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The role of migraine headache severity, associated features, and interactions

with overweight/obesity in inhibitory control

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DOI: 10.1080/00207454.2017.1366474

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 International Journal of Neuroscience

ISSN: 0020-7454 (Print) 1543-5245 (Online) Journal homepage: http://www.tandfonline.com/loi/ines20

The role of migraine headache severity, associated

features and interactions with overweight/obesity
in inhibitory control

Rachel Galioto, Kevin C. O'Leary, John Gunstad, J. Graham Thomas, Richard

B. Lipton, Jelena M. Pavlović, Julie Roth, Lucille Rathier & Dale S. Bond

To cite this article: Rachel Galioto, Kevin C. O'Leary, John Gunstad, J. Graham Thomas, Richard
B. Lipton, Jelena M. Pavlović, Julie Roth, Lucille Rathier & Dale S. Bond (2017): The role of
migraine headache severity, associated features and interactions with overweight/obesity in
inhibitory control, International Journal of Neuroscience, DOI: 10.1080/00207454.2017.1366474

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 INTERNATIONAL JOURNAL OF NEUROSCIENCE, 2017
https://doi.org/10.1080/00207454.2017.1366474

The role of migraine headache severity, associated features and interactions

with overweight/obesity in inhibitory control
Rachel Galiotoa, Kevin C. O’Learyb, John Gunstadc, J. Graham Thomasb, Richard B. Liptond, Jelena M. Pavlovicd,
Julie Rothe, Lucille Rathiera and Dale S. Bondb
a
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI, USA;
b
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes
Research Center, Providence, RI, USA; cDepartment of Psychological Sciences, Kent State University, Kent, OH, USA; dDepartment of Neurology
and the Montefiore Headache Center, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA; eDepartment of
Neurology, Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI, USA

ABSTRACT ARTICLE HISTORY

Aim of the Study: While migraine and obesity are related and both conditions are associated with Received 29 December 2016
Downloaded by [Lifespan Libraries] at 06:04 08 September 2017

reduced executive functioning, no study has examined whether obesity exacerbates executive Received 28 June 2017
dysfunction in migraine. This cross-sectional study examined whether overweight/obesity Accepted 7 August 2017
moderated associations of migraine severity and associated features with inhibitory control, one KEYWORDS
aspect of executive function. Migraine; headache;
Materials and Methods: Women (n = 124) aged 18–50 years old with overweight/obesity body executive functions; obesity;
mass index (BMI) = 35.1 § 6.4 kg/m2 and migraine completed a 28-day smartphone-based inhibitory control
headache diary assessing migraine headache severity (attack frequency, pain intensity) and
frequency of associated features (aura, photophobia, phonophobia, nausea). They then completed
computerized measures of inhibitory control during an interictal (headache-free) period.
Results: Participants with higher migraine attack frequency performed worse on the Flanker test
(accuracy and reaction time; p < .05). Migraine attack frequency and pain intensity interacted with BMI
to predict slower Stroop and/or Flanker Reaction Time (RT; p < .05). More frequent photophobia,
phonophobia and aura were independently related to slower RT on the Stroop and/or Flanker tests (p <
.05), and BMI moderated the relationship between the occurrence of aura and Stroop RT (p = .03).
Conclusions: Associations of migraine severity and presence of associated features with inhibitory
control varied by BMI in overweight/obese women with migraine. These findings warrant
consideration of weight status in clarifying the role of migraine in executive functioning.

Introduction studies have found no such associations [7,8,15,16].

Although it has been suggested that examination of
Increasing objective evidence provides support for charac-
migraine-related variables (e.g. attack frequency/sever-
terization of migraine as a neurologic disorder with com-
ity, aura status) may help to clarify these findings [17],
plex underlying pathophysiological mechanisms [1].
there is variability among the few studies in this area
Although limited, a small body of research has shown
regarding the relationship of migraine severity (i.e. fre-
associations between migraine and the presence of white
quency, intensity and duration) [9,15,18,19] and associ-
matter abnormalities [2–5], particularly in the frontal lobes,
ated features (e.g. aura) [9,19–22] with executive
altered functional connectivity/activity in frontal/executive
functions.
networks [6–8] and cerebral hypoperfusion [9,10].
It is possible that the presence of certain comorbid-
Given the possibility of frontal/executive dysfunction,
ities may underlie variability in executive functions in
there is increasing interest in whether executive func-
persons with migraine. One likely condition is obesity, as
tions (i.e. higher order cognitive abilities necessary for
it is independently related to executive dysfunction
engaging in goal-oriented behaviours and self-regula-
[20,22,23] and is an exacerbating factor for migraine [24–
tion) are impacted in individuals with migraine. Research
26]. Specifically, obesity is associated with higher odds of
examining the effects of migraine on executive functions
high-frequency migraine and attacks that are more
is limited, and, while some studies have shown that
severe and disabling [25,27]. Similarly, increased body
migraine is related to executive deficits [11–14], other

