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Triggers for Migraine

Migraine is a neurological disorder that comes in attacks. However, the unpredictability of these attacks is one of the biggest complaints among patients. At the LUMC, we conduct research into what can trigger an attack, how this works and how we can predict attacks.

How does migraine develop

Migraine patients have a lowered stimulus threshold for certain factors (triggers). These triggers do not lead to a headache attack in persons without migraine. Migraine patients are therefore hypersensitive to certain stimuli. This hypersensitivity is probably for a large part genetically determined. In addition, the sensitivity to triggers can temporarily change due to certain circumstances. Examples of triggers are (extreme) fatigue, menstruation, atmospheric changes and possibly relaxation after stress.

The cause of a migraine attack is largely unknown. It is known that by exceeding the stimulus threshold certain parts of the brain are overstimulated. This causes a temporary disruption of these parts of the brain.

Trigger factors for migraine

Much research has already been done into triggers for migraine. Proven triggers for migraine are, for example, menstruation and disruption of the biological clock (jet lag). Certain foods or drinks, the loss of stress, or changes in the weather can also trigger a migraine attack. However, the sensitivity to triggers varies from person to person. The sensitivity to a particular trigger can also change over time.

How certain triggers provoke a migraine attack is often not yet known. There are also many myths surrounding this. For example, many patients and doctors incorrectly believe that migraine attacks are triggered by stress, abnormalities in the neck or eating certain foods such as chocolate. However, it is rather the other way around: because an attack has already started unconsciously (prodromal phase), patients start to feel stressed, feel pain in the neck or eat certain foods. Since an attack then follows this, many unjustly believe that these factors caused the attack.

Avoiding certain foods, taking anti-stress therapy or physiotherapy of the neck is therefore pointless to prevent migraine attacks. At the most, it can contribute to a better tolerance of the complaints.

The study

In this study we investigate personal triggers for migraine and we are working on a model that can predict attacks. We investigate which triggers are relevant for certain people. We then use advanced techniques from Artificial Intelligence (AI) to create predictive models. With these models we can gain more insight into what triggers a migraine attack.

For this study, we focus on patients with migraine who have on average at least 1 attack per month. The participants will keep our self-developed electronic headache diary for at least 3 up to 12 months. This registers the absence or presence of migraine and certain trigger factors on a daily basis. We are also deploying a new measurement method known as smartphone behavior. With this we keep track of how you use your smartphone. The idea is that if a migraine attack is coming, the way you operate your smartphone changes. Since we know from previous research that certain functions in the brain can work differently during a migraine attack. We hope that, by combining this information with information about triggers from the headache diary, we will get a better idea of ​​how different triggers influence the development of migraine.

In this study, we use different methods to collect information that will help us learn more about triggers and the lead-up to the migraine attack. In the future, this information may be used to predict an attack. This information will be obtained through:

• Keeping the LUMC Headache Diary for a minimum of 3 months and a maximum of 12 months. You will be doing this for about 5-10 minutes a day. Once a month you fill in a longer diary that lasts a maximum of 15 minutes.

• Keeping information related to the use of your mobile phone for a minimum of 3 and a maximum of 12 months using an app. This app runs in the background and collects information without you having to do anything.

Would you like more information or register for the study? Send an email with your name and contact details to: Migraine_Triggers@lumc.nl

Want to participate?

To enrol in the triggers study sufficient mastery of the Dutch language is required. Would you like more information or register for the study? Send us an email with your name and contact details.

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