Migraine Briefs

Associations of migraine severity and presence of associated features with inhibitory control varied by body mass index (BMI) in overweight/obese women with migraine, according to a recent study. These findings, therefore, warrant consideration of weight status in clarifying the role of migraine in executive functioning. Women (n=124) aged 18–50 years with overweight/obesity BMI=35.1 ± 6.4 kg/m² and migraine completed a 28-day smartphone-based headache diary assessing migraine headache severity (attack frequency, pain intensity) and frequency of associated features (aura, photophobia, phonophobia, nausea). They then completed computerized measures of inhibitory control during an interictal (headache-free) period. Researchers found:

• Participants with higher migraine attack frequency performed worse on the Flanker test (accuracy and reaction time).
• Migraine attack frequency and pain intensity interacted with BMI to predict slower Stroop and/or Flanker Reaction Time (RT).
• More frequent photophobia, phonophobia, and aura were independently related to slower RT on the Stroop and/or Flanker tests, and BMI moderated the relationship between the occurrence of aura and Stroop RT.

The role of migraine headache severity, associated features and interactions with overweight/obesity in inhibitory control. Int J Neurosci. 2018;128(1):63-70. doi:10.1080/00207454.2017.1366474.

Associations of migraine severity and presence of associated features with inhibitory control varied by body mass index (BMI) in overweight/obese women with migraine, according to a recent study. These findings, therefore, warrant consideration of weight status in clarifying the role of migraine in executive functioning. Women (n=124) aged 18–50 years with overweight/obesity BMI=35.1 ± 6.4 kg/m² and migraine completed a 28-day smartphone-based headache diary assessing migraine headache severity (attack frequency, pain intensity) and frequency of associated features (aura, photophobia, phonophobia, nausea). They then completed computerized measures of inhibitory control during an interictal (headache-free) period. Researchers found:

• Participants with higher migraine attack frequency performed worse on the Flanker test (accuracy and reaction time).
• Migraine attack frequency and pain intensity interacted with BMI to predict slower Stroop and/or Flanker Reaction Time (RT).
• More frequent photophobia, phonophobia, and aura were independently related to slower RT on the Stroop and/or Flanker tests, and BMI moderated the relationship between the occurrence of aura and Stroop RT.

The role of migraine headache severity, associated features and interactions with overweight/obesity in inhibitory control. Int J Neurosci. 2018;128(1):63-70. doi:10.1080/00207454.2017.1366474.

Associations of migraine severity and presence of associated features with inhibitory control varied by body mass index (BMI) in overweight/obese women with migraine, according to a recent study. These findings, therefore, warrant consideration of weight status in clarifying the role of migraine in executive functioning. Women (n=124) aged 18–50 years with overweight/obesity BMI=35.1 ± 6.4 kg/m² and migraine completed a 28-day smartphone-based headache diary assessing migraine headache severity (attack frequency, pain intensity) and frequency of associated features (aura, photophobia, phonophobia, nausea). They then completed computerized measures of inhibitory control during an interictal (headache-free) period. Researchers found:

• Participants with higher migraine attack frequency performed worse on the Flanker test (accuracy and reaction time).
• Migraine attack frequency and pain intensity interacted with BMI to predict slower Stroop and/or Flanker Reaction Time (RT).
• More frequent photophobia, phonophobia, and aura were independently related to slower RT on the Stroop and/or Flanker tests, and BMI moderated the relationship between the occurrence of aura and Stroop RT.

The role of migraine headache severity, associated features and interactions with overweight/obesity in inhibitory control. Int J Neurosci. 2018;128(1):63-70. doi:10.1080/00207454.2017.1366474.

Typical practices of obtaining new baselines every 2 years in the high school population can be applied to athletes with a history of special education or learning disorders (LD) and headache/migraine treatment, a recent study found. This study examined the test-retest reliability of the 4- and 2-factor structures (ie, memory and speed) of ImPACT (Immediate Post-Concussion Assessment and Cognitive Test) over a 2-year interval across multiple groups with premorbid conditions, including those with a history of special education or LDs (n=114), treatment history for headache/migraine (n=81), and a control group (n= 792).

Researchers found:

• Significant improvement on all 4 composites were observed for the control group over a 2-year interval, whereas significant differences were observed only on visual motor speed for the LD and headache/migraine treatment history groups.
• The 2-factor structure has potential to increase test-retest reliability.

