Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
    • Education
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
    • Education
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

Share

April 05, 2022; 98 (14) Research Article

Patient-Centered Treatment of Chronic Migraine With Medication Overuse

A Prospective, Randomized, Pragmatic Clinical Trial

Todd J. Schwedt, Joseph G. Hentz, View ORCID ProfileSoma Sahai-Srivastava, Natalia Murinova, Nicole M. Spare, Christina Treppendahl, Vincent T. Martin, Marius Birlea, Kathleen Digre, David Watson, Michael Leonard, Teri Robert, David W. Dodick, on behalf of the MOTS Investigators
First published February 15, 2022, DOI: https://doi.org/10.1212/WNL.0000000000200117
Todd J. Schwedt
From the Department of Neurology (T.J.S., J.G.H., M.L., D.W.D.), Mayo Clinic, Phoenix, AZ; Department of Neurology (S.S.-S.), University of Southern California, Los Angeles; Department of Neurology (N.M.), University of Washington, Seattle; Department of Neurology (N.M.S.), Thomas Jefferson University, Philadelphia, PA; The Headache Center (C.T.), Ridgeland, MS; Department of Internal Medicine (V.T.M.), University of Cincinnati, OH; Department of Neurology (M.B.), University of Colorado, Denver; Department of Neurology (K.D.), University of Utah, Salt Lake City; Department of Neurology (D.W.), West Virginia University Rockefeller Neuroscience Institute, Morgantown; and patient advocate and educator (T.R.), Washington, WV.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Joseph G. Hentz
From the Department of Neurology (T.J.S., J.G.H., M.L., D.W.D.), Mayo Clinic, Phoenix, AZ; Department of Neurology (S.S.-S.), University of Southern California, Los Angeles; Department of Neurology (N.M.), University of Washington, Seattle; Department of Neurology (N.M.S.), Thomas Jefferson University, Philadelphia, PA; The Headache Center (C.T.), Ridgeland, MS; Department of Internal Medicine (V.T.M.), University of Cincinnati, OH; Department of Neurology (M.B.), University of Colorado, Denver; Department of Neurology (K.D.), University of Utah, Salt Lake City; Department of Neurology (D.W.), West Virginia University Rockefeller Neuroscience Institute, Morgantown; and patient advocate and educator (T.R.), Washington, WV.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Soma Sahai-Srivastava
From the Department of Neurology (T.J.S., J.G.H., M.L., D.W.D.), Mayo Clinic, Phoenix, AZ; Department of Neurology (S.S.-S.), University of Southern California, Los Angeles; Department of Neurology (N.M.), University of Washington, Seattle; Department of Neurology (N.M.S.), Thomas Jefferson University, Philadelphia, PA; The Headache Center (C.T.), Ridgeland, MS; Department of Internal Medicine (V.T.M.), University of Cincinnati, OH; Department of Neurology (M.B.), University of Colorado, Denver; Department of Neurology (K.D.), University of Utah, Salt Lake City; Department of Neurology (D.W.), West Virginia University Rockefeller Neuroscience Institute, Morgantown; and patient advocate and educator (T.R.), Washington, WV.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Soma Sahai-Srivastava
Natalia Murinova
From the Department of Neurology (T.J.S., J.G.H., M.L., D.W.D.), Mayo Clinic, Phoenix, AZ; Department of Neurology (S.S.-S.), University of Southern California, Los Angeles; Department of Neurology (N.M.), University of Washington, Seattle; Department of Neurology (N.M.S.), Thomas Jefferson University, Philadelphia, PA; The Headache Center (C.T.), Ridgeland, MS; Department of Internal Medicine (V.T.M.), University of Cincinnati, OH; Department of Neurology (M.B.), University of Colorado, Denver; Department of Neurology (K.D.), University of Utah, Salt Lake City; Department of Neurology (D.W.), West Virginia University Rockefeller Neuroscience Institute, Morgantown; and patient advocate and educator (T.R.), Washington, WV.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Nicole M. Spare
