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Migraine Affects 1.3 Billion People Worldwide as Portugal Faces Diagnosis Gap

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About 1.3 billion people worldwide live with migraine, making it one of the most common neurological disorders and a major cause of disability, while many patients continue to go without a formal diagnosis or adequate medical care.

In Portugal, migraine is estimated to affect around two million people. Research by The Work Foundation, involving researchers from Lancaster University, found that about 24% of women and 13% of men in the country experience migraines.

Women are particularly affected by the condition, which can interfere with work, education and daily activities. A recent study by the European Migraine & Headache Alliance found that 92% of women with migraine in Portugal reported that the condition had prevented them from working, studying or carrying out normal activities for at least one day.

Migraine attacks can involve more than severe headaches. Patients may experience nausea and vomiting, sensitivity to light, sounds and smells, difficulty concentrating and slowed thinking.

Despite the scale of the problem, migraine remains underdiagnosed. A national consensus published in 2025 estimated that about 40% of people experiencing headaches in Portugal do not receive medical follow-up. Among those who do seek care, more than half use private healthcare services.

The same document estimated that about 1.5 million people in Portugal could benefit from medical follow-up for headaches, with around 90% potentially being treated through primary healthcare.

The European Migraine & Headache Alliance study found that 42% of women with symptoms consistent with migraine had never received a medical diagnosis. It also found that 33.6% of people with migraine had never consulted a doctor, while 72.4% relied on self-medication.

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“These figures confirm that migraine continues to be underestimated and that access to appropriate treatment is still a challenge for many people in our country,” said Isabel Pireza, chair of the General Assembly of MiGRA Portugal, the Portuguese Association of Migraine and Headache Patients.

The condition can also have significant consequences in the workplace. Research among employees of Portuguese companies found episodes of absenteeism and reduced productivity during attacks. Among workers with headache-related conditions who said they completed less than half of the work planned during an episode, 29% had migraine.

Filipe Palavra, president of the Portuguese Headache Society, said migraine could affect family, social, educational and professional life beyond its most recognised symptom of headache.

He said recognising symptoms and obtaining an accurate diagnosis were important for helping patients receive appropriate treatment and improve their quality of life.

MiGRA Portugal said many people continue to regard persistent migraine pain as something they simply have to endure. The organisation is urging people experiencing recurring symptoms to seek medical advice rather than relying solely on self-medication.

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Birdwatching Offers New Approach to Stroke Recovery for People With Aphasia

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Birdwatching is being explored as a way to help stroke survivors practise communication and rebuild social connections, with researchers at the University of Montana using encounters with birds as part of an intensive aphasia rehabilitation programme.

The approach centres on people living with aphasia, a condition that can affect speaking, understanding speech, reading and writing after a stroke. Researchers say about one-third of stroke survivors develop aphasia, which can make ordinary conversations and social interaction difficult even when a person’s thinking and intellectual abilities remain unchanged.

“Aphasia is an identity theft,” said Catherine Off, a University of Montana researcher and co-director of the university’s Intensive Comprehensive Aphasia Program. She said people with aphasia remain themselves cognitively, but changes in language function can make communication difficult.

The programme typically runs four days a week for four weeks, providing about 80 hours of rehabilitation. Each participant is paired with a trained communication partner, often a graduate student studying speech-language pathology. Avian ecologists guide the bird-related activities and provide information about species and their behaviour.

Rather than keeping communication within a conventional therapy room, the programme uses birdwatching as a reason for participants to interact with others and communicate about something they find interesting.

“Communication function doesn’t improve until you want to communicate about something,” Off said. “We’re out of the therapy room now. We’re saying: Enjoy being with people, enjoy being outside and let the communication come.”

Birdwatching can also allow people to communicate without relying entirely on speech. Participants may point toward birds, draw pictures, look at photographs or use other gestures to share what they see. Researchers say these forms of interaction can help people remain socially involved when verbal communication is limited.

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The work was described in a paper published in Frontiers in Bird Science. The researchers stressed that the approach is still at a conceptual stage and that more formal clinical research is needed to determine whether it produces lasting improvements in communication and quality of life.

The researchers said the need for accessible stroke rehabilitation is expected to grow as the number of people affected by stroke increases. Stroke remains a major cause of death and disability worldwide, while more people are surviving strokes and living with long-term effects.

Access to high-quality prevention, emergency treatment and rehabilitation is also uneven, according to the researchers. They suggest birdwatching could offer a relatively flexible activity because participation can take place in different settings and at varying levels of physical ability.

Victoria Dreitz, an avian ecologist in the university’s Wildlife Biology Program, said people can begin simply by observing birds from a window or looking at species in their own gardens.

