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This cross-sectional study evaluated MIBS-4 utility in 81 Japanese migraine patients and examined associations with ictal disability (HIT-6) and clinical variables.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/identifying-hidden-disability-in-migraine-patients-using-the-migraine-interictal-burden-scale-4/408748/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/identifying-hidden-disability-in-migraine-patients-using-the-migraine-interictal-burden-scale-4/408748.png","ImageObject",300,407,{"name":42,"@type":43},"moss~","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-01","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What does MIBS-4 measure in migraine patients?","Question",{"text":63,"@type":64},"MIBS-4 measures interictal burden, capturing disability between migraine attacks. It helps quantify hidden effects that may be overlooked in routine clinical assessment.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Which factors were associated with higher MIBS-4 scores?",{"text":68,"@type":64},"Higher HIT-6 scores and longer disease duration were significantly associated with clinically high interictal burden. Female sex showed an association with lower MIBS-4 scores, while monthly migraine days, migraine subtype, and age were not significant predictors.",{"name":70,"@type":61,"acceptedAnswer":71},"How did the study evaluate interictal and ictal disability?",{"text":72,"@type":64},"Interictal burden was assessed using the Migraine Interictal Burden Scale-4 (MIBS-4). Ictal disability was evaluated with the Headache Impact Test-6 (HIT-6), alongside other clinical variables and regression analyses.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},408748,1790936070,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":111,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":117,"preview_page_count":4},962090895452,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Review began 11/04/2025  \nReview ended 11/28/2025  \nPublished 11/30/2025  \n© Copyright 2025  \nHashimoto et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98195  \nOpen Access Original Article  \nIdentifying Hidden Disability in Migraine Patients Using the Migraine Interictal Burden Scale-4  \nNorichika Hashimoto 1, 2, Hatsuji Uno 2, Tetsurou Tsuji 2 , Makoto Isozaki 1  \n1. Department of Neurosurgery, University of Fukui, Fukui, JPN 2. Department of Neurosurgery, Fukui General Hospital, Fukui, JPN  \nCorresponding author: Norichika Hashimoto, [hashi1972@eagle.ocn.ne.jp](hashi1972@eagle.ocn.ne.jp)  \nAbstract  \nBackground  \nMigraine is increasingly recognized as a disorder with a substantial burden, not only during attacks but also during interictal periods. However, this dimension of disability remains under-assessed in routine clinical practice, partly because clinical attention has traditionally focused on acute attack symptoms, while patients themselves may perceive interictal periods as “normal” and therefore underreport the psychosocial impact. The Migraine Interictal Burden Scale-4 (MIBS-4) provides a concise measure of this hidden burden;  \nhowever, its clinical relevance in Japanese outpatient populations has not been thoroughly investigated.  \nThis study aimed to evaluate the clinical utility of the MIBS-4 and identify its predictors in Japanese patients with migraine by examining its association with ictal disability (HIT-6) and other clinical variables.  \nMethods  \nWe conducted a cross-sectional study involving 81 patients diagnosed with migraine at the neurosurgical outpatient clinic. Interictal burden was assessed using the MIBS-4, and ictal disability was evaluated using the Headache Impact Test-6 (HIT-6) . Emotional distress was measured using validated screening tools. Multiple regression analyses were performed to identify predictors of MIBS-4 scores. The independent variables entered into the regression model were migraine subtype, monthly migraine days (MMD), disease duration, sex, age, and headache-related disability (HIT-6) .  \nResults  \nAmong 81 Japanese migraine patients, higher MIBS-4 scores were significantly associated with increased HIT-6 scores (β = 0 .26, p \u003C 0 .001), indicating that greater headache-related disability contributes to an elevated interictal burden. Female sex was also associated with lower MIBS-4 scores (β = -1.49, p = 0 .057), and longer disease duration showed a trend toward significance (p = 0 .096) . MMD, migraine subtype, and age were not significant predictors. Logistic regression revealed that higher HIT-6 scores (odds ratio (OR) = 1.33, p = 0 .001) and longer disease duration (OR = 1.01, p = 0 .016) were significantly associated with a clinically high interictal burden (MIBS-4 ≥5) .  \nConclusion  \nIn this study, MIBS-4 scores were shown to be associated with HIT-6 scores and disease duration, but not with monthly migraine days. These findings support the utility of MIBS-4 in capturing interictal disability independently of attack frequency. Routine use of MIBS-4 in outpatient practice may help uncover hidden disease burden and guide preventive treatment strategies, particularly for patients with a long disease duration or elevated headache-related disability.  \nCategories: Neurology, Pain Management, Public Health  \nKeywords: cgrp antibody therapy, hit-6, interictal burden, mibs-4, patient-reported outcomes  \nIntroduction  \nMigraine imposes a persistent burden not only during attacks but also between them. This interictal disability, including difficulties in maintaining work productivity, social participation, or family responsibilities, remains under-recognized in clinical practice [1,2] . Such a hidden burden contributes to reduced quality of life and m","cbCaiv9cxYHshKdB","https://ap.wps.com/l/cbCaiv9cxYHshKdB","pdf",375924,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusion\n# Introduction\n# Materials And Methods","[{\"question\":\"What does MIBS-4 measure in migraine patients?\",\"answer\":\"MIBS-4 measures interictal burden, capturing disability between migraine attacks. It helps quantify hidden effects that may be overlooked in routine clinical assessment.\"},{\"question\":\"Which factors were associated with higher MIBS-4 scores?\",\"answer\":\"Higher HIT-6 scores and longer disease duration were significantly associated with clinically high interictal burden. Female sex showed an association with lower MIBS-4 scores, while monthly migraine days, migraine subtype, and age were not significant predictors.\"},{\"question\":\"How did the study evaluate interictal and ictal disability?\",\"answer\":\"Interictal burden was assessed using the Migraine Interictal Burden Scale-4 (MIBS-4). Ictal disability was evaluated with the Headache Impact Test-6 (HIT-6), alongside other clinical variables and regression analyses.\"}]","Identifying Hidden Disability in Migraine Patients Using the Migraine Interictal Burden Scale-4 | PDF",1790580428]