Two-year test-retest reliability in high school athletes using the four- and two-factor ImPACT composite structures: The effects of learning disorders and headache/migraine treatment history. Clin Neuropsychol. 2018;33(2):256-226. doi:10.1093/arclin/acx059.

Typical practices of obtaining new baselines every 2 years in the high school population can be applied to athletes with a history of special education or learning disorders (LD) and headache/migraine treatment, a recent study found. This study examined the test-retest reliability of the 4- and 2-factor structures (ie, memory and speed) of ImPACT (Immediate Post-Concussion Assessment and Cognitive Test) over a 2-year interval across multiple groups with premorbid conditions, including those with a history of special education or LDs (n=114), treatment history for headache/migraine (n=81), and a control group (n= 792).

Researchers found:

• Significant improvement on all 4 composites were observed for the control group over a 2-year interval, whereas significant differences were observed only on visual motor speed for the LD and headache/migraine treatment history groups.
• The 2-factor structure has potential to increase test-retest reliability.

Two-year test-retest reliability in high school athletes using the four- and two-factor ImPACT composite structures: The effects of learning disorders and headache/migraine treatment history. Clin Neuropsychol. 2018;33(2):256-226. doi:10.1093/arclin/acx059.

Typical practices of obtaining new baselines every 2 years in the high school population can be applied to athletes with a history of special education or learning disorders (LD) and headache/migraine treatment, a recent study found. This study examined the test-retest reliability of the 4- and 2-factor structures (ie, memory and speed) of ImPACT (Immediate Post-Concussion Assessment and Cognitive Test) over a 2-year interval across multiple groups with premorbid conditions, including those with a history of special education or LDs (n=114), treatment history for headache/migraine (n=81), and a control group (n= 792).

Researchers found:

• Significant improvement on all 4 composites were observed for the control group over a 2-year interval, whereas significant differences were observed only on visual motor speed for the LD and headache/migraine treatment history groups.
• The 2-factor structure has potential to increase test-retest reliability.

Two-year test-retest reliability in high school athletes using the four- and two-factor ImPACT composite structures: The effects of learning disorders and headache/migraine treatment history. Clin Neuropsychol. 2018;33(2):256-226. doi:10.1093/arclin/acx059.

Diplopia, commonly known as double vision, was depicted in a significantly higher percentage of drawings by children (aged 6-18 years) with pseudotumor cerebri than drawings by children with migraine, a recent study found. In all other respects, headache drawings by both groups of children were similar. In this study, children attending university hospital pediatric neurology clinics were asked to draw a picture of how their headache feels. Headache drawings of 21 children (16 females) with pseudotumor were compared with those of 518 children with migraine. Researchers found:

• Pseudotumor drawings depicted a variety of symptoms including pounding pain (n=11), pressure-like pain (n=3), photophobia (n=3), dizziness (n=1), and recumbency (n=1).
• Severe pain indicators included hammers, bombs, an anvil, and vise grip.
• Positive visual phenomena included scintillations, scotomata, or blurring (n=8).
• Negative visual phenomena included field defects (n=2).

Pseudotumor drawings were similar to migraine drawings except that 6 of 21 pseudotumor drawings (28.6%) depicted diplopia, whereas only 3 of 518 migraine drawings (0.6%) depicted diplopia.

Evidence of diplopia in children's headache drawings helps to differentiate pseudotumor cerebri from migraine. 2018;79:40-44. Pediatr Neurol.  doi:10.1016/j.pediatrneurol.2017.10.020.

Diplopia, commonly known as double vision, was depicted in a significantly higher percentage of drawings by children (aged 6-18 years) with pseudotumor cerebri than drawings by children with migraine, a recent study found. In all other respects, headache drawings by both groups of children were similar. In this study, children attending university hospital pediatric neurology clinics were asked to draw a picture of how their headache feels. Headache drawings of 21 children (16 females) with pseudotumor were compared with those of 518 children with migraine. Researchers found:

• Pseudotumor drawings depicted a variety of symptoms including pounding pain (n=11), pressure-like pain (n=3), photophobia (n=3), dizziness (n=1), and recumbency (n=1).
• Severe pain indicators included hammers, bombs, an anvil, and vise grip.
• Positive visual phenomena included scintillations, scotomata, or blurring (n=8).
• Negative visual phenomena included field defects (n=2).

Pseudotumor drawings were similar to migraine drawings except that 6 of 21 pseudotumor drawings (28.6%) depicted diplopia, whereas only 3 of 518 migraine drawings (0.6%) depicted diplopia.