The researchers see that flexibility as an important part of the activity, allowing stroke survivors to participate according to their abilities while creating opportunities for communication, social interaction and time outdoors.

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More Europeans Take Up Sport, but Major Gaps Remain Across Countries

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More Europeans are exercising regularly than they were four years ago, but participation continues to vary sharply depending on where people live, their age, education and financial circumstances, according to a new European Commission survey.

The latest Eurobarometer survey on sport and physical activity found that 39% of respondents said they never exercise or play sport, down from 45% in 2022. Nearly half of the 26,508 people surveyed said they exercise or play sport every day or several times a week.

The results also showed wide differences between countries. Finland recorded the highest share of people exercising daily, at 21%, followed by Denmark at 20%. In both countries, another 59% of respondents said they exercise several times a week.

At the other end of the scale, 68% of respondents in Portugal said they never exercise or play sport. Greece and Romania followed, with 66% in each country reporting that they never take part in sport or exercise.

Time was the most commonly cited barrier among people who wanted to exercise more, with 37% identifying it as an obstacle. A lack of motivation or interest was mentioned by 26%, while 15% pointed to health problems or injury. Cost was cited by 12%.

Education and household finances were also closely linked to participation. Some 59% of people who continued their education until at least the age of 20 said they exercise or play sport several times a week. That compared with 23% among those who left education at 15 or younger.

Financial circumstances showed a similar divide. People who said they had the greatest difficulty paying their bills were twice as likely to report never exercising as those who rarely or never faced financial difficulties, at 54% compared with 26%.

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“More Europeans are getting active, but the opportunity to take part still depends too much on income, age and education,” said Roxana Mînzatu, Executive Vice-President for Social Rights and Skills, Quality Jobs and Preparedness.

The survey also highlighted a significant age gap. Nearly three-quarters of people aged 15 to 24 exercise or play sport at least several times a week, compared with 25% of those aged 75 and over. Health problems or injury were the main barrier for older respondents, while younger and middle-aged people were more likely to cite a lack of time.

Physical activity linked to everyday life also increased. Active commuting rose from 24% in 2022 to 37%, while 72% of respondents said they now walk for at least 10 minutes at a time.

The survey found, however, that some Europeans do not consider their neighbourhoods suitable for walking or cycling, potentially restricting opportunities for active travel.

Mînzatu said affordable sport and safe places to exercise should be available close to where people live, including for children from families unable to afford club fees, older people and those with disabilities.

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Congenital Infections Linked to Higher Risks of Autism and Intellectual Disability

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Children born with certain infections acquired during pregnancy face substantially higher risks of autism and intellectual disability later in life, according to a study of more than 3.7 million people in Sweden.

Researchers found that children with congenital infections were about three times more likely to be diagnosed with autism and more than seven times more likely to receive a diagnosis of intellectual disability than those without such infections.

The findings suggest that infections transmitted from a pregnant woman to her foetus may have lasting effects on brain development, although the study identifies an association rather than proving that the infections directly cause autism or intellectual disability.

The research focused on TORCH infections, a group that includes syphilis, rubella, toxoplasmosis, cytomegalovirus and herpesvirus. These infections can cross the placenta and affect the developing foetus, potentially increasing the risk of miscarriage, stillbirth and other pregnancy complications.

“Although these congenital infections are rare, some of them can be prevented, which makes them important from a public health perspective,” said Reneé Gardner of the Department of Global Public Health at Karolinska Institutet, who contributed to the study.

The researchers examined people born in Sweden between 1987 and 2021 and followed them for up to 30 years. Among the 3.7 million participants, 975 had been diagnosed with a congenital TORCH infection.

Although congenital infections accounted for only a small proportion of autism cases across the population, the risk among affected children was considerably higher. The researchers estimated that about one in five children born with a TORCH infection could later develop autism.

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The study also found elevated risks of intellectual disability across different levels of severity. The risk of severe to profound intellectual disability was as much as 30 times higher among children with a congenital infection than among those without one.

The researchers found evidence of an impact on educational outcomes even among people who were not diagnosed with autism or intellectual disability. A total of 420 participants with a TORCH infection showed poor school performance without receiving either diagnosis.

Congenital cytomegalovirus, or CMV, is the most common of these infections globally and affects roughly one in 150 newborns. Its burden is substantially greater in low- and middle-income countries.

The researchers said the findings highlight the importance of prevention, particularly in regions where these infections are more common. They pointed to vaccination programmes and other preventive measures as important tools for reducing congenital infections.

They also called for improved identification of affected newborns. Current screening systems, including those used in Sweden, may miss asymptomatic infections because universal screening for TORCH infections is not routinely carried out.

The authors said stronger screening and prevention strategies could help identify children at risk earlier and improve long-term support and care.

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