Danish Headache Center and Department of Neurology, Glostrup Hospital, Faculty of Health Sciences, University of Copenhagen, Denmark.
Neurology. 2013 Jan 29;80(5):428-31. doi: 10.1212/WNL.0b013e31827f0f10. Epub 2013 Jan 23.
It is well-known that migraine attacks can be precipitated by various stimuli. More than 50% of patients with migraine with aura (MA) know of at least one stimulus that always or often triggers their MA attacks. The objective of this study was to expose patients with MA to their self-reported trigger factors in order to assess the causal relation between trigger factors and attacks.
We recruited 27 patients with MA who reported that bright or flickering light or strenuous exercise would trigger their migraine attacks. The patients were experimentally provoked by different types of photo stimulation, strenuous exercise, or a combination of these 2 factors. During and following provocation, the patients would report any aura symptoms or other migraine-related symptoms.
Of 27 provoked patients with MA, 3 (11%) reported attacks of MA following provocation. An additional 3 patients reported migraine without aura attacks. Following exercise, 4 out of 12 patients reported migraine, while no patients developed attacks following photo stimulation.
Experimental provocation using self-reported natural trigger factors causes MA only in a small subgroup of patients with MA. Prospective confirmation is important for future studies of migraine trigger factors and in the clinical management of patients with migraine.
众所周知，偏头痛发作可由各种刺激引发。超过 50%的有先兆偏头痛（MA）患者至少有一种会经常引发其偏头痛发作的刺激因素。本研究的目的是让 MA 患者接触到他们自我报告的触发因素，以评估触发因素与发作之间的因果关系。
我们招募了 27 名报告称明亮或闪烁的光或剧烈运动可引发偏头痛发作的 MA 患者。患者通过不同类型的光刺激、剧烈运动或这两种因素的组合进行实验性诱发。在诱发过程中和之后，患者会报告任何先兆症状或其他偏头痛相关症状。
在 27 名被诱发的 MA 患者中，有 3 名（11%）在诱发后报告出现 MA 发作。另外 3 名患者报告出现无先兆偏头痛发作。运动后，12 名患者中有 4 名出现偏头痛，而没有患者在光刺激后出现发作。
使用自我报告的自然触发因素进行实验性诱发仅在一小部分 MA 患者中引起 MA。前瞻性确认对于偏头痛触发因素的未来研究和偏头痛患者的临床管理非常重要。
