Healthcare Experts Share Insights on Migraine Risk Factors and Protective Actions
Living with migraine can be challenging, and for some individuals, the frequency and severity of migraine attacks may increase over time. While preventing migraine progression has become a focus in specialized headache care, there may be less awareness in general neurology or primary care settings where many people seek treatment for migraines.
A group of healthcare professionals, clinicians, and researchers specializing in headaches recently reviewed published evidence to better understand factors linked to increased or decreased rates of migraine progression. Their goal was to establish expert opinions on managing the disease and reducing the risk of progression.
Migraine progression is often defined as the shift from having 15 or fewer monthly headache days to 15 or more among people with migraines. However, experts caution that this definition may not capture all aspects of migraine biology, and alternative definitions should be considered.
The experts identified key risk factors for migraine progression across five domains: migraine disease characteristics, treatment-related factors, comorbidities, lifestyle/exogenous factors, and demographic factors. Among these factors, evidence supports several risks, including suboptimal acute headache treatment, skin sensitivity, overuse of certain medications, specific psychiatric symptoms, other chronic pain conditions, metabolic comorbidities, sleep problems, respiratory conditions, high caffeine intake, lack of physical activity, financial constraints, tobacco use, and personal triggers.
While protective actions that could help prevent migraine progression are less studied, experts believe that understanding and addressing these risk factors is crucial. Recognizing these risks enables healthcare providers to suggest protective actions and interventions that may mitigate the progression of migraines.
The experts emphasize the need for further research through intervention studies to weigh the importance of these risk factors and test the effectiveness of strategies to reduce the risk of migraine progression. By increasing awareness and understanding of these factors, healthcare providers can better support individuals with migraines in managing their condition and improving their quality of life.
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Reference
Richard B Lipton, Dawn C Buse, Stephanie J Nahas, Gretchen E Tietjen, Vincent T Martin, Elin Löf, Thomas Brevig, Roger Cady, Hans-Christoph Diener. Risk factors for migraine disease progression: a narrative review for a patient-centered approach. J Neurol. 2023 Dec;270(12):5692-5710. doi: 10.1007/s00415-023-11880-2. Epub 2023 Aug 24.