Evidence Hub

Overlap between perceived triggers, premonitory symptoms and symptom persistence across migraine phases: A REFORM study

Thuraiaiyah J, Christensen RH, Al-Khazali HM, Wiggers A, Ashina M, Ashina H

Cephalalgia : an international journal of headache, 2025

632 participants

Abstract

AimTo evaluate the overlap between commonly reported trigger factors and corresponding premonitory symptoms in individuals with migraine.MethodsThis cross-sectional study analyzed data based on participant recall obtained through semi-structured interviews. Individuals diagnosed with migraine were enrolled from September 2020 to June 2022. Participants underwent semi-structured interviews to record their usual trigger factors, premonitory symptoms, non-headache symptoms during the headache and postdromal symptoms. The primary outcome was to assess whether reporting specific trigger factors increased the likelihood of experiencing corresponding premonitory symptoms. Furthermore, the presence of non-headache symptoms across migraine phases was examined.ResultsAmong the 632 participants (mean age 44.6 ± 12.0 years; 89% female), the most frequent triggers were sleep disturbances (70.1%), stress (67.7%) and alcohol consumption (59.0%). Common premonitory symptoms included tiredness (39.9%), concentration difficulties (35.0%) and neck pain (33.2%). Significant associations were found between specific triggers and premonitory symptoms: bright light with premonitory photophobia (odd ratio (OR) = 2.79; 95% confidence interval (CI) = 1.90-4.12; p < 0.001), loud noise with premonitory phonophobia (OR = 4.26; 95% CI = 2.77-6.59; p < 0.001) and sleep disturbances with premonitory tiredness (OR = 1.74; 95% CI = 1.15-2.64; p = 0.009).ConclusionsOur results reveal a notable overlap between…

How strong is the evidence?

Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 632 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

Read the paper

Related studies

Go deeper in Evidence Hub

Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.

Open this study Sign up free