Migraine Triggers Not As Powerful As We Think

Date: Jan-24-2013Migraine with aura triggers may not be as powerful as most people think.

The finding came from new research published in the journal Neurology, the medical journal of the American Academy of Neurology.

Migraine with aura refers to migraine headaches that are preceded by visual disturbances and other sensory symptoms, such as:
flashing lights
numbness
wavy lines
tingling of the hands and face
smell distortion

A recent study indicated that women with migraine with aura are at increased risk of stroke and heart attack, while a different report found that people with migraine with aura are more likely to develop brain lesions later in life.

Researcher Jes Olesen, MD, from the University of Copenhagen in Denmark and a Fellow of the American Academy of Neurology, explained:

"People with migraine with aura are told to avoid possible triggers, which may lead them to avoid a wide range of suspected factors. 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."

There were 27 people affected by migraine with aura who participated in the research. All subjects reported that an attack had previously been triggered by strenuous exercise, bright or flickering light, or both.

In order to determine whether these triggers actually caused a headache episode, the participants were exposed to them in the study.

The subjects either used an exercise bike or went for an intense run for 60 minutes, which pushed them to over 80% of their maximum pulse rate. For 30 to 40 minutes, they were also exposed to bright, flickering, or flashing lights.

The participants were observed for three hours following each session and were asked about any symptoms of migraine or migraine with aura.

Results showed that 11% of them reported having a migraine with aura after exercising or seeing the bright, flickering, or flashing lights. Migraines without aura affected another 11%.

"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," Olesen said.

In an accompanying editorial, Peter Goadsby, MD, PhD, with the University of California, San Francisco, and a member of the American Academy of Neurology, said that the research stirs up many questions about migraine triggers.

The authors wrote in the editorial:

"Perhaps rather than triggers, these behaviors are a brain-driven response to the early phases of the migraine itself. Maybe people are driven to exercise as an early symptom and the association with light is simply the sensitivity to light that occurs with the attack itself?"

The report was supported by the Lundbeck Foundation Center for Neurovascular Signalling, the Novo Nordisk Foundation, the University of Copenhagen, the Danish Council for Independent Research-Medical Sciences, and the Research Foundation of the Capital Region of Denmark.

Written by Sarah Glynn

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