CONTACT Dale S. Bond dbond@lifespan.org

© 2017 Informa UK Limited, trading as Taylor & Francis Group
 2 R. GALIOTO ET AL.
mass index (BMI) has also been linked to the presence of
photophobia and phonophobia [24]. Additionally, the
odds of migraine are increased in those with obesity,
particularly among white women under the age of 50
[28]. The mechanisms underlying these associations are
likely multifactorial, including common inflammatory
processes [29].
The primary aim of the current cross-sectional study
was to examine the degree of overweight as a moderator
of associations of migraine severity (attack frequency,
pain intensity) and associated features (photophobia,
phonophobia, nausea, aura) assessed via 28-day smart-
phone monitoring with performance on two objective
tests of inhibitory control during an interictal (headache-
free) period. Inhibitory control is a central aspect of exec-
utive functioning and commonly used proxy of frontal
lobe functioning. We hypothesized that greater degree of
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overweight would interact with greater migraine severity
and associated features to predict poorer performance on
the tests of inhibitory control.
Materials and methods
Participants and procedures
Participants were women aged 18–50 years old, who had
both neurologist-confirmed diagnosis of migraine
according to International Classification of Headache
Disorders criteria [30] and overweight or obesity (BMI 
25.0 kg/m2), and were seeking behavioural treatment to
lose weight and reduce their headaches as part of the
Women’s Health and Migraine trial (clinicaltrials.gov
NCT01197196) [31]. Participants were excluded for other
neurologic disorders or significant psychiatric illness (e.g.
bipolar disorder, schizophrenia). A more detailed
description of the study recruitment and procedures has
been published previously [31]. After providing informed
consent, the participants had their weight status and
migraine diagnosis confirmed by research staff and the
study neurologist, completed questionnaires assessing
headache impact and demographic characteristics and
began recording their headache activity for 28 consecu-
tive days using a smartphone diary. After this headache
monitoring period, the participants returned to the
research centre to complete the cognitive testing, which
consisted of computerized versions of the Stroop and
the modified Flanker tasks.
The participants were headache free for at least
24 hours at the time of cognitive testing, which is
referred to as the interictal period throughout the manu-
script in contrast to the ictal period or time during which
a headache is experienced. Of the 144 participants who
were deemed study eligible after completion of the
smartphone headache diary and had the opportunity to
attempt the cognitive tasks, 124 (86%) completed the
cognitive tasks. There were no differences between the
cognitive tasks completers and non-completers on
demographic characteristics, weight status or migraine
headache frequency and severity. The study protocol
was approved by the Rhode Island Hospital Institutional
Review Board.
Measures
Migraine severity and associated features
Participants recorded their headache activity for 28 con-
secutive days using a smartphone equipped with a web-
based headache diary application [31]. At the end of
each day, the participants indicated whether a headache
occurred. When a headache did occur, the participants
were prompted to rate maximum headache pain inten-
sity (0 ‘no pain’–10 ‘pain as bad as you can imagine’),
provide start and stop times to indicate the attack dura-
tion and indicate the presence of associated features (i.e.
aura, nausea, photophobia, phonophobia). These data
were automatically transmitted to the research centre
via the diary application. Daily checks were conducted
by the research staff to determine if data were incom-
plete or unclear. Participant data were summarized as
migraine frequency (assessed as the number of migraine
days/mo.), average maximum pain intensity and average
percentage of migraine days with aura and nausea, pho-
tophobia or phonophobia.
Cognitive function
Computerized versions of both the Stroop and Flanker
tasks were completed by all the participants using
Eprime Stimulus Presentation Software (Psychology Soft-
ware Tools, Pittsburgh, PA, USA).
Modified Stroop. The modified Stroop task taps into
the participants’ ability to inhibit irrelevant information
using three conditions: Word, Colour and Colour–Word.
In the Word condition, the participants responded to the
meaning of a target word (i.e. ‘red’, ‘green’ or ‘blue’ dis-
played in black), as quickly as possible. In the Colour con-
dition, the participants responded to the colours in
which an array of X’s were displayed (i.e. XXXX displayed
in red), as quickly as possible. The Colour and Word con-
ditions assess the processing speed. In the Colour–Word
condition, the participants responded to the colours
in which an incongruent colour word was displayed
(i.e. ‘RED’ displayed in green), as quickly as possible. The
Colour–Word condition assesses the inhibitory control
as the participants have to suppress the response
 INTERNATIONAL JOURNAL OF NEUROSCIENCE 3

