Time-of-day patterns and symptomology of migraine attacks assessed in real-time via mobile technologies

Authors

• KR Witonsky
• L Cui
• T Lateef
• Y Xiao
• KR Merikangas

Abstract

Manifestations of migraine vary significantly within individuals and across a lifetime. Although there is a broad clinical consensus on what distinguishes migraine from non-migraine headache, the phenomenology of migraine has not been well validated. Here we employed mobile technology to describe the real-time symptomology and time-of-day patterns of migraine attacks in a community-based sample. Data on headache symptoms, frequency and severity were collected 4x/day for two weeks via electronic diary. As reported in the diary, the current headache episode was classified as “migraine (with or without aura)”, “probable migraine (with or without aura)”, or “other headache” after aligning the participant’s reported symptoms with established ICHD diagnostic criteria. Over this two week span, 72% of the sample reported at least one headache, and 78% of everyone who had a least one headache had more than one. 90% of the daily headaches that were coded as migraine were reported by participants with a lifetime migraine diagnosis, as compared to only 49% of other headache. The symptom most commonly experienced with a migraine headache was moderate to severe pain, followed by photophobia. Headache start time was reported throughout the day for all headache subtypes, with a peak in the morning around 6:00 am. Here we describe the symptomology of the lived experience of migraine, which provides a framework for further investigation of the onset, progression, and context of individual migraine attacks. Better understanding these factors can elucidate the etiology behind this common, debilitating, and heterogeneous condition.

Scientific Focus Area: Epidemiology

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