.0, p < 0.001), greater sleep disturbances (39.1% vs. 30.6%, p = 0.006), earlier onset (16.5 vs. 17.7 years, p = 0.032), more severe pain (NRS: 8.1 vs. 7.5, p < 0.001), and higher prevalence of medication overuse (58.3% vs. 14.5%, p < 0.001), dopaminergic symptoms (45.1% vs. 35.4%, p = 0.002), allodynia (47.5% vs. 38.9%, p = 0.009), and cephalalgiaphobia (41.4% vs. 32.3%, p = 0.004). Disability was also greater (MIDAS: 76.3 vs. 41.9; HIT-6: 64.3 vs. 61.2; both p < 0.001). CONCLUSIONS: The typical patient attending Italian headache centers is a 45-year-old, normal-weight, well-educated, employed woman, often physically inactive, affected by sleep disturbances, and experiencing an average of 9.8 migraine days/month. I-GRAINE identifies migraine symptoms that may represent endophenotypes and distinct patterns associated with CM, offering valuable real-world insights to inform personalized care, research, and health policy.