Provocation of migraine with aura using natural trigger factors

Hougaard, Anders; Amin, Faisal Mohammad; Hauge, Anne Werner; Ashina, Messoud; Olesen, Jes

doi:10.1186/1129-2377-14-s1-p110

Cited by 26 publications

(47 citation statements)

References 2 publications

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“…A study of migraine aura provocation using bright lights and strenuous exercise, in patients who recognised these stimuli as consistent trigger factors, reported triggering of aura in 3 out of 27 provoked patients. 46 Migraine aura provocation using normobaric hypoxia-induced definite aura in 3 out of 15 patients, and an additional 4 possible aura cases. 47 While these non-pharmacological methods could potentially be optimized to induce aura symptoms more frequently, they do not provide an explanation of the link between vascular irritation (eg, carotid puncture) and migraine aura.…”

Section: Discussionmentioning

confidence: 99%

Intravenous Endothelin‐1 Infusion Does Not Induce Aura or Headache in Migraine Patients With Aura

et al. 2020

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Objective To investigate whether intravenously infused provokes migraine aura and migraine headache in migraine patients with aura. Background Migraine with aura has been associated with endothelial dysfunction and increased stroke risk. The initiating mechanism of migraine aura symptoms is not known. Experimental provocation of migraine headache using vasoactive peptides has provided tremendous advances in the understanding of migraine pathophysiology but substances that can induce migraine aura have not been identified. Endothelin‐1 (ET‐1), an endogenous, potent vasoconstrictor peptide released from the vascular endothelium, has been proposed to trigger migraine aura. This hypothesis is based on reports of increased plasma ET‐1 levels early during the migraine attacks and the observation that ET‐1 applied to the cortical surface potently induces the cortical spreading depolarization, the underlying electrophysiological phenomenon of migraine aura, in animals. Further, endothelial damage due to, for example, carotid puncture and vascular pathology is known to trigger aura episodes. Methods We investigated whether intravascular ET‐1 would provoke migraine aura in patients. Using a two‐way crossover, randomized, placebo‐controlled, double‐blind design, we infused high‐dose (8 ng/kg/minutes for 20 minutes) intravenous ET‐1 in patients with migraine with typical aura. The primary end‐point was the difference in incidence of migraine aura between ET‐1 and placebo. Experiments were carried out at a public tertiary headache center (Danish Headache Center, Rigshospitalet Glostrup, Denmark). Results Fourteen patients received intravenous ET‐1. No patients reported migraine aura symptoms or migraine headache during or up to 24 hours following the ET‐1 infusion. Four patients reported mild to moderate headache only on the ET‐1 day, 3 patients reported moderate headache on the placebo day, and 1 patient reported mild headache on both days. No serious adverse events occurred during or after infusion. Conclusions Provocation of migraine aura by procedures or conditions involving vascular irritation is unlikely to be mediated by ET‐1.

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Section: Discussionmentioning

confidence: 99%

Intravenous Endothelin‐1 Infusion Does Not Induce Aura or Headache in Migraine Patients With Aura

et al. 2020

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“…In a study by Hougaard et al, people with migraine were exposed to their selfreported triggers, such as bright or flickering lights or strenuous exercise. 33 He found that exposure was followed by headache in only 10% of patients.…”

Section: Retrospective Surveys Of Trigger Factorsmentioning

confidence: 99%

“…However, studies of low intensity migraine triggers that are common in daily life have led to mixed results in experimental studies. 7,33,[43][44][45][46][47][48][49] For example, of the 3 randomized trials of chocolate as migraine trigger, 2 were negative, 50,51 while 1 was positive. 52 Studies of aspartame, a chemical sugar substitute, had mixed results.…”

Section: Clinical Trials -Trigger Factorsmentioning

confidence: 99%

Trigger Factors and Premonitory Features of Migraine Attacks: Summary of Studies

et al. 2014

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We conclude that trigger factors and premonitory symptoms are very common, but that the frequency estimates vary widely based on the study approach and population. We recommend that multimodal approaches are necessary for the comprehensive study of predictive biophenotypes as determined by triggers and premonitory symptoms, including retrospective and prospective cohort studies and case-crossover studies.

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“…Some studies used the patients' self-report which is assessed retrospectively and may therefore suffer from recall bias; others used predetermined lists of assumed triggers [1,2,5]. Few examinations were based on headache diaries [5,[8][9][10] or on experimental designs [5,11,12].…”

Section: Introductionmentioning

confidence: 99%

Reliability of assessing lifestyle and trigger factors in patients with migraine – findings from the PAMINA study

Zebenholzer

Frantal

Pablik

et al. 2015

Euro J of Neurology

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Provocation of migraine with aura using natural trigger factors

Cited by 26 publications

References 2 publications

Intravenous Endothelin‐1 Infusion Does Not Induce Aura or Headache in Migraine Patients With Aura

Intravenous Endothelin‐1 Infusion Does Not Induce Aura or Headache in Migraine Patients With Aura

Trigger Factors and Premonitory Features of Migraine Attacks: Summary of Studies

Reliability of assessing lifestyle and trigger factors in patients with migraine – findings from the PAMINA study

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