Migraine Briefs

Comorbidity between headaches with a range of physical conditions that have been associated with adult migraine demonstrates that multimorbidity occurs early in development. This according to a recent study that examined the associations between headaches and migraine with physical and mental disorders in a large pediatric registry. The study included 9,329 youth aged 8-21 years from the Philadelphia Neurodevelopmental Cohort. Physical conditions, including headache, were ascertained from electronic medical records and in-person interviews. Modified International Classification of Headache Disorders (ICHD-II) criteria were used to classify migraine symptoms. Forty-two other physical conditions were classified into 14 classes of medical disorders. Researchers found:

• Lifetime prevalence of any headache was 45.5%, and of migraine was 22.6%.
• Any headache was associated with a broad range of physical disorders, attention-deficit/hyperactivity disorder (odds ratio [OR] 1.2), and behavior disorders (1.3).
• Youth with migraine had greater odds of specific physical conditions and mental disorders, including respiratory, neurologic/central nervous system, developmental, anxiety, behavior, and mood disorders than those with non-migraine headache (OR ranged from 1.3 to 1.9).

Lateef T, He J-P, Nelson K, et al. Physical–mental comorbidity of pediatric migraine in the Philadelphia Neurodevelopmental Cohort. [Published online ahead of print October 29, 2018]. J Pediatr. doi:10.1016/j.jpeds.2018.09.033.

Comorbidity between headaches with a range of physical conditions that have been associated with adult migraine demonstrates that multimorbidity occurs early in development. This according to a recent study that examined the associations between headaches and migraine with physical and mental disorders in a large pediatric registry. The study included 9,329 youth aged 8-21 years from the Philadelphia Neurodevelopmental Cohort. Physical conditions, including headache, were ascertained from electronic medical records and in-person interviews. Modified International Classification of Headache Disorders (ICHD-II) criteria were used to classify migraine symptoms. Forty-two other physical conditions were classified into 14 classes of medical disorders. Researchers found:

• Lifetime prevalence of any headache was 45.5%, and of migraine was 22.6%.
• Any headache was associated with a broad range of physical disorders, attention-deficit/hyperactivity disorder (odds ratio [OR] 1.2), and behavior disorders (1.3).
• Youth with migraine had greater odds of specific physical conditions and mental disorders, including respiratory, neurologic/central nervous system, developmental, anxiety, behavior, and mood disorders than those with non-migraine headache (OR ranged from 1.3 to 1.9).

Lateef T, He J-P, Nelson K, et al. Physical–mental comorbidity of pediatric migraine in the Philadelphia Neurodevelopmental Cohort. [Published online ahead of print October 29, 2018]. J Pediatr. doi:10.1016/j.jpeds.2018.09.033.

Comorbidity between headaches with a range of physical conditions that have been associated with adult migraine demonstrates that multimorbidity occurs early in development. This according to a recent study that examined the associations between headaches and migraine with physical and mental disorders in a large pediatric registry. The study included 9,329 youth aged 8-21 years from the Philadelphia Neurodevelopmental Cohort. Physical conditions, including headache, were ascertained from electronic medical records and in-person interviews. Modified International Classification of Headache Disorders (ICHD-II) criteria were used to classify migraine symptoms. Forty-two other physical conditions were classified into 14 classes of medical disorders. Researchers found:

• Lifetime prevalence of any headache was 45.5%, and of migraine was 22.6%.
• Any headache was associated with a broad range of physical disorders, attention-deficit/hyperactivity disorder (odds ratio [OR] 1.2), and behavior disorders (1.3).
• Youth with migraine had greater odds of specific physical conditions and mental disorders, including respiratory, neurologic/central nervous system, developmental, anxiety, behavior, and mood disorders than those with non-migraine headache (OR ranged from 1.3 to 1.9).

Lateef T, He J-P, Nelson K, et al. Physical–mental comorbidity of pediatric migraine in the Philadelphia Neurodevelopmental Cohort. [Published online ahead of print October 29, 2018]. J Pediatr. doi:10.1016/j.jpeds.2018.09.033.