of reading the word. The participants completed three Statistical analyses

45-second blocks of each condition, in a counterbal-
Descriptive statistics were calculated to characterize the
anced order. For each condition, all targets were dis-
sample. Bivariate correlations were conducted to exam-
played until the participant provided a response. Task
ine relationships between demographic variables and
performance indices were assessed including the total
performance on executive function tests to determine
correct trials and reaction time (RT), along with Golden
covariates. After analysis, age and education were
Interference [32], which quantifies the participants’ abil-
entered as covariates in subsequent analyses given their
ity to parse out irrelevant information. Greater Interfer-
significant associations with executive function tests per-
ence scores are indicative of better inhibitory control.
formance. Separate linear regressions were first con-
Flanker task. The modified flanker task [33,34] also
ducted to examine the main effects of migraine-
taps into the participants’ ability to inhibit automatic
associated features (percentage of migraine days with
and irrelevant responses. The participants were
photophobia, phonophobia, aura and nausea) and
instructed to respond to a centrally presented target
migraine headache patterns (attack frequency, maxi-
arrow amid lateral flanking arrows by pressing a key
mum intensity) on inhibitory control tests after control-
with their left or right index fingers if the arrow faced
ling for age and education. We then tested a model
towards the left or right, respectively (e.g. ‘<’ or ‘>’).
including interactions of migraine-associated features
Congruent trials consisted of the target arrow sur-
and migraine headache patterns with BMI on inhibitory
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rounded by arrows that faced the same direction (e.g.

control tests. Significance was defined as p < .05
<<<< or >>>>). Incongruent trials consisted of the
target arrow surrounded by arrows that faced the oppo-
site direction (e.g. >><>> or <<><<). Incongruent Results
trials, relative to the congruent trials, elicit slower and
more incorrect responses as they concurrently activate Characteristics of the sample
both the correct response (elicited by the target) and Table 1 shows the demographic, anthropometric and
the incorrect response (elicited by the flanking arrows) migraine of the sample (n = 124). On average, the
prior to completion of stimulus evaluation, causing a par- participants were 38 years of age and had severe obesity.
ticipant to use greater amounts of executive function. Approximately one-quarter (23%) of the participants
One counterbalanced block of 100 trials was given dur- were non-white and 18% had Hispanic ethnicity. The
ing each task with equal probability of congruency and majority of participants (86%) had at least some college
directionality. The stimuli were 3 cm tall white arrows education. On average, the participants reported having
comprising a 13 cm wide array presented focally on a a migraine on 8.3 § 4.4 days over the 28-day monitoring
black background 60 cm away from the participant. period and rated the average maximum pain intensity of
Stimuli were displayed for 80 ms with a fixed inter-trial
interval of 1200 ms. Accuracy (% correct) and RT for all Table 1. Demographic, anthropometric and headache character-
istics of the sample (n = 124).
correct trials were assessed, along with interference
Variable Mean (§SD) (%)
score measures. Interference scores were determined by Demographic and anthropometric characteristics
simple subtraction across task conditions (i.e. Accuracy: Age (years) 38.26 (8.24)
Congruent – Incongruent; RT: Incongruent – Congruent), Race
African–American 11%
with higher scores indicative of a lower ability to inhibit White 76%
task-irrelevant information. Other 12%
Ethnicity
Non-Hispanic 81%
Hispanic 18%
Anthropometric characteristics Unknown 1%
Height and weight were measured using a wall-mounted Education
High school 14%
Harpenden stadiometer (Holtain Ltd., Crosswell, Crymyh, Post-high school 86%
Pembs, UK) and calibrated digital scale (Tanita BWB 800: Body mass index (kg/m2) 35.1 (6.4)
Tanita Corporation of America Inc, Arlington Heights, IL, Migraine Severity
Frequency (# episodes) 8.5 (4.6)
USA). BMI was calculated from these measures using the Intensity (out of 10) 5.9 (1.5)
formula: BMI (kg/m2) = weight (kg)/(height (m)2). Duration (hours) 20.0(14.2)
Migraine days 8.3 (4.4)
Associated Features (% days)
Aura 16.5 (26.8)
Demographic characteristics Photophobia 66.8 (24.3)
Age, marital status, race/ethnicity and the level of educa- Phonophobia 62.0 (25.9)
tion were assessed via questionnaire. Nausea 39.1 (28.6)
 4 R. GALIOTO ET AL.

