Migraine triggers may not be as strong as you think

"People with migraine with aura are told to avoid possible triggers, which may lead them to avoid a wide range of suspected factors," said study author Jes Olesen, MD, with the University of Copenhagen in Denmark and a Fellow of the American Academy of Neurology. "Yet the most commonly reported triggers are stress, bright light, emotional influences and physical effort, which can be difficult to avoid and potentially detrimental, if people avoid all physical activity."

The study involved 27 people with migraine with aura who reported that bright or flickering light, vigorous exercise, or both, previously triggered an attack. The participants were then exposed to the triggers to see if they caused a headache episode.

Participants either went for an intense run or used an exercise bike for one hour, reaching at least 80 percent of their maximum heart rate. Participants also were exposed to bright, flashing or flickering lights for 30 to 40 minutes. After each session, the participants were monitored for about three hours and asked to report any migraine or migraine with aura symptoms.

The study found that 11 percent of participants reported a migraine with aura after being exposed to light or exercise. Another 11 percent of participants experienced migraines without aura. No participants developed migraine with aura after light exposure alone.

"Our study suggests that if a person is exposed to a suspected trigger for three months and does not have a migraine attack, they no longer have to worry about avoiding that trigger," said Olesen.

Peter Goadsby, MD, PhD, with the University of California, San Francisco, and a member of the American Academy of Neurology, noted in an accompanying editorial that the study brings up several questions about migraine triggers. "Perhaps rather than triggers, these behaviors are a brain-driven response to the early phases of the migraine itself. Maybe people are driven to exercise as an early symptom and the association with light is simply the sensitivity to light that occurs with the attack itself?"

The study was supported by the University of Copenhagen, the Lundbeck Foundation Center for Neurovascular Signalling, the Danish Council for Independent Research-Medical Sciences, the Novo Nordisk Foundation and the Research Foundation of the Capital Region of Denmark.