- Triggers of migraine attacks are clinically significant because of their potential role in determining when and why attacks occur in individual patients.
- At study registration, participants were asked to list their suspected, self-reported triggers. After 90 days of recording daily exposure to their suspected triggers, it was found that in over two thirds of participants even the most commonly suspected triggers were not statistically associated with their attacks.
- For this reason, daily recording of trigger exposure followed by statistical analysis of association with attacks is critical in accurately determining an individual's potential triggers and premonitory symptoms.
CAMBRIDGE, Mass., June 29, 2022 /PRNewswire/ -- Curelator Inc. today announced new data from an observational longitudinal cohort study of 328 individuals with migraine who, between October 2014 and June 2017, registered to track their headaches prospectively using the N1-Headache application. For 90 days, N1-Headache users entered daily data about headache symptoms, as well as potential triggers and premonitory symptoms that may be associated with attack risk.
In these individuals, the average number of triggers moderately or highly suspected was 28 per individual, selected from a list of up to 38 possible triggers. Of these, only an average of 2.2 triggers per individual were associated with increased risk of attacks in statistical models. In fact, the most commonly suspected triggers (sleep quality, stress, tiredness/fatigue, sleep duration, dehydration, neck pain, missed meals, eyestrain, barometric pressure and anxiety) were statistically associated in less than 33% of individuals suspecting them, except for neck pain (associated in 39%).
In conclusion, people with migraine believe that many triggers may contribute to their attacks, but very few of these triggers demonstrate a statistical association to attack occurrence at the individual level. Behavioral strategies together with improved personal knowledge of potential triggers and premonitory symptoms may help individuals with migraine mitigate the risk of new attacks.
This figure shows the percentage of individuals in whom a self-reported trigger showed a statistically significant association to attacks occurrence, for the most commonly self-reported triggers (ordered from highest rated belief -sleep quality- to lowest -anxiety). Neck pain was the self-reported trigger with the highest proportion of statistical associations with attacks (38.7%), 117 of 302 individuals).
Amparo Casanova MD, PhD, lead author of the research paper, Vice President of Clinical Statistics, Curelator Inc. commented: "The findings of our study challenge the recommendation often given to people with migraine of "avoiding all known triggers". We should first clarify whether a trigger is indeed a trigger for that person, starting by confirming a statistical association, and then consider behavioral experiments to explore causality."
Paul R. Martin PhD, senior author of the study, School of Applied Psychology and Menzies Health Institute, Griffith University, Brisbane, QLD, Australia and Department of Psychiatry, Southern Clinical School, Monash University, Melbourne, VIC, Australia also commented: "I believe that using a clinically validated app to collect and analyze prospective data about daily factors that precede migraine attacks is an important first step in improving an individual's understanding of their disorder, specifically why attacks occur when they do."
Individualized digital data capture and analytics were enabled by Curelator's N1-Headache, a digital platform that combines a simple smartphone data entry process with personalized N=1 analytics. After 90 days of data entry, the application generates Individual Trigger Map, Protector Map and No Association Map for each user incorporated within a Personal Analytical Report. The information featured in the Personal Report enables patients and their clinicians to generate individual, high resolution phenotypic profiles to manage risk factors and monitor medication use.
Reference
Casanova, A, Vives-Mestres, M, Donoghue, S, Mian, A, Martin, PR. An observational study of self-reported migraine triggers and prospective evaluation of the relationships with occurrence of attacks enabled by a smartphone application (App). Headache. 2022; 00: 1- 10. doi:10.1111/head.14328
About Curelator
Founded in Cambridge, Massachusetts, in 2013, Curelator is a data-driven digital health company focused on developing clinical grade, personalized disease management tools for patients and clinicians. Since its inception, Curelator has published dozens of papers and abstracts in major headache and migraine journals and conferences, and it has enrolled thousands of patients on clinical studies through its N1-Headache platform.
About N1-Headache
N1-Headache is a unique patient engagement platform that delivers personalized, disease management tools for people with a history of migraine or medication overuse, allowing them to understand their migraine attack patterns in an individualized manner. This personalized information enables patients and their healthcare providers to manage individual migraine risk factors, assess therapeutic response to drugs and identify opportunities to prevent medication overuse.
Contact for additional information:
Curelator
Magdalena Kurtz
Marketing & Communications
mkurtz@curelator.com
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