Recent findings suggest an abnormal sensory integration for spatial orientation in vestibular migraine (VM), related to daily dizziness in these patients. Researchers investigated the effect of static head tilts on errors of upright perception in a group of 27 patients with VM in comparison with a group of 27 healthy controls. Perception of upright was measured in a dark room using a subjective visual vertical (SVV) paradigm at 3 head tilt positions (upright, ±20°). VM patients were also surveyed about the quality of their dizziness and spatial symptoms during daily activities. Researchers found:

• In the upright head position, SVV errors were within the normal range for VM patients and healthy controls (within 2° from true vertical).
• During the static head tilts of 20° to the right, VM patients showed larger SVV errors consistent with overestimation of the tilt magnitude (ie, as if they felt further tilted toward the right side) (VM: −3.21° ± 0.93 vs control: 0.52° ± 0.70).
• During the head tilt to the left, SVV errors in VM patients did not differ significantly from controls (VM: 0.77° ± 1.05 vs control: −0.04° ± 0.68).

Winnick A, Sadeghpour S, Otero-Millan J, Chang T-P, Kheradmand A. Errors of upright perception in patients with vestibular migraine. [Published online ahead of print October 30, 2018]. Front Neurol. doi:10.3389/fneur.2018.00892.

Recent findings suggest an abnormal sensory integration for spatial orientation in vestibular migraine (VM), related to daily dizziness in these patients. Researchers investigated the effect of static head tilts on errors of upright perception in a group of 27 patients with VM in comparison with a group of 27 healthy controls. Perception of upright was measured in a dark room using a subjective visual vertical (SVV) paradigm at 3 head tilt positions (upright, ±20°). VM patients were also surveyed about the quality of their dizziness and spatial symptoms during daily activities. Researchers found:

• In the upright head position, SVV errors were within the normal range for VM patients and healthy controls (within 2° from true vertical).
• During the static head tilts of 20° to the right, VM patients showed larger SVV errors consistent with overestimation of the tilt magnitude (ie, as if they felt further tilted toward the right side) (VM: −3.21° ± 0.93 vs control: 0.52° ± 0.70).
• During the head tilt to the left, SVV errors in VM patients did not differ significantly from controls (VM: 0.77° ± 1.05 vs control: −0.04° ± 0.68).

Winnick A, Sadeghpour S, Otero-Millan J, Chang T-P, Kheradmand A. Errors of upright perception in patients with vestibular migraine. [Published online ahead of print October 30, 2018]. Front Neurol. doi:10.3389/fneur.2018.00892.

Recent findings suggest an abnormal sensory integration for spatial orientation in vestibular migraine (VM), related to daily dizziness in these patients. Researchers investigated the effect of static head tilts on errors of upright perception in a group of 27 patients with VM in comparison with a group of 27 healthy controls. Perception of upright was measured in a dark room using a subjective visual vertical (SVV) paradigm at 3 head tilt positions (upright, ±20°). VM patients were also surveyed about the quality of their dizziness and spatial symptoms during daily activities. Researchers found:

• In the upright head position, SVV errors were within the normal range for VM patients and healthy controls (within 2° from true vertical).
• During the static head tilts of 20° to the right, VM patients showed larger SVV errors consistent with overestimation of the tilt magnitude (ie, as if they felt further tilted toward the right side) (VM: −3.21° ± 0.93 vs control: 0.52° ± 0.70).
• During the head tilt to the left, SVV errors in VM patients did not differ significantly from controls (VM: 0.77° ± 1.05 vs control: −0.04° ± 0.68).

Winnick A, Sadeghpour S, Otero-Millan J, Chang T-P, Kheradmand A. Errors of upright perception in patients with vestibular migraine. [Published online ahead of print October 30, 2018]. Front Neurol. doi:10.3389/fneur.2018.00892.

Migraine with aura was associated with increased risk of incident atrial fibrillation (AF), according to a recent study, and this may potentially lead to ischemic strokes. In the Atherosclerosis Risk in Communities (ARIC) study, a longitudinal, community-based cohort study, participants were interviewed for migraine history between 1993 and 1995 and were followed for incident AF through 2013. AF was adjudicated using electrocardiographs (ECGs), discharge codes, and death certificates. Researchers found:

• Of 11,939 participants assessed for headache and without prior AF or stroke, 426 reported migraines with visual aura, 1090 with migraine without visual aura, 1018 non-migraine headache, and 9405 no headache.
• Over a 20-year follow-up period, incident AF was noted in 232 (15%) of 1516 with migraine and 1623 (17%) of 9405 without headache.
• After adjustment for multiple confounders, migraine with visual aura was associated with increased risk of AF compared to no headache (hazard ratio 1.30) as well as when compared to migraine without visual aura (hazard ratio 1.39).
• The data suggest that AF may be a potential mediator of migraine with visual aura–stroke risk.

