Premonitory symptoms in migraine from China: A multi-clinic study of 4821 patients

Wang, Xiaolin; Yin, Ziming; Lian, Yajun; Xu, Yan; Li, Yajie; Liu, Jiale; Gu, Qun; Yan, Fei; Ge, Zhaoli; Lian, Yu; Hu, Dongmei; Chen, Sufen; Wang, Rongfei; Chen, Xiaoyan; Liu, Jing; Zhang, Mingjie; Ye, Ran; Zhou, Ping; Ma, Jingyi; Li, Xudong; Dong, Zhao; Yu, Shengyuan

doi:10.1177/0333102421997850

Cited by 21 publications

(18 citation statements)

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“…There is speculation that some triggers may represent other premonitory symptoms, which can induce and accelerate the headache transformation process. Other triggers may induce brain dysfunction, making patients more prone to headache attacks [ 14 ]. Among CH patients in our study, the strong association between triggers and PAS also supports this speculation that triggers may prompt brain dysfunction in the pre-attack phase.…”

Section: Discussionmentioning

confidence: 99%

Pre-attack and pre-episode symptoms in cluster headache: a multicenter cross-sectional study of 327 Chinese patients

Sun

Xue³

et al. 2022

J Headache Pain

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Background There have been a few studies regarding the pre-attack symptoms (PAS) and pre-episode symptoms (PES) of cluster headache (CH), but none have been conducted in the Chinese population. The purpose of this study was to identify the prevalence and features of PAS and PES in Chinese patients, as well as to investigate their relationships with pertinent factors. Methods The study included patients who visited a tertiary headache center and nine other headache clinics between January 2019 and September 2021. A questionnaire was used to collect general data and information about PAS and PES. Results Among the 327 patients who met the CH criteria (International Classification of Headache Disorders, 3rd edition), 269 (82.3%) patients experienced at least one PAS. The most common PAS were head and facial discomfort (74.4%). Multivariable logistic regression analysis depicted that the number of triggers (OR = 1.798, p = 0.001), and smoking history (OR = 2.067, p = 0.026) were correlated with increased odds of PAS. In total, 68 (20.8%) patients had PES. The most common symptoms were head and facial discomfort (23, 33.8%). Multivariable logistic regression analysis showed that the number of triggers were associated with increased odds of PES (OR = 1.372, p = 0.005). Conclusions PAS are quite common in CH patients, demonstrating that CH attacks are not comprised of a pain phase alone; investigations of PAS and PES could help researchers better understand the pathophysiology of CH.

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Section: Discussionmentioning

confidence: 99%

Pre-attack and pre-episode symptoms in cluster headache: a multicenter cross-sectional study of 327 Chinese patients

Sun

Xue³

et al. 2022

J Headache Pain

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“…Sensory hypersensitivity to stimuli is most prominent during headache attacks but may also be present during interictal periods [2]. Beyond merely accompanying headache attacks, hypersensitivities to light, sound, and smell have also been reported as premonitory symptoms or triggers before a headache attack [10]. This observation suggests that these sensory hypersensitivity symptoms may reflect abnormal brain activity at the earliest stage of a migraine attack in the absence of pain [11].…”

Section: Discussionmentioning

confidence: 99%

Investigating the relationships between the burden of multiple sensory hypersensitivity symptoms and headache-related disability in patents with migraine

Suzuki

Shiina

et al. 2021

J Headache Pain

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Objective Sensory hypersensitivities such as photophobia, phonophobia, and osmophobia are common in patients with migraine. We investigated the burden of these multiple sensory hypersensitivities in migraine. Methods In this cross-sectional study, 187 consecutive patients with migraine (26 men/161 women; age, 45.9 ± 13.2 years) were included. Sensory hypersensitivity symptoms such as photo−/phono−/osmophobia and accompanying symptoms were determined by neurologists in interviews. The Migraine Disability Assessment (MIDAS) was used to assess headache-related disability. The Kessler Psychological Distress Scale (K6) was also administered. Results Photophobia, phonophobia and osmophobia were observed in 75.4%, 76.5% and 55.1% of the patients with migraine, respectively. A significant overlap in sensory hypersensitivities (photo−/phono−/osmophobia) was found; the proportions of patients with 2 and 3 coexisting sensory hypersensitivities were 33.2% and 41.7%, respectively. The MIDAS score was higher in those with 3 sensory hypersensitivity symptoms than in those with 0 to 2 sensory hypersensitivity symptoms. A generalized linear model with ordinal logistic regression analysis revealed that multiple sensory hypersensitivities, younger age, more migraine days per month, and a higher K6 score were significantly related to the higher MIDAS score. Conclusion Our study showed that sensory hypersensitivities commonly occur and overlap in patients with migraine and that multiple sensory hypersensitivity symptoms have a significant impact on headache-related disability.

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“…The premonitory phase has been studied in some detail in the literature over the years, in both adults and children, with a variety of study designs and patient populations ( Blau, 1980 ; Drummond and Lance, 1984 ; Waelkens, 1985 ; Rasmussen and Olesen, 1992 ; Russell et al, 1996 ; Giffin et al, 2003 ; Kelman, 2004 ; Quintela et al, 2006 ; Schoonman et al, 2006 ; Cuvellier et al, 2009 ; Guo et al, 2016 ; Karsan et al, 2016 , 2020b ; Laurell et al, 2016 ; Jacobs and Pakalnis, 2019 ; Onderwater et al, 2020 ; Wang et al, 2021 ). While some studies have looked at prevalence and the ability of these symptoms to predict impending headache, others have focused on phenotype.…”

Section: Non-painful Symptoms In Migraine (Ictally During Any Phase or Interictally)mentioning

confidence: 99%

Migraine Is More Than Just Headache: Is the Link to Chronic Fatigue and Mood Disorders Simply Due to Shared Biological Systems?

Karsan

Goadsby

2021

Front. Hum. Neurosci.

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Migraine is a symptomatically heterogeneous condition, of which headache is just one manifestation. Migraine is a disorder of altered sensory thresholding, with hypersensitivity among sufferers to sensory input. Advances in functional neuroimaging have highlighted that several brain areas are involved even prior to pain onset. Clinically, patients can experience symptoms hours to days prior to migraine pain, which can warn of impending headache. These symptoms can include mood and cognitive change, fatigue, and neck discomfort. Some epidemiological studies have suggested that migraine is associated in a bidirectional fashion with other disorders, such as mood disorders and chronic fatigue, as well as with other pain conditions such as fibromyalgia. This review will focus on the literature surrounding alterations in fatigue, mood, and cognition in particular, in association with migraine, and the suggested links to disorders such as chronic fatigue syndrome and depression. We hypothesize that migraine should be considered a neural disorder of brain function, in which alterations in aminergic networks integrating the limbic system with the sensory and homeostatic systems occur early and persist after headache resolution and perhaps interictally. The associations with some of these other disorders may allude to the inherent sensory sensitivity of the migraine brain and shared neurobiology and neurotransmitter systems rather than true co-morbidity.

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Premonitory symptoms in migraine from China: A multi-clinic study of 4821 patients

Cited by 21 publications

References 50 publications

Pre-attack and pre-episode symptoms in cluster headache: a multicenter cross-sectional study of 327 Chinese patients

Pre-attack and pre-episode symptoms in cluster headache: a multicenter cross-sectional study of 327 Chinese patients

Investigating the relationships between the burden of multiple sensory hypersensitivity symptoms and headache-related disability in patents with migraine

Migraine Is More Than Just Headache: Is the Link to Chronic Fatigue and Mood Disorders Simply Due to Shared Biological Systems?

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