Evidence of diplopia in children's headache drawings helps to differentiate pseudotumor cerebri from migraine. 2018;79:40-44. Pediatr Neurol.  doi:10.1016/j.pediatrneurol.2017.10.020.

Diplopia, commonly known as double vision, was depicted in a significantly higher percentage of drawings by children (aged 6-18 years) with pseudotumor cerebri than drawings by children with migraine, a recent study found. In all other respects, headache drawings by both groups of children were similar. In this study, children attending university hospital pediatric neurology clinics were asked to draw a picture of how their headache feels. Headache drawings of 21 children (16 females) with pseudotumor were compared with those of 518 children with migraine. Researchers found:

• Pseudotumor drawings depicted a variety of symptoms including pounding pain (n=11), pressure-like pain (n=3), photophobia (n=3), dizziness (n=1), and recumbency (n=1).
• Severe pain indicators included hammers, bombs, an anvil, and vise grip.
• Positive visual phenomena included scintillations, scotomata, or blurring (n=8).
• Negative visual phenomena included field defects (n=2).

Pseudotumor drawings were similar to migraine drawings except that 6 of 21 pseudotumor drawings (28.6%) depicted diplopia, whereas only 3 of 518 migraine drawings (0.6%) depicted diplopia.

Evidence of diplopia in children's headache drawings helps to differentiate pseudotumor cerebri from migraine. 2018;79:40-44. Pediatr Neurol.  doi:10.1016/j.pediatrneurol.2017.10.020.

Women with migraine have a higher relative risk of developing hypertension compared to women without migraine, according to a recent study. Researchers performed a prospective cohort study among 29,040 women without hypertension at baseline. Women were classified as having active migraine with aura, active migraine without aura, a past history of migraine, or no history of migraine. Incident hypertension was defined as new physician diagnosis or newly self-reported systolic or diastolic blood pressure ≥140 mmHg or ≥90 mmHg, respectively. They found:

• During a mean follow-up of 12.2 years, 15,176 incident hypertension cases occurred.
• Compared to those with no history of migraine, women who experience migraine with aura had a 9% increase in their risk of developing hypertension; women who experience migraine without aura had a 21% increase in their risk of developing hypertension; and women with a past history of migraine had a 15% increase in their risk of developing hypertension.

Migraine and the risk of incident hypertension among women. [Published online ahead of print February 1, 2018]. Cephalalgia. doi:10.1177/0333102418756865.

Women with migraine have a higher relative risk of developing hypertension compared to women without migraine, according to a recent study. Researchers performed a prospective cohort study among 29,040 women without hypertension at baseline. Women were classified as having active migraine with aura, active migraine without aura, a past history of migraine, or no history of migraine. Incident hypertension was defined as new physician diagnosis or newly self-reported systolic or diastolic blood pressure ≥140 mmHg or ≥90 mmHg, respectively. They found:

• During a mean follow-up of 12.2 years, 15,176 incident hypertension cases occurred.
• Compared to those with no history of migraine, women who experience migraine with aura had a 9% increase in their risk of developing hypertension; women who experience migraine without aura had a 21% increase in their risk of developing hypertension; and women with a past history of migraine had a 15% increase in their risk of developing hypertension.

Migraine and the risk of incident hypertension among women. [Published online ahead of print February 1, 2018]. Cephalalgia. doi:10.1177/0333102418756865.

Women with migraine have a higher relative risk of developing hypertension compared to women without migraine, according to a recent study. Researchers performed a prospective cohort study among 29,040 women without hypertension at baseline. Women were classified as having active migraine with aura, active migraine without aura, a past history of migraine, or no history of migraine. Incident hypertension was defined as new physician diagnosis or newly self-reported systolic or diastolic blood pressure ≥140 mmHg or ≥90 mmHg, respectively. They found:

• During a mean follow-up of 12.2 years, 15,176 incident hypertension cases occurred.
• Compared to those with no history of migraine, women who experience migraine with aura had a 9% increase in their risk of developing hypertension; women who experience migraine without aura had a 21% increase in their risk of developing hypertension; and women with a past history of migraine had a 15% increase in their risk of developing hypertension.

Migraine and the risk of incident hypertension among women. [Published online ahead of print February 1, 2018]. Cephalalgia. doi:10.1177/0333102418756865.