attacks as moderate. None of the participants reported 1050

having a current migraine attack on the day of cognitive 1000

testing. 950

Reacon Time
Regarding performance on the executive function 900
tests, 21 (16%) individuals were excluded for Stroop 850
analyses (resulting in a sample of n = 107) and 4 (3%) 800
individuals (resulting in a sample of n = 120) were 750
excluded from the Flanker analyses for achieving less 700
than 50% accuracy; poor performance may have been 1 2 3 4 5 6 7 8 9

due to poor effort or understanding of the task and this Pain Intensity

rate is similar to previous studies using similar cognitive
tasks [32–34]. Of those included, the participants aver-
aged 96.5% accuracy for the Flanker congruent trials
(range = 66%–100%), 91% on the Flanker incongruent
trials (range = 56%–100%), 98% on Stroop colour (range
= 91%–100%), 98% of Stroop word (range = 82%–100%)
-1 SD BMI Mean BMI +1 SD BMI
Figure 1. Interaction between pain intensity and BMI on Stroop
colour reaction time.
Note: This figure depicts the interaction between headache pain intensity and
reaction time on the Stroop colour test at three levels of BMI. This figure is
representative of all significant interactions.

and 94% on Stroop Colour–Word (range = 55%–100%).

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of poorer inhibitory control. More frequent phonophobia

Migraine severity (headache attack frequency and
pain intensity)
Independent associations
Higher headache frequency was associated with lower
Flanker congruent accuracy (b = ¡.230, SE = ¡2.40, p =
.02) and RT (b = 2.09, SE = 2.21, p = .03). Pain intensity
was not independently associated with performance on
the Stroop or Flanker tests.
Interactions with BMI
Headache frequency interacted with BMI to predict perfor-
mance on Stroop Word RT (b = ¡1.161, SE = ¡2.04, p =
.04), such that, with increasing headache frequency and
BMI, RT became slower. Pain intensity interacted with BMI
to predict performance on Flanker congruent (b = 1.321,
SE = 2.07, p = .04) and incongruent (b = 1.377, SE = 2.13,
p = .04) RTs, and on Stroop Colour (b = 2.222, SE = 3.73,
p < .001), Word (b = 2.128, SE = 3.52, p < .01) and Colour–
Word (b = 1.311, SE = 2.05, p = .04) RTs, such that the accu-
racy on Flanker tests and RT on Stroop tasks decreased
with increasing levels of BMI and headache intensity.
Figure 1 depicts the interaction between headache pain
intensity and BMI on RT on the Stroop Colour test. Figure 2
Reacon Time (ms)
was related to slower Stroop Colour RT (b = ¡.257, SE =
¡2.06, p = .04), indicative of slower processing speed.
Migraine aura was independently associated with
greater Flanker Accuracy Interference (b = ¡.197, SE =
¡2.08, p = .04) and Flanker RT Interference (b = ¡.223,
SE = ¡2.40, p = .02), indicative of poorer inhibitory
control.
Interactions with BMI
There was a significant aura by BMI interaction for Stroop
Colour RT (b = 1.306, SE = 2.19, p = .03) such that with
increasing BMI and percentage of days with aura, RT
(processing speed) became slower. There was no BMI by
associated features interactions for other Stroop or
Flanker variables.
Discussion
The present study examined whether migraine severity
and associated features interacted with the degree of
overweight, in relation to predict performance on
540

520
depicts the interaction between headache pain intensity 500
and BMI on Flanker RT. These figures are representative of 480
all significant interactions. 460

440

Associated features of migraine 420

400
Independent associations 2 3 4 5 6 7 8 9 10

More frequent photophobia was related to slower Maximum Pain Severity

-1 SD BMI Mean BMI +1 SD BMI
Stroop Word RT (b = .255, SE = 2.00, p = .048) indicative
of slower processing speed, and greater Flanker Accu- Figure 2. Interaction between maximum pain intensity and BMI
racy Interference (b = .257, SE = 2.11, p = .04), indicative on Flanker reaction time.

