Many people who suffer from migraine have learned to avoid “triggers” that can bring on a headache and visual disturbances known as aura. But a small Danish study suggests that triggers for migraine with aura may not be as strong as some people think.
The study is being published in Neurology, the journal of the American Academy of Neurology.
“People with migraine with aura are told to avoid possible triggers, which may lead them to avoid a wide range of suspected factors,” said lead author Jes Olesen, MD, of the University of Copenhagen in Denmark and a Fellow of the American Academy of Neurology. “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 patients with migraine with aura who reported that bright or flickering light, intense exercise, or both, often triggered migraine attacks.
The participants were then exposed to the triggers to see if a migraine ensued. They ran or used an exercise bike for an hour; then were exposed to bright, flashing or flickering lights for 30 to 40 minutes.
Afterwards, only 11 percent of participants reported a migraine with aura after being exposed to light or exercise. Another 11% 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.
In an accompanying editorial, Peter Goadsby, MD, of the University of California, San Francisco, notes that the Danish study raises 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,” Goadsby wrote.
The study was supported by the University of Copenhagen, the Lundbeck Foundation Center for Neurovascular Signaling, the Danish Council for Independent Research-Medical Sciences, the Novo Nordisk Foundation and the Research Foundation of the Capital Region of Denmark.