Group education on headache evaluation and lifestyle management has potential as an effective, low-cost intervention for treatment of chronic headaches among adolescents, according to a recent study. This retrospective chart review study evaluated a group education program for 155 adolescents, aged 12-17 years, enrolled in the US military medical system with at least 3 months of chronic headaches and who were referred to a headache evaluation clinic. The primary outcome of the study was self-reported number of days with a headache in the previous 30 days based on patient recall. Researchers found:

• Most participants in the program were female (114/155 [73.5%]) and suffered from migraine headaches (108/155 [69.8%]).
• Severe headache-related disability was reported by 40.6% of subjects (63/155).
• Subjects reported an average of 19 days with headache during the previous 30 days.
• Participation in the group education was associated with an 11.5-day decrease in the frequency of headaches during the previous 30 days at follow-up at least 6 months after the class, with largest decline seen in patients with the highest level of migraine-related disability at baseline.

Group education and multidisciplinary management for chronic headaches among adolescents in a military treatment facility: A retrospective chart review. [Published online ahead of print February 7, 2018]. Headache. doi:10.1111/head.13274.

Group education on headache evaluation and lifestyle management has potential as an effective, low-cost intervention for treatment of chronic headaches among adolescents, according to a recent study. This retrospective chart review study evaluated a group education program for 155 adolescents, aged 12-17 years, enrolled in the US military medical system with at least 3 months of chronic headaches and who were referred to a headache evaluation clinic. The primary outcome of the study was self-reported number of days with a headache in the previous 30 days based on patient recall. Researchers found:

• Most participants in the program were female (114/155 [73.5%]) and suffered from migraine headaches (108/155 [69.8%]).
• Severe headache-related disability was reported by 40.6% of subjects (63/155).
• Subjects reported an average of 19 days with headache during the previous 30 days.
• Participation in the group education was associated with an 11.5-day decrease in the frequency of headaches during the previous 30 days at follow-up at least 6 months after the class, with largest decline seen in patients with the highest level of migraine-related disability at baseline.

Group education and multidisciplinary management for chronic headaches among adolescents in a military treatment facility: A retrospective chart review. [Published online ahead of print February 7, 2018]. Headache. doi:10.1111/head.13274.

Group education on headache evaluation and lifestyle management has potential as an effective, low-cost intervention for treatment of chronic headaches among adolescents, according to a recent study. This retrospective chart review study evaluated a group education program for 155 adolescents, aged 12-17 years, enrolled in the US military medical system with at least 3 months of chronic headaches and who were referred to a headache evaluation clinic. The primary outcome of the study was self-reported number of days with a headache in the previous 30 days based on patient recall. Researchers found:

• Most participants in the program were female (114/155 [73.5%]) and suffered from migraine headaches (108/155 [69.8%]).
• Severe headache-related disability was reported by 40.6% of subjects (63/155).
• Subjects reported an average of 19 days with headache during the previous 30 days.
• Participation in the group education was associated with an 11.5-day decrease in the frequency of headaches during the previous 30 days at follow-up at least 6 months after the class, with largest decline seen in patients with the highest level of migraine-related disability at baseline.

Group education and multidisciplinary management for chronic headaches among adolescents in a military treatment facility: A retrospective chart review. [Published online ahead of print February 7, 2018]. Headache. doi:10.1111/head.13274.

The results of a recent study are consistent with an additive increase in stroke risk with combined hormonal contraceptives (CHC) use in women who have migraine with aura. Since the absolute risk of stroke is low even in the presence of these risk factors, use of CHCs in women who have migraine with aura should be based on an individualized assessment of harms and benefits. Researchers conducted a literature search of PubMed, the Cochrane Library, and EMBASE from inception through January 2016 for relevant studies. They included studies that examined exposure to CHCs and reported outcomes of ischemic or hemorrhagic stroke. They found:

• Of 2480 records, 15 studies met inclusion criteria.
• No studies reported odds ratios for stroke risk as a function of estrogen dose in women with migraine, largely due to insufficient sample sizes.
• No interaction effect between migraine and CHCs was seen in the 7 studies that assessed this.
• One study differentiated risk by presence or absence of migraine aura and found an increased risk in the migraine with aura population.

Risk of stroke associated with use of estrogen containing contraceptives in women with migraine: A systematic review. [Published online ahead of print November 15, 2017]. Headache. doi:10.1111/head.13229.

