Methodological Issues in Studying Trigger Factors and Premonitory Features of Migraine

Lipton, Richard B.; Pavlović, Jelena; Haut, Sheryl R.; Grosberg, Brian M.; Buse, Dawn C.

doi:10.1111/head.12464

Cited by 89 publications

(134 citation statements)

References 79 publications

(184 reference statements)

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“…However, it is difficult to study migraine trigger factors. Several study designs have been proposed, all associated with different limitations and methodological issues [12]. Retrospective studies are common, but include a risk of recall bias.…”

Section: Introductionmentioning

confidence: 99%

Provocation of Migraine after Maximal Exercise: A Test-Retest Study

Varkey¹,

Sveälv

Edin

et al. 2017

Eur Neurol

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Background: Exercise is often recommended in migraine treatment, but strenuous physical activity is also reported as a migraine trigger. The main aim of this study was to evaluate whether migraine can be triggered by a maximal exercise test, using a prospective test-retest method. A secondary aim was to compare the participants who responded to the maximal exercise test with a migraine attack with those who did not suffer a migraine attack after the test. Methods: A total of 19 patients reporting exercise as a potential trigger for their migraines were included in the study. After a baseline period of 1 month with measurements of migraine frequency, a cycle ergometer test until exhaustion was used twice on each patient. Results: A total of 14 patients were test-retested, and of these, 3 reported migraine following both tests, 5 after one of the tests, and 6 did not report migraine after either test. We observed a higher risk of migraine after 1 or 2 tests in patients with a higher baseline migraine frequency (p = 0.036). Conclusion: In conclusion, the study showed that although maximal aerobic exercise can trigger migraine attacks, it does not always provoke an attack even in those who report exercise as a migraine trigger.

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Section: Introductionmentioning

confidence: 99%

Provocation of Migraine after Maximal Exercise: A Test-Retest Study

Varkey¹,

Sveälv

Edin

et al. 2017

Eur Neurol

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“…Understanding the interactions that occur when processing multiple external stimuli and activation of the trigeminal system may help to explain migraine symptoms and mechanisms by which exposure to visual, auditory, and olfactory stimuli can trigger migraine attacks. However, identifying trigger factors or premonitory features that reliably predict headache onset in migraine remains an ongoing clinical challenge (Lipton et al, 2014; Pavlovic et al, 2014). …”

Section: Introductionmentioning

confidence: 99%

Cortico–Cortical Connections of Primary Sensory Areas and Associated Symptoms in Migraine

Hodkinson

Veggeberg

Kucyi

et al. 2016

eNeuro

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Migraine is a recurring, episodic neurological disorder characterized by headache, nausea, vomiting, and sensory disturbances. These events are thought to arise from the activation and sensitization of neurons along the trigemino–vascular pathway. From animal studies, it is known that thalamocortical projections play an important role in the transmission of nociceptive signals from the meninges to the cortex. However, little is currently known about the potential involvement of cortico–cortical feedback projections from higher-order multisensory areas and/or feedforward projections from principle primary sensory areas or subcortical structures. In a large cohort of human migraine patients (N = 40) and matched healthy control subjects (N = 40), we used resting-state intrinsic functional connectivity to examine the cortical networks associated with the three main sensory perceptual modalities of vision, audition, and somatosensation. Specifically, we sought to explore the complexity of the sensory networks as they converge and become functionally coupled in multimodal systems. We also compared self-reported retrospective migraine symptoms in the same patients, examining the prevalence of sensory symptoms across the different phases of the migraine cycle. Our results show widespread and persistent disturbances in the perceptions of multiple sensory modalities. Consistent with this observation, we discovered that primary sensory areas maintain local functional connectivity but express impaired long-range connections to higher-order association areas (including regions of the default mode and salience network). We speculate that cortico–cortical interactions are necessary for the integration of information within and across the sensory modalities and, thus, could play an important role in the initiation of migraine and/or the development of its associated symptoms.

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“…In part, this variability may reflect the variability in the symptomatology of preictal phase. To reduce such variability, the methodology to be used for assessing the prodromal symptoms should be considered carefully [15].…”

Section: Prevalencementioning

confidence: 99%

Preictal Symptomatology in Migraines: Diagnostic and Therapeutic Significance

Gupta¹,

Gupta²

2015

Journal of Headache &Amp; Pain Management

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Prodrome and aura constitute preictal symptomatology of migraines. The objective of this clinical review is to examine the diagnostic and therapeutic significance of preictal symptomatology in children with migraines. The systemic review of the literature identified a single study in children with migraines. The majority studies were in adults. Based on our search and longitudinal clinical observation, we describe the clinical characteristics of diagnostic and therapeutic significance of preictal symptoms and various types of auras in migraines. Such significance can be substantially increased by including prodromal physical signs in children with migraines. Future studies' methodology should include physical signs in addition to symptoms and identify the spectrum of the various auras, and relate to their temporal association with ictal and postictal phases of migraines. In addition these clinical parameters should be statistically analyzed.

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Methodological Issues in Studying Trigger Factors and Premonitory Features of Migraine

Cited by 89 publications

References 79 publications

Provocation of Migraine after Maximal Exercise: A Test-Retest Study

Provocation of Migraine after Maximal Exercise: A Test-Retest Study

Cortico–Cortical Connections of Primary Sensory Areas and Associated Symptoms in Migraine

Preictal Symptomatology in Migraines: Diagnostic and Therapeutic Significance

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