Sen S, Androulakis XM, Duda V, et al. Migraine with visual aura a risk factor for incident atrial fibrillation. A cohort study. [Published online ahead of print November 14, 2018]. Neurology. doi:10.1212/WNL.0000000000006650.

Migraine with aura was associated with increased risk of incident atrial fibrillation (AF), according to a recent study, and this may potentially lead to ischemic strokes. In the Atherosclerosis Risk in Communities (ARIC) study, a longitudinal, community-based cohort study, participants were interviewed for migraine history between 1993 and 1995 and were followed for incident AF through 2013. AF was adjudicated using electrocardiographs (ECGs), discharge codes, and death certificates. Researchers found:

• Of 11,939 participants assessed for headache and without prior AF or stroke, 426 reported migraines with visual aura, 1090 with migraine without visual aura, 1018 non-migraine headache, and 9405 no headache.
• Over a 20-year follow-up period, incident AF was noted in 232 (15%) of 1516 with migraine and 1623 (17%) of 9405 without headache.
• After adjustment for multiple confounders, migraine with visual aura was associated with increased risk of AF compared to no headache (hazard ratio 1.30) as well as when compared to migraine without visual aura (hazard ratio 1.39).
• The data suggest that AF may be a potential mediator of migraine with visual aura–stroke risk.

Sen S, Androulakis XM, Duda V, et al. Migraine with visual aura a risk factor for incident atrial fibrillation. A cohort study. [Published online ahead of print November 14, 2018]. Neurology. doi:10.1212/WNL.0000000000006650.

Migraine with aura was associated with increased risk of incident atrial fibrillation (AF), according to a recent study, and this may potentially lead to ischemic strokes. In the Atherosclerosis Risk in Communities (ARIC) study, a longitudinal, community-based cohort study, participants were interviewed for migraine history between 1993 and 1995 and were followed for incident AF through 2013. AF was adjudicated using electrocardiographs (ECGs), discharge codes, and death certificates. Researchers found:

• Of 11,939 participants assessed for headache and without prior AF or stroke, 426 reported migraines with visual aura, 1090 with migraine without visual aura, 1018 non-migraine headache, and 9405 no headache.
• Over a 20-year follow-up period, incident AF was noted in 232 (15%) of 1516 with migraine and 1623 (17%) of 9405 without headache.
• After adjustment for multiple confounders, migraine with visual aura was associated with increased risk of AF compared to no headache (hazard ratio 1.30) as well as when compared to migraine without visual aura (hazard ratio 1.39).
• The data suggest that AF may be a potential mediator of migraine with visual aura–stroke risk.

Sen S, Androulakis XM, Duda V, et al. Migraine with visual aura a risk factor for incident atrial fibrillation. A cohort study. [Published online ahead of print November 14, 2018]. Neurology. doi:10.1212/WNL.0000000000006650.

Patients with migrane are more sensitive to all colors of light during the ictal phase than the during interictal phase, according to a recent study, but control subjects do not experience pain when exposed to different colors of light. In order to identify the origin of this photophobia in migraineurs, researchers compared the electrical waveforms that were generated in the retina and visual cortex of 46 interictal migraineurs to those generated in 42 healthy controls using color-based electroretinography and visual evoked potential paradigms. They found:

• Unexpectedly, it was the amplitude of the retinal rod-driven b-wave, which was consistently larger in the migraineurs than in the controls, rather than the retinal cone-driven a-wave or the visual evoked potentials that differ most strikingly between the 2 groups.
• Mechanistically, these findings suggest that the inherent hypersensitivity to light among migraine patients may originate in the retinal rods rather than retinal cones or the visual cortex.

Clinically, these findings may explain why migraineurs complain that the light is too bright even when it is dim.

Bernstein CA, N R-R, Noseda R, et al. The migraine eye: distinct rod-driven retinal pathways’ response to dim light challenges the visual cortex hyperexcitability theory. [Published online ahead of print October 29, 2018]. Pain. doi:10.1097/j.pain.0000000000001434.