The results of a recent study are consistent with an additive increase in stroke risk with combined hormonal contraceptives (CHC) use in women who have migraine with aura. Since the absolute risk of stroke is low even in the presence of these risk factors, use of CHCs in women who have migraine with aura should be based on an individualized assessment of harms and benefits. Researchers conducted a literature search of PubMed, the Cochrane Library, and EMBASE from inception through January 2016 for relevant studies. They included studies that examined exposure to CHCs and reported outcomes of ischemic or hemorrhagic stroke. They found:

• Of 2480 records, 15 studies met inclusion criteria.
• No studies reported odds ratios for stroke risk as a function of estrogen dose in women with migraine, largely due to insufficient sample sizes.
• No interaction effect between migraine and CHCs was seen in the 7 studies that assessed this.
• One study differentiated risk by presence or absence of migraine aura and found an increased risk in the migraine with aura population.

Risk of stroke associated with use of estrogen containing contraceptives in women with migraine: A systematic review. [Published online ahead of print November 15, 2017]. Headache. doi:10.1111/head.13229.

The results of a recent study are consistent with an additive increase in stroke risk with combined hormonal contraceptives (CHC) use in women who have migraine with aura. Since the absolute risk of stroke is low even in the presence of these risk factors, use of CHCs in women who have migraine with aura should be based on an individualized assessment of harms and benefits. Researchers conducted a literature search of PubMed, the Cochrane Library, and EMBASE from inception through January 2016 for relevant studies. They included studies that examined exposure to CHCs and reported outcomes of ischemic or hemorrhagic stroke. They found:

• Of 2480 records, 15 studies met inclusion criteria.
• No studies reported odds ratios for stroke risk as a function of estrogen dose in women with migraine, largely due to insufficient sample sizes.
• No interaction effect between migraine and CHCs was seen in the 7 studies that assessed this.
• One study differentiated risk by presence or absence of migraine aura and found an increased risk in the migraine with aura population.

Risk of stroke associated with use of estrogen containing contraceptives in women with migraine: A systematic review. [Published online ahead of print November 15, 2017]. Headache. doi:10.1111/head.13229.

More than a quarter of initial emergency department (ED) visits for migraine are followed by headache revisits in less than 6 months, a recent study found. Using the New York City Department of Health and Mental Hygiene Syndromic Surveillance database, researchers conducted a retrospective nested cohort study. They analyzed visits from 18 New York City EDs with discharge diagnoses in the first 6 months of 2015, and conducted descriptive analyses to determine the frequency of headache revisit within 6 months of an index ED visit for migraine and the elapsed time to revisit. They found:

• Of 1052 ED visits with an ED discharge diagnosis of migraine during the first 6 months of 2015, 277 patients (26.3%) had a headache revisit within 6 months of their initial migraine visit and 131 (12.5%) had 2 or more revisits at the same hospital.
• Of the revisits for headache, 9% occurred within 72 hours and 46% occurred within 90 days of the initial migraine visit.
• Sex, age, and poverty level were not associated with an ED revisit.

A retrospective nested cohort study of emergency department revisits for migraine in New York City. [Published online ahead of print November 2, 2017]. Headache. doi:10.1111/head.13216.

More than a quarter of initial emergency department (ED) visits for migraine are followed by headache revisits in less than 6 months, a recent study found. Using the New York City Department of Health and Mental Hygiene Syndromic Surveillance database, researchers conducted a retrospective nested cohort study. They analyzed visits from 18 New York City EDs with discharge diagnoses in the first 6 months of 2015, and conducted descriptive analyses to determine the frequency of headache revisit within 6 months of an index ED visit for migraine and the elapsed time to revisit. They found:

• Of 1052 ED visits with an ED discharge diagnosis of migraine during the first 6 months of 2015, 277 patients (26.3%) had a headache revisit within 6 months of their initial migraine visit and 131 (12.5%) had 2 or more revisits at the same hospital.
• Of the revisits for headache, 9% occurred within 72 hours and 46% occurred within 90 days of the initial migraine visit.
• Sex, age, and poverty level were not associated with an ED revisit.

A retrospective nested cohort study of emergency department revisits for migraine in New York City. [Published online ahead of print November 2, 2017]. Headache. doi:10.1111/head.13216.

