OBJECTIVE: It is well-known that migraine attacks can be precipitated by various stimuli. More than 50% of patients with migraine with aura (MA) know of at least one stimulus that always or often triggers their MA attacks. The objective of this study was to expose patients with MA to their self-reported trigger factors in order to assess the causal relation between trigger factors and attacks. METHODS: We recruited 27 patients with MA who reported that bright or flickering light or strenuous exercise would trigger their migraine attacks. The patients were experimentally provoked by different types of photo stimulation, strenuous exercise, or a combination of these 2 factors. During and following provocation, the patients would report any aura symptoms or other migraine-related symptoms. RESULTS: Of 27 provoked patients with MA, 3 (11%) reported attacks of MA following provocation. An additional 3 patients reported migraine without aura attacks. Following exercise, 4 out of 12 patients reported migraine, while no patients developed attacks following photo stimulation. CONCLUSION: Experimental provocation using self-reported natural trigger factors causes MA only in a small subgroup of patients with MA. Prospective confirmation is important for future studies of migraine trigger factors and in the clinical management of patients with migraine.
OBJECTIVE: It is well-known that migraine attacks can be precipitated by various stimuli. More than 50% of patients with migraine with aura (MA) know of at least one stimulus that always or often triggers their MA attacks. The objective of this study was to expose patients with MA to their self-reported trigger factors in order to assess the causal relation between trigger factors and attacks. METHODS: We recruited 27 patients with MA who reported that bright or flickering light or strenuous exercise would trigger their migraine attacks. The patients were experimentally provoked by different types of photo stimulation, strenuous exercise, or a combination of these 2 factors. During and following provocation, the patients would report any aura symptoms or other migraine-related symptoms. RESULTS: Of 27 provoked patients with MA, 3 (11%) reported attacks of MA following provocation. An additional 3 patients reported migraine without aura attacks. Following exercise, 4 out of 12 patients reported migraine, while no patients developed attacks following photo stimulation. CONCLUSION: Experimental provocation using self-reported natural trigger factors causes MA only in a small subgroup of patients with MA. Prospective confirmation is important for future studies of migraine trigger factors and in the clinical management of patients with migraine.
Authors: Richard B Lipton; Dawn C Buse; Charles B Hall; Howard Tennen; Tiffani A Defreitas; Thomas M Borkowski; Brian M Grosberg; Sheryl R Haut Journal: Neurology Date: 2014-03-26 Impact factor: 9.910
Authors: Elizabeth Mostofsky; Murray A Mittleman; Catherine Buettner; Wenyuan Li; Suzanne M Bertisch Journal: Am J Med Date: 2019-08-08 Impact factor: 4.965
Authors: Elizabeth Mostofsky; Suzanne M Bertisch; Angeliki Vgontzas; Catherine Buettner; Wenyuan Li; Michael Rueschman; Murray A Mittleman Journal: Ann Med Date: 2020-04-29 Impact factor: 4.709
Authors: Markus A Dahlem; Sebastian Rode; Arne May; Naoya Fujiwara; Yoshito Hirata; Kazuyuki Aihara; Jürgen Kurths Journal: Transl Neurosci Date: 2013-09 Impact factor: 1.757
Authors: Megan B Irby; Dale S Bond; Richard B Lipton; Barbara Nicklas; Timothy T Houle; Donald B Penzien Journal: Headache Date: 2015-12-08 Impact factor: 5.887