executive function tests measuring inhibitory control,
including indices of processing speed. With respect to
migraine severity, pain intensity interacted with BMI to
predict slower speed across both inhibitory control and
processing speed aspects of both tests, such that the
association between greater pain intensity and lower
inhibitory control and slower processing speed were
stronger with increasing degree of overweight. Addition-
ally, attack frequency interacted with BMI to predict
slower processing speed on the Stroop task such that
the relationship between headache frequency and
slowed processing speed was stronger with increasing
degree of overweight. Greater attack frequency was also
independently associated with poorer inhibitory control
as measured by the Flanker test. The above findings sug-
gest that more severe migraine attacks are associated
with slower processing speed and poorer inhibitory con-
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trol, particularly with increasing degree of overweight/
obesity. Our findings are consistent with those of a previ-
ous study by Calandre et al. [9] who found associations
of migraine attack frequency and pain intensity with per-
formance on tests of inhibitory control and RT. Other
studies have examined the relationship of other types of
executive functioning and headache characteristics,
showing that greater migraine pain intensity predicted
poorer performance on tests of set-shifting/cognitive
flexibility and problem-solving [9,18] and higher fre-
quency of attacks was related to lower working memory
[9]. However, several other studies have found no rela-
tionship of headache characteristics with measures of
executive function [15,19]. Although the reasons for
these discordant findings are unclear, it is likely that het-
erogeneity in executive function measures and sample
characteristics, particularly with respect to migraine-
related comorbidities that may impact cognition, play a
role. Our findings showing that the degree of over-
weight/obesity modifies the relationship of migraine
and executive function are novel and warrant consider-
ation of obesity and other comorbidities in clarifying the
role of migraine in executive function.
The present study also extends previous research by
examining the relationship of associated features of
migraine, and how often they occur, with executive func-
tion. More frequent photophobia was associated with
slower processing speed and lower inhibitory control
while more frequent phonophobia was associated with
slower processing speed. Additionally, more frequent
aura was independently associated with poorer inhibi-
tory control and interacted with increasing degree of
overweight/obesity such that the relationship between
more frequent aura and slower processing speed was
stronger at higher levels of overweight/obesity. Previous
research has been mixed in terms of whether aura
INTERNATIONAL JOURNAL OF NEUROSCIENCE 5
impacts performance on tests of executive functions
[19,21]. This may be explained by the fact that previous
studies did not assess aura prospectively. It is also possi-
ble that the relationship between aura and executive
function is complicated by overweight/obesity.
The mechanisms for deficits in executive functions
among patients with migraine is not well understood
but may be related to frontal lobe dysfunction as
described above [2–8] and decreased cerebral perfusion
[9,10]. Obesity likely exacerbates these abnormalities
given that obesity and migraine share common inflam-
matory processes [26,27,35,36] and are also indepen-
dently related to both reduced white matter integrity
[37,38] and cerebral perfusion to the prefrontal cortex
[39]. Both decreased white matter integrity [40–42] and
cerebral hypoperfusion [43–46] have been linked to
slower processing speed and impaired executive func-
tions, and may also explain why our findings are primar-
ily related to speed on the task, rather than accuracy. It is
possible that the migraine brain is particularly vulnerable
to the hypoperfusion/hypoxia changes related to obe-
sity, thus leading to an amplified susceptibility to frontal
lobe impairment in those with co-morbid migraine and
obesity. Future research is needed to clarify these
mechanisms.
This study has several strengths. It is the largest study
to date to examine relationships between migraine and
executive function. It is also the first to examine over-
weight/obesity as a moderator of the relationship
between migraine and executive functioning. As stated
previously, this study also advances previous research by
assessing the importance of a variety of associated fea-
tures, measured prospectively for one month and in
near real time via a smartphone diary and analyzed con-
tinuously. Our findings in the context of previous
research in this area support the potential usefulness of
this approach in understanding the relationships
between migraine-associated features and executive
functions. Additionally, we employed objective comput-
erized tests of cognitive function which reduces possible
bias and administration error. Further, we demonstrated
consistent findings between two different tasks of inhibi-
tory control, providing greater confidence in the reliabil-
