Calcitonin Gene‐Related Peptide ( <scp>CGRP</scp> ) Levels of Children and Adolescents With Migraine: A Systematic Review and Meta‐Analysis of Observational Studies
Bibliographic record
Abstract
BACKGROUND AND OBJECTIVE: Although calcitonin gene-related peptide (CGRP) has emerged as a promising therapeutic target in migraine management, current clinical evidence regarding its dynamic variations in paediatric migraine populations remains inconclusive. We conducted a meta-analysis to explore the relationship between blood CGRP levels and paediatric migraine. DATABASES AND DATA TREATMENT: We systematically searched for observational studies that reported CGRP levels in paediatric migraine published in English from the PubMed, Web of Science, and Embase electronic databases, or in Chinese from the Chinese National Knowledge Infrastructure and the WanFang Med database. The Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of the included studies. The quality of evidence for each outcome was assessed according to the Grading of Recommendations, Assessment, Development, and Evaluation guidelines. RESULTS: Of the 1134 identified studies, eight were eligible for inclusion. There was a 'Moderate' level of evidence demonstrating significantly elevated CGRP levels in children with migraine compared to controls (standardised mean difference [SMD] = 1.44, 95% CI 0.61-2.31). Stratification analysis showed the 'Low' level of evidence revealed higher levels during both ictal (SMD = 2.39, 95% CI 0.59-4.19) and interictal phases (SMD = 1.27, 95% CI 0.54-1.99). 'Very low' quality of evidence supported paediatric migraine patients with (SMD = 1.47, 95% CI 0.67-2.27) and without (SMD = 1.11, 95% CI 0.50-1.72) aura had higher CGRP levels than non-migraine controls. CONCLUSIONS: Our findings suggest that CGRP levels may be a potential diagnostic biomarker and prophylactic therapeutic target for paediatric migraine, but need high-quality longitudinal studies to validate. SIGNIFICANCE STATEMENT: This systematic review and meta-analysis provides significant evidence that CGRP levels serve as a potential diagnostic biomarker for migraine in children and adolescents. Future research should further explore the diagnostic value of CGRP levels in this population. However, the current evidence does not confirm CGRP as an acute-phase therapeutic target for pediatric and adolescent migraine, necessitating validation through higher-quality studies. TRIAL REGISTRATION: PROSPERO number: CRD42025635332.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.036 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.016 | 0.032 |
| Bibliometrics | 0.006 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".