Patients with migrane are more sensitive to all colors of light during the ictal phase than the during interictal phase, according to a recent study, but control subjects do not experience pain when exposed to different colors of light. In order to identify the origin of this photophobia in migraineurs, researchers compared the electrical waveforms that were generated in the retina and visual cortex of 46 interictal migraineurs to those generated in 42 healthy controls using color-based electroretinography and visual evoked potential paradigms. They found:

• Unexpectedly, it was the amplitude of the retinal rod-driven b-wave, which was consistently larger in the migraineurs than in the controls, rather than the retinal cone-driven a-wave or the visual evoked potentials that differ most strikingly between the 2 groups.
• Mechanistically, these findings suggest that the inherent hypersensitivity to light among migraine patients may originate in the retinal rods rather than retinal cones or the visual cortex.

Clinically, these findings may explain why migraineurs complain that the light is too bright even when it is dim.

Bernstein CA, N R-R, Noseda R, et al. The migraine eye: distinct rod-driven retinal pathways’ response to dim light challenges the visual cortex hyperexcitability theory. [Published online ahead of print October 29, 2018]. Pain. doi:10.1097/j.pain.0000000000001434.

Patients with migrane are more sensitive to all colors of light during the ictal phase than the during interictal phase, according to a recent study, but control subjects do not experience pain when exposed to different colors of light. In order to identify the origin of this photophobia in migraineurs, researchers compared the electrical waveforms that were generated in the retina and visual cortex of 46 interictal migraineurs to those generated in 42 healthy controls using color-based electroretinography and visual evoked potential paradigms. They found:

• Unexpectedly, it was the amplitude of the retinal rod-driven b-wave, which was consistently larger in the migraineurs than in the controls, rather than the retinal cone-driven a-wave or the visual evoked potentials that differ most strikingly between the 2 groups.
• Mechanistically, these findings suggest that the inherent hypersensitivity to light among migraine patients may originate in the retinal rods rather than retinal cones or the visual cortex.

Clinically, these findings may explain why migraineurs complain that the light is too bright even when it is dim.

Bernstein CA, N R-R, Noseda R, et al. The migraine eye: distinct rod-driven retinal pathways’ response to dim light challenges the visual cortex hyperexcitability theory. [Published online ahead of print October 29, 2018]. Pain. doi:10.1097/j.pain.0000000000001434.

Parental migraine impacts children aged 11 to 17 living in the home, particularly in the domains of global well‐being and the parent/child relationship, according to a recent study. This cross‐sectional observational study included parents who met International Classification of Headache Disorders criteria for migraine and their 11- to 17‐year‐old children currently living with the parent with migraine recruited from neurologist offices and online. Researchers found:

• Children (n=40) reported the greatest impact of their parent’s migraine on the Global Well‐Being and Parent/Child Relationship subscales.
• There were no significant differences between the average child and parent rating of parental migraine impact on children.
• Correlations between parent and child ratings of parental migraine impact were strongest for the Social Impact subscale, and non‐significant for the Parent/Child Relationship and Friends Reactions subscales.

Seng EK, Mauser ED, Marzouk N, Patel ZS, Rosen N, Buse DC. When mom has migraine: An observational study of the impact of parental migraine on adolescent children. [Published online ahead of print October 31, 2018]. Headache. doi:10.1111/head.13433.

Parental migraine impacts children aged 11 to 17 living in the home, particularly in the domains of global well‐being and the parent/child relationship, according to a recent study. This cross‐sectional observational study included parents who met International Classification of Headache Disorders criteria for migraine and their 11- to 17‐year‐old children currently living with the parent with migraine recruited from neurologist offices and online. Researchers found:

• Children (n=40) reported the greatest impact of their parent’s migraine on the Global Well‐Being and Parent/Child Relationship subscales.
• There were no significant differences between the average child and parent rating of parental migraine impact on children.
• Correlations between parent and child ratings of parental migraine impact were strongest for the Social Impact subscale, and non‐significant for the Parent/Child Relationship and Friends Reactions subscales.

Seng EK, Mauser ED, Marzouk N, Patel ZS, Rosen N, Buse DC. When mom has migraine: An observational study of the impact of parental migraine on adolescent children. [Published online ahead of print October 31, 2018]. Headache. doi:10.1111/head.13433.

Parental migraine impacts children aged 11 to 17 living in the home, particularly in the domains of global well‐being and the parent/child relationship, according to a recent study. This cross‐sectional observational study included parents who met International Classification of Headache Disorders criteria for migraine and their 11- to 17‐year‐old children currently living with the parent with migraine recruited from neurologist offices and online. Researchers found:

• Children (n=40) reported the greatest impact of their parent’s migraine on the Global Well‐Being and Parent/Child Relationship subscales.
• There were no significant differences between the average child and parent rating of parental migraine impact on children.
• Correlations between parent and child ratings of parental migraine impact were strongest for the Social Impact subscale, and non‐significant for the Parent/Child Relationship and Friends Reactions subscales.