From the Department of Neurology (T.J.S., J.G.H., M.L., D.W.D.), Mayo Clinic, Phoenix, AZ; Department of Neurology (S.S.-S.), University of Southern California, Los Angeles; Department of Neurology (N.M.), University of Washington, Seattle; Department of Neurology (N.M.S.), Thomas Jefferson University, Philadelphia, PA; The Headache Center (C.T.), Ridgeland, MS; Department of Internal Medicine (V.T.M.), University of Cincinnati, OH; Department of Neurology (M.B.), University of Colorado, Denver; Department of Neurology (K.D.), University of Utah, Salt Lake City; Department of Neurology (D.W.), West Virginia University Rockefeller Neuroscience Institute, Morgantown; and patient advocate and educator (T.R.), Washington, WV.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Christina Treppendahl
From the Department of Neurology (T.J.S., J.G.H., M.L., D.W.D.), Mayo Clinic, Phoenix, AZ; Department of Neurology (S.S.-S.), University of Southern California, Los Angeles; Department of Neurology (N.M.), University of Washington, Seattle; Department of Neurology (N.M.S.), Thomas Jefferson University, Philadelphia, PA; The Headache Center (C.T.), Ridgeland, MS; Department of Internal Medicine (V.T.M.), University of Cincinnati, OH; Department of Neurology (M.B.), University of Colorado, Denver; Department of Neurology (K.D.), University of Utah, Salt Lake City; Department of Neurology (D.W.), West Virginia University Rockefeller Neuroscience Institute, Morgantown; and patient advocate and educator (T.R.), Washington, WV.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Vincent T. Martin
From the Department of Neurology (T.J.S., J.G.H., M.L., D.W.D.), Mayo Clinic, Phoenix, AZ; Department of Neurology (S.S.-S.), University of Southern California, Los Angeles; Department of Neurology (N.M.), University of Washington, Seattle; Department of Neurology (N.M.S.), Thomas Jefferson University, Philadelphia, PA; The Headache Center (C.T.), Ridgeland, MS; Department of Internal Medicine (V.T.M.), University of Cincinnati, OH; Department of Neurology (M.B.), University of Colorado, Denver; Department of Neurology (K.D.), University of Utah, Salt Lake City; Department of Neurology (D.W.), West Virginia University Rockefeller Neuroscience Institute, Morgantown; and patient advocate and educator (T.R.), Washington, WV.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Marius Birlea
From the Department of Neurology (T.J.S., J.G.H., M.L., D.W.D.), Mayo Clinic, Phoenix, AZ; Department of Neurology (S.S.-S.), University of Southern California, Los Angeles; Department of Neurology (N.M.), University of Washington, Seattle; Department of Neurology (N.M.S.), Thomas Jefferson University, Philadelphia, PA; The Headache Center (C.T.), Ridgeland, MS; Department of Internal Medicine (V.T.M.), University of Cincinnati, OH; Department of Neurology (M.B.), University of Colorado, Denver; Department of Neurology (K.D.), University of Utah, Salt Lake City; Department of Neurology (D.W.), West Virginia University Rockefeller Neuroscience Institute, Morgantown; and patient advocate and educator (T.R.), Washington, WV.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kathleen Digre
From the Department of Neurology (T.J.S., J.G.H., M.L., D.W.D.), Mayo Clinic, Phoenix, AZ; Department of Neurology (S.S.-S.), University of Southern California, Los Angeles; Department of Neurology (N.M.), University of Washington, Seattle; Department of Neurology (N.M.S.), Thomas Jefferson University, Philadelphia, PA; The Headache Center (C.T.), Ridgeland, MS; Department of Internal Medicine (V.T.M.), University of Cincinnati, OH; Department of Neurology (M.B.), University of Colorado, Denver; Department of Neurology (K.D.), University of Utah, Salt Lake City; Department of Neurology (D.W.), West Virginia University Rockefeller Neuroscience Institute, Morgantown; and patient advocate and educator (T.R.), Washington, WV.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
David Watson
