Provocation of migraine with aura using natural trigger factors

TY - JOUR

T1 - Provocation of migraine with aura using natural trigger factors

AU - Hougaard, Anders

AU - Amin, Faisal

AU - Hauge, Anne Werner

AU - Ashina, Messoud

AU - Olesen, Jes

PY - 2013/1/29

Y1 - 2013/1/29

N2 - Objective: It is well-known that migraine attacks can be precipitated by various stimuli. More than 50%of patients withmigraine 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 selfreported 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.

AB - Objective: It is well-known that migraine attacks can be precipitated by various stimuli. More than 50%of patients withmigraine 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 selfreported 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.

U2 - 10.1212/WNL.0b013e31827f0f10

DO - 10.1212/WNL.0b013e31827f0f10

M3 - Journal article

C2 - 23345632

SN - 0028-3878

VL - 80

SP - 428

EP - 431

JO - Neurology

JF - Neurology

IS - 5

ER -