Migraine and Triggers: Post Hoc Ergo Propter Hoc?

Abstract

The influence of environmental factors on the clinical manifestation of migraine has been a matter of extensive debate over the past decades. Migraineurs commonly report foods, alcohol, meteorologic or atmospheric changes, exposure to light, sounds, or odors, as factors that trigger or aggravate their migraine attacks. In the same way, physicians frequently follow this belief in their recommendations in how migraineurs may reduce their attack frequency, especially with regard to the consumption of certain food components. Interestingly, despite being such a common belief, most of the clinical studies have shown conflicting results. The aim of the review is to critically analyze clinical and pathophysiological facts that support or refute a correlation between certain environmental stimuli and the occurrence of migraine attacks. Given the substantial discrepancy between patients' reports and objective clinical data, the methodological difficulties of investigating the link between environmental factors and migraine are highlighted.

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Acknowledgments

This work was supported by the National Institutes of Health (National Institute of Neurological Disorders and Stroke) [K08 –NS066087].

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Conflict of Interest

Dr. Jan Hoffmann received a grant from Deutsche Forschungsgemeinschaft-DFG and payment for manuscript preparation from the Journal Watch Neurology. Dr. Hoffmann had travel/accommodations expenses covered or reimbursed by Allergan, International Headache Society, and American Headache Society.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to Ana Recober.

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This article is part of the Topical Collection on Migraine

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Hoffmann, J., Recober, A. Migraine and Triggers: Post Hoc Ergo Propter Hoc?. Curr Pain Headache Rep 17, 370 (2013). https://doi.org/10.1007/s11916-013-0370-7

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Keywords

  • Migraine
  • Trigger
  • Environmental stimuli
  • Headache
  • Precipitant