History of Abuse Linked to More Severe Migraine Sensory Symptoms

A history of abuse is associated with greater migraine-related sensory hypersensitivity symptoms according to new research. The abstract will be presented at the American Academy of Neurology’s 73rd Annual Meeting, being held virtually between April 17-22, 2021.

Previous research has shown psychiatric comorbidities such as anxiety and depression are common among migraineurs. In addition, “prior studies have established an association between abuse and development of migraine and suggested this is attenuated after controlling for depression,” the researchers wrote, but limited research is available investigating abuse and individual migraine symptoms.

Notably, one 2020 study concluded the direct effect of childhood trauma on migraine is outweighed by the mediation effect of adulthood attachment. Individuals exposed to childhood trauma tend to exhibit insecure attachment patterns and are more prone to chronic and pain-related conditions, such as migraine.

Because individuals with high-attachment anxiety are prone to experience many interpersonal interactions as a source of distress, the researchers hypothesized being daily under stress may be a factor in the onset of migraine, triggering some attacks.

In the current study, researchers sought to assess the associations between a history of emotion, physical, and sexual abuse with severity of hypersensitivity symptoms in migraineurs, by having over 1000 adult migraineurs fill out multiple questionnaires.

A total of 1020 participants from the American Registry for Migraine Research completed the Generalized Anxiety Disorder-7, Patient Health Questionnaire-2 for depression, Photosensitivity Assessment Questionnaire, Hyperacusis Questionnaire, and Allodynia Symptom Checklist.

Thirty Six percent of patients self-reported a history of abuse (n = 365) while T-tests compared scores between cohorts with and without a history of abuse. Analyses revealed “abuse was associated with greater headache frequency (P = .019), anxiety (P <.001), depression (P <.001), photophobia (P <.001), hyperacusis (P <.001), ictal allodynia (P <.001), and interictal allodynia (P = .001).”

Analyses adjusted for age, gender, and headache frequency showed:

• Abuse was significantly associated with photophobia (B = 0.111; P <.001), hyperacusis (B = 4.328; P <.001), ictal allodynia (B = 0.125; P <.001), and interictal allodynia (B = 0.109; P=.002)
• Anxiety significantly mediated the relationships between abuse with photophobia (indirect mediated effect [IE] = 0.027; 95% CI, 0.015-0.041), hyperacusis (IE = 1.256; 95% CI, 0.828-1.752), and ictal allodynia (IE = 0.015; 95% CI, 0.002-0.028)
• Depression significantly mediated the relationship between abuse with photophobia (IE = 0.026; 95% CI, 0.015-0.040), hyperacusis (IE = 1.057; 95% CI, 0.662-1.514), and ictal allodynia (IE = 0.019; 95% CI, 0.007-0.032).

Future research into the pathophysiological mechanisms underlying the associations seen between abuse, psychiatric comorbidities, and migraine symptoms is needed, the researchers wrote. More studies “could lead to interventions that reduce the negative impact of abuse on the expressions and severity of migraine symptoms,” they concluded.

Reference:

Trivedi M, Dumkrieger G, Chong C, Dodick D, Schwedt T. Impact of abuse on migraine symptoms and comorbidity: results from the American registry for migraine research (ARMR). Presented at American Academy of Neurology 73rd Annual Meeting; April 17-22, 2021; Virtual. Accessed April 12, 2021. https://index.mirasmart.com/AAN2021/PDFfiles/AAN2021-002187.html