Seng EK, Mauser ED, Marzouk N, Patel ZS, Rosen N, Buse DC. When mom has migraine: An observational study of the impact of parental migraine on adolescent children. [Published online ahead of print October 31, 2018]. Headache. doi:10.1111/head.13433.

Headache disorders, and migraine in particular, are important causes of disability worldwide, and deserve greater attention in health policy debates and research resource allocation. This according to a recent investigation that used data from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2016 study to provide new estimates for prevalence and years of life lived with disability (YLDs) for migraine and tension-type headache. Prevalence for gender and 5-year age group interval at different time points from 1990 and 2016 in all countries and GBD regions were estimated using a Bayesian meta-regression model. Researchers found:

• Almost 3 billion individuals were estimated to have a migraine or tension-type headache in 2016: 1.89 billion with tension-type headache and 1.04 billion with migraine.
• However, because migraine had a much higher disability weight than tension-type headache, migraine caused 45.1 million and tension-type headache only 7.2 million YLDs globally in 2016.
• The headaches were most burdensome in women between ages 15 and 49 years, with migraine causing 20.3 million and tension-type headache 2.9 million YLDs in 2016, which was 11.2% of all YLDs in this age group and sex.

Stovner LJ, Nichols E, Steiner TJ, et al. GBD 2016 Headache Collaborators. Global, regional, and national burden of migraine and tension-type headache, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2018;17(11):954-976. doi:10.1016/S1474-4422(18)30322-3.

Headache disorders, and migraine in particular, are important causes of disability worldwide, and deserve greater attention in health policy debates and research resource allocation. This according to a recent investigation that used data from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2016 study to provide new estimates for prevalence and years of life lived with disability (YLDs) for migraine and tension-type headache. Prevalence for gender and 5-year age group interval at different time points from 1990 and 2016 in all countries and GBD regions were estimated using a Bayesian meta-regression model. Researchers found:

• Almost 3 billion individuals were estimated to have a migraine or tension-type headache in 2016: 1.89 billion with tension-type headache and 1.04 billion with migraine.
• However, because migraine had a much higher disability weight than tension-type headache, migraine caused 45.1 million and tension-type headache only 7.2 million YLDs globally in 2016.
• The headaches were most burdensome in women between ages 15 and 49 years, with migraine causing 20.3 million and tension-type headache 2.9 million YLDs in 2016, which was 11.2% of all YLDs in this age group and sex.

Stovner LJ, Nichols E, Steiner TJ, et al. GBD 2016 Headache Collaborators. Global, regional, and national burden of migraine and tension-type headache, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2018;17(11):954-976. doi:10.1016/S1474-4422(18)30322-3.

Headache disorders, and migraine in particular, are important causes of disability worldwide, and deserve greater attention in health policy debates and research resource allocation. This according to a recent investigation that used data from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2016 study to provide new estimates for prevalence and years of life lived with disability (YLDs) for migraine and tension-type headache. Prevalence for gender and 5-year age group interval at different time points from 1990 and 2016 in all countries and GBD regions were estimated using a Bayesian meta-regression model. Researchers found:

• Almost 3 billion individuals were estimated to have a migraine or tension-type headache in 2016: 1.89 billion with tension-type headache and 1.04 billion with migraine.
• However, because migraine had a much higher disability weight than tension-type headache, migraine caused 45.1 million and tension-type headache only 7.2 million YLDs globally in 2016.
• The headaches were most burdensome in women between ages 15 and 49 years, with migraine causing 20.3 million and tension-type headache 2.9 million YLDs in 2016, which was 11.2% of all YLDs in this age group and sex.

Stovner LJ, Nichols E, Steiner TJ, et al. GBD 2016 Headache Collaborators. Global, regional, and national burden of migraine and tension-type headache, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2018;17(11):954-976. doi:10.1016/S1474-4422(18)30322-3.