From the Department of Neurology (T.J.S., J.G.H., M.L., D.W.D.), Mayo Clinic, Phoenix, AZ; Department of Neurology (S.S.-S.), University of Southern California, Los Angeles; Department of Neurology (N.M.), University of Washington, Seattle; Department of Neurology (N.M.S.), Thomas Jefferson University, Philadelphia, PA; The Headache Center (C.T.), Ridgeland, MS; Department of Internal Medicine (V.T.M.), University of Cincinnati, OH; Department of Neurology (M.B.), University of Colorado, Denver; Department of Neurology (K.D.), University of Utah, Salt Lake City; Department of Neurology (D.W.), West Virginia University Rockefeller Neuroscience Institute, Morgantown; and patient advocate and educator (T.R.), Washington, WV.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michael Leonard
From the Department of Neurology (T.J.S., J.G.H., M.L., D.W.D.), Mayo Clinic, Phoenix, AZ; Department of Neurology (S.S.-S.), University of Southern California, Los Angeles; Department of Neurology (N.M.), University of Washington, Seattle; Department of Neurology (N.M.S.), Thomas Jefferson University, Philadelphia, PA; The Headache Center (C.T.), Ridgeland, MS; Department of Internal Medicine (V.T.M.), University of Cincinnati, OH; Department of Neurology (M.B.), University of Colorado, Denver; Department of Neurology (K.D.), University of Utah, Salt Lake City; Department of Neurology (D.W.), West Virginia University Rockefeller Neuroscience Institute, Morgantown; and patient advocate and educator (T.R.), Washington, WV.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Teri Robert
From the Department of Neurology (T.J.S., J.G.H., M.L., D.W.D.), Mayo Clinic, Phoenix, AZ; Department of Neurology (S.S.-S.), University of Southern California, Los Angeles; Department of Neurology (N.M.), University of Washington, Seattle; Department of Neurology (N.M.S.), Thomas Jefferson University, Philadelphia, PA; The Headache Center (C.T.), Ridgeland, MS; Department of Internal Medicine (V.T.M.), University of Cincinnati, OH; Department of Neurology (M.B.), University of Colorado, Denver; Department of Neurology (K.D.), University of Utah, Salt Lake City; Department of Neurology (D.W.), West Virginia University Rockefeller Neuroscience Institute, Morgantown; and patient advocate and educator (T.R.), Washington, WV.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
David W. Dodick
From the Department of Neurology (T.J.S., J.G.H., M.L., D.W.D.), Mayo Clinic, Phoenix, AZ; Department of Neurology (S.S.-S.), University of Southern California, Los Angeles; Department of Neurology (N.M.), University of Washington, Seattle; Department of Neurology (N.M.S.), Thomas Jefferson University, Philadelphia, PA; The Headache Center (C.T.), Ridgeland, MS; Department of Internal Medicine (V.T.M.), University of Cincinnati, OH; Department of Neurology (M.B.), University of Colorado, Denver; Department of Neurology (K.D.), University of Utah, Salt Lake City; Department of Neurology (D.W.), West Virginia University Rockefeller Neuroscience Institute, Morgantown; and patient advocate and educator (T.R.), Washington, WV.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
From the Department of Neurology (T.J.S., J.G.H., M.L., D.W.D.), Mayo Clinic, Phoenix, AZ; Department of Neurology (S.S.-S.), University of Southern California, Los Angeles; Department of Neurology (N.M.), University of Washington, Seattle; Department of Neurology (N.M.S.), Thomas Jefferson University, Philadelphia, PA; The Headache Center (C.T.), Ridgeland, MS; Department of Internal Medicine (V.T.M.), University of Cincinnati, OH; Department of Neurology (M.B.), University of Colorado, Denver; Department of Neurology (K.D.), University of Utah, Salt Lake City; Department of Neurology (D.W.), West Virginia University Rockefeller Neuroscience Institute, Morgantown; and patient advocate and educator (T.R.), Washington, WV.
Full PDF
Short Form
Citation
Patient-Centered Treatment of Chronic Migraine With Medication Overuse
A Prospective, Randomized, Pragmatic Clinical Trial
Todd J. Schwedt, Joseph G. Hentz, Soma Sahai-Srivastava, Natalia Murinova, Nicole M. Spare, Christina Treppendahl, Vincent T. Martin, Marius Birlea, Kathleen Digre, David Watson, Michael Leonard, Teri Robert, David W. Dodick, on behalf of the MOTS Investigators
Neurology Apr 2022, 98 (14) e1409-e1421; DOI: 10.1212/WNL.0000000000200117

