The epidemiology of primary headaches in patients with multiple sclerosis

Abstract Objective Recent studies have shown a pathophysiologic link between headache and multiple sclerosis (MS), but the prevalence of primary headaches among patients with MS differs substantially across studies. This meta‐analysis aimed to comprehensively gather available evidence to estimate the prevalence of primary headaches among patients with MS. Method We systematically searched the electronic databases including PubMed, Embase, and Scopus for cohort, case–control, cross‐sectional studies that measured the prevalence of headache among patients with MS. Two reviewers independently screened titles and abstracts to identify the eligible studies and the full texts of the included studies were reviewed. Newcastle‐Ottawa Scale (NOS) was used to assess the risk of bias of the included literatures. We then conducted a meta‐analysis using Stata Software 15.0 to calculate the pooled prevalence of headaches among patients with MS and assess the source of heterogeneity. Results We identified 16 eligible studies covering a total of 3,560 patients with MS. The pooled estimated prevalence of primary headaches among patients with MS was 56%. The statistical heterogeneity was moderate with I2 of 82.1% (p