Researchers did not find any difference in number of self-reported premenstrual syndrome (PMS) symptoms between migraineurs with and without menstrual migraine (MM), according to a recent study. A total of 237 women from the general population who self-reported migraine in at least 50% of their menstrual periods were invited to a clinical interview and diagnosed by a neurologist. All women were asked to complete a self-administered form containing 11 questions about PMS symptoms adapted from the Diagnostic and Statistical Manual of Mental Disorders. In addition, each participant completed the Headache Impact test (HIT-6) and Migraine Disability Assessment Score (MIDAS). They found:

• 193 women returned a complete PMS questionnaire, of which 67 women were excluded from the analyses due to current use of hormonal contraception (n=61) or because they did not fulfill the ICHD-criteria for migraine (n=6).
• Among the remaining 126 migraineurs, 78 had MM and 48 had non-menstrually related migraine.
• PMS symptoms were equally frequent in migraineurs with and without MM (5.4 vs 5.9).
• Women with MM reported more migraine days/month, longer lasting migraine attacks, and higher HIT-6 scores than those without MM, but MIDAS scores were similar.

Vetvik KG, MacGregor EA, Lundqyist C, Russell MB. Symptoms of premenstrual syndrome in female migraineurs with and without menstrual migraine. [Published online ahead of print October 17, 2018]. J Headache Pain. doi:10.1186/s10194-018-0931-6.

Researchers did not find any difference in number of self-reported premenstrual syndrome (PMS) symptoms between migraineurs with and without menstrual migraine (MM), according to a recent study. A total of 237 women from the general population who self-reported migraine in at least 50% of their menstrual periods were invited to a clinical interview and diagnosed by a neurologist. All women were asked to complete a self-administered form containing 11 questions about PMS symptoms adapted from the Diagnostic and Statistical Manual of Mental Disorders. In addition, each participant completed the Headache Impact test (HIT-6) and Migraine Disability Assessment Score (MIDAS). They found:

• 193 women returned a complete PMS questionnaire, of which 67 women were excluded from the analyses due to current use of hormonal contraception (n=61) or because they did not fulfill the ICHD-criteria for migraine (n=6).
• Among the remaining 126 migraineurs, 78 had MM and 48 had non-menstrually related migraine.
• PMS symptoms were equally frequent in migraineurs with and without MM (5.4 vs 5.9).
• Women with MM reported more migraine days/month, longer lasting migraine attacks, and higher HIT-6 scores than those without MM, but MIDAS scores were similar.

Vetvik KG, MacGregor EA, Lundqyist C, Russell MB. Symptoms of premenstrual syndrome in female migraineurs with and without menstrual migraine. [Published online ahead of print October 17, 2018]. J Headache Pain. doi:10.1186/s10194-018-0931-6.

Researchers did not find any difference in number of self-reported premenstrual syndrome (PMS) symptoms between migraineurs with and without menstrual migraine (MM), according to a recent study. A total of 237 women from the general population who self-reported migraine in at least 50% of their menstrual periods were invited to a clinical interview and diagnosed by a neurologist. All women were asked to complete a self-administered form containing 11 questions about PMS symptoms adapted from the Diagnostic and Statistical Manual of Mental Disorders. In addition, each participant completed the Headache Impact test (HIT-6) and Migraine Disability Assessment Score (MIDAS). They found:

• 193 women returned a complete PMS questionnaire, of which 67 women were excluded from the analyses due to current use of hormonal contraception (n=61) or because they did not fulfill the ICHD-criteria for migraine (n=6).
• Among the remaining 126 migraineurs, 78 had MM and 48 had non-menstrually related migraine.
• PMS symptoms were equally frequent in migraineurs with and without MM (5.4 vs 5.9).
• Women with MM reported more migraine days/month, longer lasting migraine attacks, and higher HIT-6 scores than those without MM, but MIDAS scores were similar.

Vetvik KG, MacGregor EA, Lundqyist C, Russell MB. Symptoms of premenstrual syndrome in female migraineurs with and without menstrual migraine. [Published online ahead of print October 17, 2018]. J Headache Pain. doi:10.1186/s10194-018-0931-6.

Typical aura without headache, a rare subtype of migraine, occurs exclusively in 4% patients with migraine, and may take place at some point in 38% of patients with migraine with aura, according to recent study. Furthermore, typical aura without headache, also known as migraine aura without headache or acephalgic migraine, commonly presents with visual aura without headache, brainstem aura without headache, and can also develop later in life, known as late-onset migraine accompaniment. Its pathophysiology is suggested to be similar to classic migraines, with cortical spreading depression leading to aura formation but without an associated headache. Presently, no clinical trials have been performed to evaluate treatment options, but case reports suggest that most patients will respond to the traditional treatments for migraine with aura.