More than a quarter of initial emergency department (ED) visits for migraine are followed by headache revisits in less than 6 months, a recent study found. Using the New York City Department of Health and Mental Hygiene Syndromic Surveillance database, researchers conducted a retrospective nested cohort study. They analyzed visits from 18 New York City EDs with discharge diagnoses in the first 6 months of 2015, and conducted descriptive analyses to determine the frequency of headache revisit within 6 months of an index ED visit for migraine and the elapsed time to revisit. They found:

• Of 1052 ED visits with an ED discharge diagnosis of migraine during the first 6 months of 2015, 277 patients (26.3%) had a headache revisit within 6 months of their initial migraine visit and 131 (12.5%) had 2 or more revisits at the same hospital.
• Of the revisits for headache, 9% occurred within 72 hours and 46% occurred within 90 days of the initial migraine visit.
• Sex, age, and poverty level were not associated with an ED revisit.

A retrospective nested cohort study of emergency department revisits for migraine in New York City. [Published online ahead of print November 2, 2017]. Headache. doi:10.1111/head.13216.

For a minority of women who are overweight or obese, physical activity consistently contributed to the worsening of migraine pain, according to a recent study. Furthermore, more frequent physical activity-related pain worsening was related to greater severity of other migraine symptoms and pain sensitivity. Participants included 132 women, aged 18 to 50 years, with neurologist-confirmed migraine and overweight/obesity seeking weight loss treatment in the Women’s Health and Migraine trial. Researchers found:

• Subjects reported 5.5 ± 2.8 (mean ± standard deviation) migraine attacks over 28 days.
• The intraclass correlation indicated high consistency in participants’ reports of activity-related pain worsening or not.
• On average, activity worsened pain in 34.8 ± 35.6% of attacks, had no effect on pain in 61.8 ± 34.6% of attacks, and improved pain in 3.4 ± 12.7% of attacks.
• Few participants (9.8%) reported activity-related pain worsening in all attacks.
• A higher percentage of attacks where physical activity worsened pain demonstrated small-sized correlations with more severe nausea, photophobia, phonophobia, and allodynia.

Pain worsening with physical activity during migraine attacks in women with overweight/obesity: A prospective evaluation of frequency, consistency, and correlates. [Published online ahead of print December 13, 2017]. Cephalalgia. doi:10.1177/0333102417747231.

For a minority of women who are overweight or obese, physical activity consistently contributed to the worsening of migraine pain, according to a recent study. Furthermore, more frequent physical activity-related pain worsening was related to greater severity of other migraine symptoms and pain sensitivity. Participants included 132 women, aged 18 to 50 years, with neurologist-confirmed migraine and overweight/obesity seeking weight loss treatment in the Women’s Health and Migraine trial. Researchers found:

• Subjects reported 5.5 ± 2.8 (mean ± standard deviation) migraine attacks over 28 days.
• The intraclass correlation indicated high consistency in participants’ reports of activity-related pain worsening or not.
• On average, activity worsened pain in 34.8 ± 35.6% of attacks, had no effect on pain in 61.8 ± 34.6% of attacks, and improved pain in 3.4 ± 12.7% of attacks.
• Few participants (9.8%) reported activity-related pain worsening in all attacks.
• A higher percentage of attacks where physical activity worsened pain demonstrated small-sized correlations with more severe nausea, photophobia, phonophobia, and allodynia.

Pain worsening with physical activity during migraine attacks in women with overweight/obesity: A prospective evaluation of frequency, consistency, and correlates. [Published online ahead of print December 13, 2017]. Cephalalgia. doi:10.1177/0333102417747231.

For a minority of women who are overweight or obese, physical activity consistently contributed to the worsening of migraine pain, according to a recent study. Furthermore, more frequent physical activity-related pain worsening was related to greater severity of other migraine symptoms and pain sensitivity. Participants included 132 women, aged 18 to 50 years, with neurologist-confirmed migraine and overweight/obesity seeking weight loss treatment in the Women’s Health and Migraine trial. Researchers found:

• Subjects reported 5.5 ± 2.8 (mean ± standard deviation) migraine attacks over 28 days.
• The intraclass correlation indicated high consistency in participants’ reports of activity-related pain worsening or not.
• On average, activity worsened pain in 34.8 ± 35.6% of attacks, had no effect on pain in 61.8 ± 34.6% of attacks, and improved pain in 3.4 ± 12.7% of attacks.
• Few participants (9.8%) reported activity-related pain worsening in all attacks.
• A higher percentage of attacks where physical activity worsened pain demonstrated small-sized correlations with more severe nausea, photophobia, phonophobia, and allodynia.

Pain worsening with physical activity during migraine attacks in women with overweight/obesity: A prospective evaluation of frequency, consistency, and correlates. [Published online ahead of print December 13, 2017]. Cephalalgia. doi:10.1177/0333102417747231.