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Background <p>Migraine is the leading cause of years lived with disability (YLDs) in young and middle-aged populations globally. Despite strategic initiatives to standardize headache care in China, large-scale real-world evidence regarding clinical management patterns remains sparse. The China Migraine Registry (CHIME) was established to bridge this gap. This study aims to delineate the CHIME methodology and report the baseline clinical characteristics, diagnostic accuracy, and therapeutic patterns of its initial cohort.</p> Methods <p>CHIME is a nationwide, multi-center, prospective, longitudinal cohort study involving over 100 specialized headache centers across 28 provinces in China. Initiated in May 2024, the study utilizes a proprietary digital health platform integrated with a clinical decision support system (CDSS 2.0) for headache disorders. Data collection encompasses structured clinical profiles, patient-reported outcomes, and specialized sub-study cores. This baseline analysis details the cross-sectional characteristics of patients enrolled through February 15, 2026.</p> Results <p>Among 11,814 participants (79.43% female; mean age 37.42 ± 10.94 years), 10,123 (85.7%) had episodic migraine (EM), 1,019 (8.6%) had chronic migraine (CM), and 672 (5.7%) had probable migraine. A profound diagnostic-therapeutic gap was identified: only 31.0% of patients had received a correct prior diagnosis. Paradoxically, 91.43% had undergone auxiliary investigations, primarily cranial imaging (87.36%). Acute treatment relied heavily on non-specific analgesics (NSAIDs: 59.77% EM, 51.03% CM). Among patients meeting clinical criteria for prophylaxis, only 26.59% were receiving preventive therapy, and the treatment maintenance rate was critically low (12.56% for ≥3 months). CM patients exhibited significantly higher disability (MIDAS Grade IV: 52.2% vs. 26.9%) and psychiatric comorbidities compared to EM patients (<i>p</i> &lt; 0.001).</p> Conclusions <p>The CHIME study reveals a paradoxical “treatment odyssey” in China characterized by a low correct diagnosis rate, pervasive diagnostic over-investigation, alongside a systemic under-utilization of evidence-based therapies. These findings highlight the urgent need for standardized diagnostic implementation and improved prophylactic maintenance in China’s headache care system.</p>

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Methodology and baseline characteristics of the China Migraine registry (CHIME): a nationwide, multi-center, prospective cohort study of 11,814 patients