Shah DR, Dilwali S, Friedman DI. Migraine aura without headache. Curr Pain Headache Rep. 2018;22:77. doi:10.1007/s11916-018-0725-1.

Typical aura without headache, a rare subtype of migraine, occurs exclusively in 4% patients with migraine, and may take place at some point in 38% of patients with migraine with aura, according to recent study. Furthermore, typical aura without headache, also known as migraine aura without headache or acephalgic migraine, commonly presents with visual aura without headache, brainstem aura without headache, and can also develop later in life, known as late-onset migraine accompaniment. Its pathophysiology is suggested to be similar to classic migraines, with cortical spreading depression leading to aura formation but without an associated headache. Presently, no clinical trials have been performed to evaluate treatment options, but case reports suggest that most patients will respond to the traditional treatments for migraine with aura.

Shah DR, Dilwali S, Friedman DI. Migraine aura without headache. Curr Pain Headache Rep. 2018;22:77. doi:10.1007/s11916-018-0725-1.

Typical aura without headache, a rare subtype of migraine, occurs exclusively in 4% patients with migraine, and may take place at some point in 38% of patients with migraine with aura, according to recent study. Furthermore, typical aura without headache, also known as migraine aura without headache or acephalgic migraine, commonly presents with visual aura without headache, brainstem aura without headache, and can also develop later in life, known as late-onset migraine accompaniment. Its pathophysiology is suggested to be similar to classic migraines, with cortical spreading depression leading to aura formation but without an associated headache. Presently, no clinical trials have been performed to evaluate treatment options, but case reports suggest that most patients will respond to the traditional treatments for migraine with aura.

Shah DR, Dilwali S, Friedman DI. Migraine aura without headache. Curr Pain Headache Rep. 2018;22:77. doi:10.1007/s11916-018-0725-1.

Patients with migraines and patients classified as Caucasian had higher odds of being diagnosed with transient global amnesia (TGA), according to a recent study. All minority populations, however, showed a lower rate of diagnosis that fell short of statistical significance.  Data were obtained from the Nationwide Inpatient Sample using ICD-9 and procedure codes. Descriptive and survey logistic regression analyses were conducted and adjusted for influence of comorbidities, demographic characteristics, and hospitalization-related factors. Researchers found:

• Patients with migraines were 5.98 times more likely to also have a diagnosis of TGA compared with patients without migraines.
• Similarly, patients with TGA were more likely to have hypertension, precerebral disease, and hyperlipidemia.
• The odds of being diagnosed with TGA was lower among African Americans and Hispanics as well as among patients classified as Asian/other, compared with Caucasians.
• TGA was associated with lower hospital charges ($14,242 vs $21,319), shorter hospital stays (mean days: 2.49 [SE=0.036] vs 4.72 [SE=0.025]), and routine hospital discharges (91.4% vs 74.5%).

Yi M, Sherzai AZ, Ani C, et al. Strong association between migraine and transient global amnesia: A National Inpatient Sample analysis. [Published online ahead of print October 11, 2018]. J Neuropsychiatry Clin Neurosci. doi:10.1176/appi.neuropsych.17120353.

Patients with migraines and patients classified as Caucasian had higher odds of being diagnosed with transient global amnesia (TGA), according to a recent study. All minority populations, however, showed a lower rate of diagnosis that fell short of statistical significance.  Data were obtained from the Nationwide Inpatient Sample using ICD-9 and procedure codes. Descriptive and survey logistic regression analyses were conducted and adjusted for influence of comorbidities, demographic characteristics, and hospitalization-related factors. Researchers found:

• Patients with migraines were 5.98 times more likely to also have a diagnosis of TGA compared with patients without migraines.
• Similarly, patients with TGA were more likely to have hypertension, precerebral disease, and hyperlipidemia.
• The odds of being diagnosed with TGA was lower among African Americans and Hispanics as well as among patients classified as Asian/other, compared with Caucasians.
• TGA was associated with lower hospital charges ($14,242 vs $21,319), shorter hospital stays (mean days: 2.49 [SE=0.036] vs 4.72 [SE=0.025]), and routine hospital discharges (91.4% vs 74.5%).

Yi M, Sherzai AZ, Ani C, et al. Strong association between migraine and transient global amnesia: A National Inpatient Sample analysis. [Published online ahead of print October 11, 2018]. J Neuropsychiatry Clin Neurosci. doi:10.1176/appi.neuropsych.17120353.