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
494

Share

  • Article
  • Figures & Data
  • Info & Disclosures
  • CME Course
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

Background and Objectives Overuse of symptomatic (i.e., acute) medications is common among those with chronic migraine. It is associated with developing frequent headaches, medication side effects, and reduced quality of life. The optimal treatment strategy for patients who have chronic migraine with medication overuse (CMMO) has long been debated. The study objective was to determine whether migraine preventive therapy without switching or limiting the frequency of the overused medication was noninferior to migraine preventive therapy with switching from the overused medication to an alternative medication that could be used on ≤2 d/wk.

Methods The Medication Overuse Treatment Strategy (MOTS) trial was an open-label, pragmatic clinical trial, randomizing adult participants 1:1 to migraine preventive medication and (1) switching from the overused medication to an alternative used ≤2 d/wk or (2) continuation of the overused medication with no maximum limit. Participants were enrolled between February 2017 and December 2020 from 34 clinics in the United States, including headache specialty, general neurology, and primary care clinics. The primary outcome was moderate to severe headache day frequency during weeks 9 to 12 and subsequently during weeks 1 to 2 after randomization.

Results Seven hundred twenty participants were randomized; average age was 44 (SD 13) years; and 87.5% were female. At baseline, participants averaged 22.5 (SD 5.1) headache days over 4 weeks, including 12.8 (SD 6.7) moderate to severe headache days and 21.4 (SD 5.8) days of symptomatic medication use. Migraine preventive medication without switching of the overused medication was not inferior to preventive medication with switching for moderate to severe headache day frequency during weeks 9 to 12 (switching 9.3 [SD 7.2] vs no switching 9.1 [SD 6.8]; p = 0.75, 95% CI −1.0 to 1.3). The treatment strategies also provided similar outcomes during the first 2 weeks (switching 6.6 [SD 3.7] moderate to severe headaches days vs no switching 6.4 [SD 3.6]; p = 0.57, 95% CI −0.4 to 0.7).

Discussion When reduction in moderate to severe headache days was used as the outcome of interest for the management of CMMO, migraine preventive medication without switching or limiting symptomatic medication is not inferior to migraine preventive medication with switching to a different symptomatic medication with a maximum limit of 2 treatment days per week.

Trial Registration Information ClinicalTrials.gov identifier NCT02764320.

Classification of Evidence This study provides Class III evidence that, for patients who have CMMO, migraine preventive medication without switching or limiting the overused medication is noninferior to migraine preventive medication with switching and limiting symptomatic medication.

Glossary

AE=
adverse event;
CM=
chronic migraine;
COMOESTAS=
Continuous Monitoring of Medication Overuse Headache in Europe and Latin America: Development and Standardization of an Alert and Decision Support System;
EQ-5D-5L=
EuroQol 5 dimensions;
GAD-7=
Generalized Anxiety Disorder 7;
HIT-6=
Headache Impact Test 6;
ICHD-3=
International Classification of Headache Disorders 3;
IRB=
Institutional Review Board;
MO=
medication overuse;
MOH=
MO headache;
MOTS=
Medication Overuse Treatment Strategy;
PHQ-9=
Patient Health Questionnaire 9;
PROMIS=
Patient-Reported Outcomes Measurement Information System

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • The MOTS coinvestigators are listed at links.lww.com/WNL/B827.

  • Editorial, page 563

  • Class of Evidence: NPub.org/coe

  • CME Course: NPub.org/cmelist

  • Podcast: NPub.org/Podcast9814

  • Received September 1, 2021.
  • Accepted in final form January 11, 2022.
  • © 2022 American Academy of Neurology
View Full Text

AAN Members

We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.

Google Safari Microsoft Edge Firefox

Click here to login

AAN Non-Member Subscribers

Click here to login

Purchase access

For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)

Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here 

Purchase
Individual access to articles is available through the Add to Cart option on the article page.  Access for 1 day (from the computer you are currently using) is US$ 39.00.  Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means.  The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use.  Distributing copies (electronic or otherwise) of the article is not allowed.

Disputes & Debates: Rapid online correspondence

  • Reader Response: Patient-Centered Treatment of Chronic Migraine With Medication Overuse: A Prospective, Randomized, Pragmatic Clinical Trial
    • Umberto Pensato, Neurologist, Department of Neurology, IRCCS Humanitas Research Hospital, Milan, Italy
    • Eleonora Matteo, Neurologist, Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
    • Davide Mascarella, Neurologist, Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
    • Sabina Cevoli, Neurologist, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
    Submitted March 09, 2022
  • Reader Response: Patient-Centered Treatment of Chronic Migraine With Medication Overuse: A Prospective, Randomized, Pragmatic Clinical Trial
    • VINOD K GUPTA, Physician-Medical Director, GUPTA MEDICAL CENTRE, MIGRAINE-HEADACHE INSTITUTE, S-407, Greater Kailash-Part Two, New Delhi, INDIA-110048
    Submitted February 21, 2022
Comment

REQUIREMENTS

If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org

Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.

If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.

Submission specifications:

  • Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
  • Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
  • Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Publishing Agreement Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
    • Abstract
    • Glossary
    • Methods
    • Results
    • Discussion
    • Study Funding
    • Disclosure
    • Acknowledgment
    • Appendix 1 Authors
    • Appendix 2 Coinvestigators
    • Footnotes
    • References
  • Figures & Data
  • Info & Disclosures
  • CME Course

More Online

CME Course

Related Articles

  • Patient-Centered Treatment of Chronic Migraine With Medication OveruseMore Is Not Always Better

Alert Me

  • Alert me when eletters are published
Neurology: 98 (24)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • Neurology: Education
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2022 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise