Cluster Analysis of Global Research Hotspots and Thematic Evolution in Chronic Migraine: A Bibliometric Study (1917-2024).

BACKGROUND: Chronic migraine is a prevalent and disabling neurological disorder with substantial impact on patients' quality of life. Understanding the thematic structure and evolution of chronic migraine research is critical for guiding future studies and clinical practice. This study utilized cluster analysis to map research hotspots, thematic developments, and emerging trends in the global literature on chronic migraine. METHODS: Relevant publications on chronic migraine from 1917 to 2024 were retrieved from the Web of Science Core Collection. Bibliometric and cluster analyses were performed using VOSviewer, CiteSpace, and R 4.3.3, focusing on keyword co-occurrence, thematic clustering, and citation burst analysis to identify research hotspots and their evolution. RESULTS: A total of 6366 articles were included. Cluster analysis of high-frequency keywords identified five major research clusters: (1) Pathophysiological mechanisms and molecular targets, (2) epidemiology, comorbidities, and quality of life, (3) clinical trials and therapeutic strategies, (4) diagnosis and classification, and (5) regional and national burden. Thematic evolution analysis revealed a shift from early focus on epidemiology and symptomatology to recent emphasis on gene-related peptides, preventive therapies, and resistance mechanisms. Burst keyword analysis highlighted emerging topics such as "calcitonin gene-related peptide," "preventive treatment," and "central sensitization," reflecting a growing interest in novel biologics and mechanisms of treatment resistance. The United States led in publication volume and collaboration, with Headache, Cephalalgia, and Neurology as core journals and Harvard University and the Mayo Clinic as the leading institutions. CONCLUSIONS: Cluster analysis identified five core research areas in chronic migraine and revealed a shift from epidemiological description to molecular mechanisms and individualized treatment. Future research is likely to focus on integrating pharmacological and non-pharmacological interventions to further optimize patient outcomes.