Patients with migraines and patients classified as Caucasian had higher odds of being diagnosed with transient global amnesia (TGA), according to a recent study. All minority populations, however, showed a lower rate of diagnosis that fell short of statistical significance.  Data were obtained from the Nationwide Inpatient Sample using ICD-9 and procedure codes. Descriptive and survey logistic regression analyses were conducted and adjusted for influence of comorbidities, demographic characteristics, and hospitalization-related factors. Researchers found:

• Patients with migraines were 5.98 times more likely to also have a diagnosis of TGA compared with patients without migraines.
• Similarly, patients with TGA were more likely to have hypertension, precerebral disease, and hyperlipidemia.
• The odds of being diagnosed with TGA was lower among African Americans and Hispanics as well as among patients classified as Asian/other, compared with Caucasians.
• TGA was associated with lower hospital charges ($14,242 vs $21,319), shorter hospital stays (mean days: 2.49 [SE=0.036] vs 4.72 [SE=0.025]), and routine hospital discharges (91.4% vs 74.5%).

Yi M, Sherzai AZ, Ani C, et al. Strong association between migraine and transient global amnesia: A National Inpatient Sample analysis. [Published online ahead of print October 11, 2018]. J Neuropsychiatry Clin Neurosci. doi:10.1176/appi.neuropsych.17120353.

Multiple studies clearly demonstrate triggers in episodic migraine, often related to change in homeostasis or environment, according to a recent investigation. Furthermore, many common migraine triggers are not easily modifiable, and avoiding triggers may not be realistic. However, healthy lifestyle choices such as exercise, adequate sleep, stress management, and eating regularly may prevent triggers and transformation to chronic migraine over time. Multiple migraine attack triggers have been established based on patient surveys, diary studies, and clinical trials. Key points include:

• Stress, menstrual cycle changes, weather changes, sleep disturbances, alcohol, and other foods are among the most common factors mentioned.
• Clinical studies have also verified that fasting, premenstrual periods in women, “letdown” after stress, and most likely low barometric pressures are migraine triggers.
• Premonitory symptoms such as neck pain, fatigue, and sensitivity to lights, sounds, or odors may mimic triggers.

Marmura MJ. Triggers, protectors, and predictors in episodic migraine. Curr Pain Headache Rep. 2018;22:81. doi:10.1007/s11916-018-0734-0.

Multiple studies clearly demonstrate triggers in episodic migraine, often related to change in homeostasis or environment, according to a recent investigation. Furthermore, many common migraine triggers are not easily modifiable, and avoiding triggers may not be realistic. However, healthy lifestyle choices such as exercise, adequate sleep, stress management, and eating regularly may prevent triggers and transformation to chronic migraine over time. Multiple migraine attack triggers have been established based on patient surveys, diary studies, and clinical trials. Key points include:

• Stress, menstrual cycle changes, weather changes, sleep disturbances, alcohol, and other foods are among the most common factors mentioned.
• Clinical studies have also verified that fasting, premenstrual periods in women, “letdown” after stress, and most likely low barometric pressures are migraine triggers.
• Premonitory symptoms such as neck pain, fatigue, and sensitivity to lights, sounds, or odors may mimic triggers.

Marmura MJ. Triggers, protectors, and predictors in episodic migraine. Curr Pain Headache Rep. 2018;22:81. doi:10.1007/s11916-018-0734-0.

Multiple studies clearly demonstrate triggers in episodic migraine, often related to change in homeostasis or environment, according to a recent investigation. Furthermore, many common migraine triggers are not easily modifiable, and avoiding triggers may not be realistic. However, healthy lifestyle choices such as exercise, adequate sleep, stress management, and eating regularly may prevent triggers and transformation to chronic migraine over time. Multiple migraine attack triggers have been established based on patient surveys, diary studies, and clinical trials. Key points include:

• Stress, menstrual cycle changes, weather changes, sleep disturbances, alcohol, and other foods are among the most common factors mentioned.
• Clinical studies have also verified that fasting, premenstrual periods in women, “letdown” after stress, and most likely low barometric pressures are migraine triggers.
• Premonitory symptoms such as neck pain, fatigue, and sensitivity to lights, sounds, or odors may mimic triggers.

Marmura MJ. Triggers, protectors, and predictors in episodic migraine. Curr Pain Headache Rep. 2018;22:81. doi:10.1007/s11916-018-0734-0.