The role of prodromal symptoms in predicting headache onset: A longitudinal electronic momentary assessment study
Abstract
OBJECTIVE: This longitudinal observational study investigated the role of prodromal symptoms in predicting headache onset, using electronic headache diaries to assess symptom occurrence and predictive utility in individuals with migraine.
BACKGROUND: Prodromal symptoms are early indicators of migraine that occur 2-48 h before the headache phase. Whereas commonly reported symptoms include fatigue, stiff neck, and sensitivity to light and sound, few studies have assessed their predictive abilities for headache onset. Understanding the relationship and reliability of these symptoms is important for early migraine intervention strategies.
METHODS: This is a secondary analysis of a longitudinal observational headache diary study. Participants with episodic migraine (N = 43) were recruited from Einstein College of Medicine between 2017 and 2021 and completed a mobile headache diary three times daily over 3 months. They reported the presence of 11 prodromal symptoms and headache anticipation during headache-free intervals. Associations between prodromal symptoms, anticipation, and subsequent headache onset were examined across multiple time lags. Headache anticipation was evaluated as a moderator of these relationships.
RESULTS: Across 7061 headache-free observations, prodromal symptoms were reported in 52.7% of cases (n = 3721). Phonophobia doubled the odds of head pain onset 6 h before head pain. Nausea, photophobia, and difficulty thinking/concentrating were associated with…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 3,721 participants or records.
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