Translation and validation of the Migraine Interictal Burden Scale (MIBS-4) in an Italian clinical cohort

The Migraine Interictal Burden Scale (MIBS-4) is a brief validated patient-reported measure of migraine interictal impact; however, an official Italian translation is not currently available. The MIBS-4 was translated and culturally adapted into Italian language and psychometrically evaluated in adults with episodic or chronic migraine enrolled in the Italian Headache Registry (RICe). In a 4-week test–retest design, participants completed the Italian version of MIBS-4 and the Migraine Disability Assessment (MIDAS) at baseline (T0) and at follow up (T1). We assessed internal consistency, dimensionality, test–retest reliability, convergent validity, and known-groups validity across MIDAS disability grades. A total of 191 patients with migraine were included in test–retest analyses. Internal consistency was good to excellent (Cronbach’s α = 0.86 at T0; 0.90 at T1; ordinal α = 0.91–0.94; McDonald’s ω = 0.88–0.91). Parallel analysis supported a stable one-factor solution at both timepoints. Item-level agreement was moderate (weighted κ = 0.45–0.60; all p < 0.001), as was the total-score stability (ICC[A,1] = 0.62, 95% CI 0.50–0.72). Convergent validity with MIDAS was moderate (ρ = 0.40 at T0; ρ = 0.33 at T1; both p < 0.001). The present findings indicate that the Italian MIBS-4 is psychometrically robust and captures a dimension of migraine burden that is only partially explained by conventional attack-focused disability measures. The Italian version of MIBS-4 provides a reliable instrument for quantifying interictal burden in Italian-speaking migraine individuals, enabling a more comprehensive evaluation of migraine and supporting individualized management.