Trigger factors in primary headaches subtypes: a cross-sectional study from a tertiary centre in Greece.

Panagiotis Iliopoulos,Elli Kerezoudi,Aikaterini Tsagkovits,Michael Xifaras,Georgia Limpitaki,Petros Skapinakis,Dionysoula Skiada,Dimitris Damigos

doi:10.1186/s13104-015-1390-7

Panagiotis Iliopoulos, Elli Kerezoudi + Show 6 more

Open Access

https://doi.org/10.1186/s13104-015-1390-7

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Abstract

BackgroundPrevious studies have shown that common headache triggers contribute to the onset of headache attacks on predisposed individuals and are considered important in the prevention of headache. The aim of this study was to compare the different characteristics of triggers among the most common primary headache subtypes (migraine without aura, migraine with aura and tension type headache).MethodsA total of 116 headache patients of the neurology outpatient department of a tertiary hospital in Athens were selected according to the criteria of the International Classification of Headaches—3nd Edition Beta. Patients were interviewed using a questionnaire that contained 35 potential trigger factors.ResultsThe findings showed that migraine and tension-type headache patients report multiple triggers, on a frequent but variable basis. The most frequent triggers reported by all subjects were stressful life events followed by intense emotions. The same applies to both genders, as well as the three headache subgroups. Patients suffering from migraine with aura reported the highest mean number of trigger per person and the highest frequency in almost all the trigger categories. Furthermore, patients with migraine with aura were more likely to report the following triggers: oversleeping, premenstrual period, stressful life events, hot/cold weather, relaxation after stress, menstruation, wind, intense emotions, shining, hunger and bright sunlight. These associations were mostly independent of the sociodemographic characteristics and the presence of anxiety or depressive symptoms.ConclusionThe sensitivity to trigger factors should be considered by both clinicians and headache sufferers.

Highlights

Previous studies have shown that common headache triggers contribute to the onset of headache attacks on predisposed individuals and are considered important in the prevention of headache
No statistically significant variation was detected among migraine without aura (MoA), migraine with aura (MA) and tension type headache (TTH) (Table 1)
The current study gives a general picture of the headache trigger factors in Athens, Greece

Summary

Introduction

Previous studies have shown that common headache triggers contribute to the onset of headache attacks on predisposed individuals and are considered important in the prevention of headache. The aim of this study was to compare the different characteristics of triggers among the most common primary headache subtypes (migraine without aura, migraine with aura and tension type headache). The most common primary headaches, tension-type headache and migraine are ranked as the second and third most common complications (“sequelae”) of the diseases covered by the Global Burden of Disease study for all Despite the progress in the prevention and acute drug treatment of headaches, the recognition and management of the potential trigger factors remains an important key element for the successful clinical approach of headache patients [4]. A review of the literature demonstrated stress, skipping meals, sleep deprivation and weather changes as the most frequently mentioned triggers [8,9,10], even though factors such as fatigue, food, menstrual cycle, sunlight are consistently cited with various prevalence proportions [11,12,13], possibly due to different socio-cultural characteristics of the samples used

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