Abstract text (incl. figure legends and references)

Objectives: To compare the difference in burden- symptom, functional, social, economic & quality of life (QoL) of migraine among Indian male & female patients.

Methods: A cross-sectional survey was conducted from 20th April 2022 – 21st June 2022 in 300 adult male and female (1:1) migraine patients. Survey questionnaire was validated by a steering committee of 10 Indian neurologists. Data was collected by using telephonic and face to face interview mode. The results were analyzed using descriptive statistics

Results: Average number of migraine symptoms was higher in females (F) Vs males (M). [5.73 (F); 4.73%(M)]; fatigue [59% (F); 37%(M)] abdominal pain [29% (F); 11%(M)] & stomach upset [21% (F); 11%(M)]. Higher proportion of females had triggers like stress [80% (F); 76%(M)] & physical activity [56% (F); 44%(M)]. Average duration of migraine attack was higher in females [5.8 hours (F); 5.3 hours (M)] with higher comorbidities like anxiety [24% (F); 18%(M)] & obesity [23% (F); 17%(M)]. Higher proportion of females reported that migraine impacted their social & personal life [80.6% (F); 30.6 (M)]. While there was no difference in the direct costs associated with migraine; indirect costs were higher in females (INR 9100) Vs males (INR 8367). More number of working days were lost due to migraine in females than that in males. [3.7 (F); 2.2 (M)].

Conclusion: Magnitude of migraine burden in terms of symptoms, functional, social and economic burden among females is higher than that in males in India. Customized approach towards migraine care for females comprising of counselling, lifestyle modification, trigger management & early use of targeted pharmacotherapy would improve clinical outcomes.

Key words: Migraine; Burden; Gender; Targeted approach