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  • 发表日期：

    2026年5月20日

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  • Ye Ran,
  • Zizi He,
  • Xun Han,
  • Hui Su,
  • Mingjie Zhang,
  • Shuhua Zhang,
  • Longteng Ma,
  • Shengyuan Yu,
  • Zhao Dong,
  • Chunfu Chen,
  • Hong Ye,
  • Min Cheng,
  • Liang Zhang,
  • Ligong Zhang,
  • Suiyi Xu,
  • Li Li,
  • Jiying Zhou,
  • Guogang Luo,
  • Yajun Lian,
  • Dongjun Wan,
  • Yuanrong Yao,
  • Hui Xue,
  • Nengwei Yu,
  • Kunlin Zhang,
  • Li Mei,
  • Hongyan Li,
  • Qiang Li,
  • Ping Gu,
  • Zhenguo Liu,
  • Kaiming Liu,
  • Wenping Gu,
  • Hongli Qu,
  • Zheman Xiao,
  • Xianliang Li,
  • Shixiong Huang,
  • Jie Zhang,
  • Ming Dong,
  • Hang Shen,
  • Hebo Wang,
  • Peng Feng,
  • Zhongling Zhang,
  • Zhe Wang,
  • Li Chen,
  • Hongbin Cai,
  • Taiqing Zhu,
  • Yangmei Chen,
  • Jiasi Li,
  • Jin Wang,
  • Xijin Wang,
  • Jiajun Yang,
  • Chengjie Mao,
  • Yuncheng Wu,
  • Qiuling Tong,
  • Wei Gui,
  • Wei Shao,
  • Yuhu Zhang,
  • Xiaojuan Wang,
  • Sufen Chen,
  • Wei Wu,
  • Huixing Wei,
  • Hongxing Liu,
  • Hanxing Liu,
  • Yungang Cao,
  • Li’an Huang,
  • Xuying He,
  • Haiyan Li,
  • Zhaoli Ge,
  • Gesheng Lei,
  • Xianguo Jiang,
  • Chengqing Zhong,
  • Shilun Zuo,
  • Peiwei Hong,
  • Li Zhou,
  • Peng Xu,
  • Xueqian Yuan,
  • Qian Tian,
  • Shuqin Zhan,
  • Li Ren,
  • Na Zhao,
  • Zhenyun Yuan,
  • Zhengyu Sun,
  • Nanfang Cheng,
  • Yuzhou Guo,
  • Haiyan Yu,
  • Yafei Wang,
  • Bingmei Deng,
  • Lei Zhang,
  • Ying Zhou,
  • Lu Liu,
  • Dan Wang,
  • Feng Wang,
  • Chaohui Tang,
  • Ran Zhang,
  • Yi Zhang,
  • Hao Chen,
  • Chen Chen,
  • Juan Ma,
  • Xin Wang,
  • Rong Fu,
  • Ling Chen,
  • Yi Zhang,
  • Lin Li,
  • Xinzuo Jiang,
  • Tianxia Zhang,
  • Xiaoyu Gao,
  • Dongmei Hu,
  • Min Ye,
  • Yunliang Xie,
  • Shuhua Gui,
  • Lian Zuo,
  • Zhenchan Lu,
  • Faming Wang,
  • Jinfeng He,
  • Jianjun Chen,
  • Yunfei Li,
  • Zhonglin Liu,
  • Shuisheng Zhong,
  • Wei Sun,
  • Gang Li,
  • Jinliang Wang,
  • Huipian Lai

摘要

Background

Migraine is the leading cause of years lived with disability (YLDs) in young and middle-aged populations globally. Despite strategic initiatives to standardize headache care in China, large-scale real-world evidence regarding clinical management patterns remains sparse. The China Migraine Registry (CHIME) was established to bridge this gap. This study aims to delineate the CHIME methodology and report the baseline clinical characteristics, diagnostic accuracy, and therapeutic patterns of its initial cohort.

Methods

CHIME is a nationwide, multi-center, prospective, longitudinal cohort study involving over 100 specialized headache centers across 28 provinces in China. Initiated in May 2024, the study utilizes a proprietary digital health platform integrated with a clinical decision support system (CDSS 2.0) for headache disorders. Data collection encompasses structured clinical profiles, patient-reported outcomes, and specialized sub-study cores. This baseline analysis details the cross-sectional characteristics of patients enrolled through February 15, 2026.

Results

Among 11,814 participants (79.43% female; mean age 37.42 ± 10.94 years), 10,123 (85.7%) had episodic migraine (EM), 1,019 (8.6%) had chronic migraine (CM), and 672 (5.7%) had probable migraine. A profound diagnostic-therapeutic gap was identified: only 31.0% of patients had received a correct prior diagnosis. Paradoxically, 91.43% had undergone auxiliary investigations, primarily cranial imaging (87.36%). Acute treatment relied heavily on non-specific analgesics (NSAIDs: 59.77% EM, 51.03% CM). Among patients meeting clinical criteria for prophylaxis, only 26.59% were receiving preventive therapy, and the treatment maintenance rate was critically low (12.56% for ≥3 months). CM patients exhibited significantly higher disability (MIDAS Grade IV: 52.2% vs. 26.9%) and psychiatric comorbidities compared to EM patients (p < 0.001).

Conclusions

The CHIME study reveals a paradoxical “treatment odyssey” in China characterized by a low correct diagnosis rate, pervasive diagnostic over-investigation, alongside a systemic under-utilization of evidence-based therapies. These findings highlight the urgent need for standardized diagnostic implementation and improved prophylactic maintenance in China’s headache care system.