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Migraine-with-aura triggers called into question

Saturday January 26, 2013
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Triggers for migraine with aura may not be as strong as some people think, according to a small study.

"People with migraine with aura are told to avoid possible triggers, which may lead them to avoid a wide range of suspected factors," Jes Olesen, MD, who conducted the study out of the University of Copenhagen in Denmark, said in a news release. "Yet the most commonly reported triggers are stress, bright light, emotional influences and physical effort, which can be difficult to avoid and potentially detrimental, if people avoid all physical activity."

The study involved 27 people with migraine with aura who reported that bright or flickering light, vigorous exercise or both previously triggered an attack. The participants were exposed to the triggers to see whether they caused a headache episode.

Participants either went for an intense run or used an exercise bike for an hour, reaching at least 80% of their maximum heart rate. Participants also were exposed to bright, flashing or flickering lights for 30 to 40 minutes. After each session, the participants were monitored for about three hours and asked to report any migraine or migraine with aura symptoms.

The study found that 11% of participants reported a migraine with aura following provocation. Another 11% of participants experienced migraines without aura. No participants developed migraine with aura after light exposure alone.

"Our study suggests that if a person is exposed to a suspected trigger for three months and does not have a migraine attack, they no longer have to worry about avoiding that trigger," said Olesen, a member of the American Academy of Neurology.

Peter Goadsby, MD, PhD, of the University of California, San Francisco, and a member of the American Academy of Neurology, noted in an accompanying editorial that the study raises questions about migraine triggers: "Perhaps rather than triggers, these behaviors are a brain-driven response to the early phases of the migraine itself."

The study is scheduled for publication in the journal Neurology. The study abstract is available at www.neurology.org/content/early/2013/01/23/WNL.0b013e31827f0f10.abstract.


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