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

Zebenholzer, Karin; Frantal, Sophie; Pablik, Eleonore; Lieba‐Samal, Doris; Salhofer‐Polanyi, Sabine; Wöber‐Bingöl, Çiçek; Wöber, Christian

doi:10.1111/ene.12817

Cited by 24 publications

(23 citation statements)

References 17 publications

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“…Surprise Is Not Just Change in Triggers.-While, historically, most literature has focused on the association of trigger presence with a migraine attack, [31][32][33][34] several studies have highlighted the predictive utility of calculating changes in trigger experiences from yesterday to today. [35][36][37][38][39][40] For example, Lipton et al 37 examined the impact of change in stress by analyzing 771 sets of observations and presenting the change scores of stress from one night to the next in association with onset of migraine attack over the next 24 hours.…”

Section: -Associations Between Total Mood Disturbance and Future Headmentioning

confidence: 99%

Headache Triggers as Surprise

et al. 2019

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Objectives To examine the hypothesis that surprising experiences of headache triggers are associated with daily headache activity. Background Little is known about the specific environmental or behavioral interactions that might trigger a headache attack in a prone individual. We propose that headache trigger exposures can be usefully characterized, not only by their mechanisms of action, but also on the degree of “surprise” they present to the individual. This hypothesis is based on elements of information theory: that unusual events and experiences carry more information than common events and experiences and that headache attacks are associated with reactions to uncommon or unexpected biopsychosocial exposures. Methods A secondary analysis of the Headache Prediction Study, this prospective cohort study followed N = 95 individuals with episodic migraine who contributed 4195 days of diary data. Information was collected on daily levels of several common headache triggers: number of caffeinated beverages, number of alcoholic beverages, stress (Daily Stress Inventory), and mood disturbance (Profile of Mood States). The probability of observing variations in each trigger was used to estimate the “surprisal” of experiencing each trigger, and this information, measured in bits, was used to predict headache attacks. Results Participants experienced a headache attack on 1613 of 4195 days (38.5%). Each of the triggers was modestly related to the probability of experiencing a future headache in a complex manner that involved interactions between current headache status, current levels of the trigger, and lagged (previous) levels of the trigger. However, when expressed as a surprisal, the associations were simplified and strengthened. For example, each of the individual trigger surprisals exhibited a meaningful association with the development of a future headache attack (expressed as a 1 SD change in surprisal), with odds ratios ranging from a low of 1.11 (95%CI: 1.00 to 1.24) for alcohol to a high of 1.30 (95%CI: 1.14 to 1.46) for stress. The individual surprisals could be summed for total trigger surprise and exhibited a reliable association with new onset headache, OR 1.35 (95%CI: 1.17 to 1.49). This score exhibited superior discrimination between headache and non‐headache days from all of the individual triggers (ignoring base rate, AUC: 0.61; AUC: 0.71 with base rate). Conclusions Diverse headache triggers can be uniformly described using their probability distributions. Rare values of headache triggers, or surprising values, were found to have consistent associations with headache activity across a variety of triggers. This finding, if validated in external data using other triggers, has potential to be used to conceptualize the influence of a wide range of headache triggers.

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Section: -Associations Between Total Mood Disturbance and Future Headmentioning

confidence: 99%

Headache Triggers as Surprise

et al. 2019

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“…Comparisons of studies reporting trigger factors are difficult to perform due to variable study designs and definitions . Additionally, the tendency to overestimate or underestimate impact of trigger factors in retrospective studies should be taken into account . Furthermore, it is difficult to separate the effect of sunlight or other bright light exposure from the impact of seasonal variation in this retrospective designed study.…”

Section: Discussionmentioning

confidence: 99%

Photophobia and Seasonal Variation of Migraine in a Subarctic Population

et al. 2017

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“…Headache triggers are varied and may have different results at different times, so it can be very difficult to identify them. A headache diary can be a useful way to keep headache attacks under control [39]. Headache triggers often include stress, sleep disorders, weather, lights, odours, sounds and specific foods [40–42].…”

Section: Reviewmentioning

confidence: 99%

Behavioral management of headache in children and adolescents

et al. 2016

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Headache is the most frequent neurological symptom and the most prevalent pain in children and adolescents, and constitutes a serious health problem that may lead to impairment in several areas. Psychosocial factors, social environment, life events, school and family stressors are all closely related to headaches. A multidisciplinary strategy is fundamental in addressing headache in children and adolescents. Applying such a strategy can lead to reductions in frequency and severity of the pain, improving significantly the quality of life of these children.It has been demonstrated that behavioral intervention is highly effective, especially in the treatment of paediatric headache, and can enhance or replace pharmacotherapy, with the advantage of eliminating dangerous side effects and or reducing costs. Behavioral interventions appear to maximize long-term therapeutic benefits and improve compliance with pharmacological treatment, which has proven a significant problem with child and adolescent with headache.The goal of this review is to examine the existing literature on behavioral therapies used to treat headache in children and adolescents, and so provide an up-to-date picture of what behavioral therapy is and what its effectiveness is.

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

Abstract: Comparing questionnaire and diary assessments of lifestyle and trigger factors in patients with migraine shows that questionnaire assessment of lifestyle is reliable, whereas trigger factors are overestimated and/or underestimated in retrospective questionnaires.

Cited by 24 publications

References 17 publications

Headache Triggers as Surprise

Headache Triggers as Surprise

Photophobia and Seasonal Variation of Migraine in a Subarctic Population

Behavioral management of headache in children and adolescents

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