Curelator Headache study in Cephalagia shows migraineurs may have "unique" trigger profiles
25 May, 2016, 08:17 ET
CAMBRIDGE, Mass., May 25, 2016 /PRNewswire/ -- Individuals with migraine are not likely to have similar trigger attack profiles, according to data just published online in Cephalagia, the official journal of the International Headache Society (1). The new findings unexpectedly indicate that the majority of individuals with migraine have highly individualized sets of dietary, environmental, behavioral and hormonal factors that may act as triggers of their migraines. The discovery that the majority of people with migraine may have "unique" trigger combinations further underscores the need for management and treatments expressly tailored to individuals, as opposed to approaches based on the assumption that the vast majority of migraineurs have similar pathologies.
The new research employed Curelator Headache™, a digital platform that uses an N=1 statistical approach, which enables analysis of individual as well as aggregate populations. An N=1 approach allowed comparisons of potential trigger profiles for each of the 327 patients in the previously published PAMINA study at the Medical University of Vienna, Austria (2). The PAMINA study, which was previously used to identify common factors associated with migraine attacks from a population analysis, is one of the most comprehensive daily migraine trigger databases. In that study, patients used paper-based diaries for 90 days to track 33 factors (potential triggers or premonitory symptoms) possibly associated with migraine attacks. Prof. Christian Wöber, MD, one of the co-authors of the new paper, was also lead author of the PAMINA study.
Prof. Wöber explains, "The new analysis provides, for the first time at the individual patient level, information about the association between migraine attacks and a spectrum of potential migraine triggers that might not be evident in a population but important in the composition of an individual's trigger profile." At the population level, a total of eight significant factors were identified and associated with increased risk of attack: menstruation (53%), neck tension (40%), tiredness (21%), bright lights (19%), loud noise (17%), excessive sleep (11%), restless sleep (11%) and odors (10%).
In contrast, Curelator's N=1 statistical approach revealed individual factor-attack association profiles for 87% of the patients out of whom an unexpectedly high proportion of patients—85%—had "unique" trigger profiles. In other words, the vast majority of patients were found to have factors significantly associated with their individual attacks that were not apparent at a population level. For example, dietary factors were very strong triggers for some individuals. Other factors, such as weather, also not evident on a population level were, in fact, significantly associated with attacks in other individuals.
"The tremendous variation in trigger profiles between individuals has important therapeutic implications because it suggests that one-size-fits-all approaches to avoiding potential triggers may be leading patients in directions that are not helpful to them," explains Alec Mian, PhD, CEO and founder of Curelator, Inc., the Cambridge, MA-based company that funded the study.
About Curelator Inc.
Curelator Headache is a patient-centric digital platform that enables patients, clinicians and healthcare providers to optimize individual therapeutic pathways in chronic diseases with episodic attacks.
(1) Peris F, Donoghue S, Torres, F, Mian A, Wober C. Towards improved migraine management: Determining potential trigger factors in individual patients. Cephalagia 2016; DOI: 10.1177/0333102416649761.
(2) Wöber C, Brannath W,S chmidt K,etal. Prospective analysis of factors related to migraine attacks: The PAMINA study. Cephalalgia 2007; 27: 304–314
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SOURCE Curelator Inc.
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