ity of the findings. This study also has important clinical
implications. Specifically, both migraine and obesity are
highly prevalent and are likely to be encountered in clini-
cal practice. Accordingly, it is important for care pro-
viders to understand the impact that the two conditions
together may have on executive functions which could
possibly impact ability and/or willingness to adhere to
treatment regimens.
This study is also not without limitations. Primarily,
this study employed a cross-sectional design which
 6 R. GALIOTO ET AL.
precludes the examination of causality. Also, of particular
importance, this study did not have a healthy weight or
non-migraine control group, or access to normative data
for the two cognitive tests. Therefore, this study is meant
to be an observational examination of the contribution
of the degree of overweight/obesity on tests of inhibi-
tory control and statements cannot be made regarding
task performance relative to the population or other
samples. Additionally, inferences cannot be made about
the level of ‘impairment’ among these individuals. As an
initial examination, our assessment of executive func-
tions was limited to inhibitory control. Future research is
needed to examine whether obesity moderates the asso-
ciation between migraine characteristics and other
aspects of executive functions as well. Finally, this study
only included female participants, which limits the gen-
eralizability of these findings to male populations; the
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possibility of an interaction with gender should be exam-
ined in future research.
In conclusion, the present study showed that greater
migraine severity was associated with poorer inhibitory
control, particularly in the context of increasing degree of
overweight/obesity. Additionally, primary associated fea-
tures of migraine including photophobia, phonophobia
and aura were independently related to slower process-
ing speed and lower inhibitory control. Finally, the rela-
tionship between more frequent experience of aura and
inhibitory control was moderated by overweight/obesity.
Future prospective studies are needed to understand
whether executive function improves with improvements
in migraine and/or weight loss.
Acknowledgments
The authors wish to acknowledge Krystal DeFaria and Jennifer
Webster for their assistance with data collection and the
women who participated in this study.
Disclosure statement
No potential conflict of interest was reported by the authors.
Funding
This work was supported by the National Institute of Neurologi-
cal Disorders and Stroke [grant number R01 NS077925].
Notes on contributors
Dr Galioto is a postdoctoral fellow at Rhode Island Hospital/
Brown Alpert Medical School. Her research focuses on the asso-
ciation between obesity and cognition.
Kevin O’Leary is a senior project director at the Miriam Hospi-
tal/Brown Alpert Medical School’s Weight Control and Diabetes
Research Center. He received his BS in exercise and sport sci-
ence at Elon University and his MS in kinesiology at the Univer-
sity of Illinois at Urbana-Champaign.
Dr Gunstad is a professor in the Department of Psychological
Sciences and director of the Applied Psychology Center at Kent
State University.
Dr Thomas is an associate professor of psychiatry and human
behavior at the Alpert Medical School of Brown University and
the Weight Control & Diabetes Research Center of The Miriam
Hospital. His research is focused on the use of technology for
assessment and intervention on health behaviors, with an
emphasis on obesity and related conditions. Dr Thomas has
been awarded grants from the NIH and other organizations to
use the Internet, mobile health (mHealth) technology, and vir-
tual reality technology in his research.
Dr Lipton is the Edwin S. Lowe Professor and vice chair of neu-
rology, professor of epidemiology and population health and
professor of psychiatry and behavioral sciences at the Albert
Einstein College of Medicine. He is a diplomate of the American
Board of Psychiatry and Neurology and a fellow of the Ameri-
can Academy of Neurology. His research focuses on cognitive
aging, Alzheimer’s disease, and migraine headaches.
Dr Pavlovic is an assistant professor of neurology at the Albert
Einstein College of Medicine. Her research interests broadly
focus on migraine biophenotypes with a particular interest in
processes that lead to the progression from episodic to chronic
migraine.
Dr Roth is the director of Women’s Neurology at Rhode Island
Hospital, and an assistant professor of neurology at the Warren
Alpert Medical School of Brown University. Her specialties and
interests include epilepsy, migraine, and neurological issues in
pregnancy.
Dr Rathier is an associate professor (Clinical) at Alpert Medical
School and the clinical director of Behavioral Medicine Clinical
Services at Lifespan.
Dr Bond is an associate professor (research) of psychiatry and
human behavior at The Miriam Hospital/Brown Alpert Medical
School. One of the principal areas of his research focuses on
enhancing and leveraging understanding of the relationship
between migraine and obesity to inform development of effec-
tive treatments for this comorbidity.
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