Abstract Details

Title Characterizing Pre-headache (Prodrome) Features of Migraine Attacks: Results From the CaMEO Study

Topic Headache

Presentation(s) S4 - Hot Topics in Headache Medicine (1:36 PM-1:48 PM)

Poster/Presentation
Number 004

Background Pre-headache signs and symptoms are common in people with migraine but may or may not be recognized as potential heralds of an impending headache.

Objective To characterize common pre-headache (prodrome) features of migraine attacks.

Design/Methods CaMEO was a web-based, longitudinal study of individuals in the US who met criteria for migraine based on a validated questionnaire. We examined characteristics of respondents who reported feelings or warnings that they may soon get a headache (from a pre-identified list) and respondents who reported pre-headache features not considered warnings. Respondents who reported warning features were subcategorized based on monthly headache days (MHDs).

Results Among 12,810 respondents with migraine, 10,800 (84.3%) endorsed at least 1 pre-headache feature; of those, 6129 (56.7%) considered them warnings of impending headache. Among the pre-headache symptoms considered to be warnings, the most common were “neck pain or stiffness” (51.2% [3139/6129]), “vision problems” (49.2% [3013/6129]), “feeling dizzy or light-headed” (41.3% [2531/6129]), “difficulty thinking or concentrating” (39.6% [2428/6129]), “feeling irritable or moody” (36.4% [2234/6129]), and “feeling tired or weary” (32.5% [1990/6129]). Of those reporting warning symptoms of a visual nature, 48.8% (1471/3013) also reported ever experiencing aura. The top four pre-headache features were the same in those who did and did not consider them warnings. Respondents who reported warnings more often had moderate/severe anxiety, moderate/severe depression, and higher interictal burden compared with those who did not. Reporting a warning feature was more common among respondents with higher MHD frequency: 57.5% of those with ≥15 MHDs compared with 43.4% of those in the 0-3 MHD group.

Conclusions Over 84% of people with migraine recognize pre-headache features, and about half believe these symptoms are warnings of impending headache. Explicit study of person-level and population-level links to pre-headache symptoms in migraine is required to better understand the complex nature of the disease and its attacks.

Authors/Disclosures
Todd J. Schwedt, MD, FAAN (Mayo Clinic) PRESENTER	Dr. Schwedt has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Allergan. Dr. Schwedt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Schwedt has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eli Lilly. Dr. Schwedt has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Schwedt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Satsuma. Dr. Schwedt has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biodelivery Science. Dr. Schwedt has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. Dr. Schwedt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Axsome. Dr. Schwedt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Collegium. Dr. Schwedt has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Linpharma. Dr. Schwedt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Theranica. Dr. Schwedt has received personal compensation in the range of $0-$499 for serving as a Consultant for Amgen. Dr. Schwedt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Scilex. Dr. Schwedt has stock in Aural Analytics. Dr. Schwedt has stock in Nocira. The institution of Dr. Schwedt has received research support from Amgen. The institution of Dr. Schwedt has received research support from National Institutes of Health. The institution of Dr. Schwedt has received research support from United States Department of Defense. The institution of Dr. Schwedt has received research support from Patient Centered Outcomes Research Institute. The institution of Dr. Schwedt has received research support from SPARK Neuro. The institution of Dr. Schwedt has received research support from Henry Jackson Foundation. Dr. Schwedt has received intellectual property interests from a discovery or technology relating to health care. Dr. Schwedt has received publishing royalties from a publication relating to health care.
Stephanie J. Nahas, MD, FAAN (Thomas Jefferson University)	Dr. Nahas has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for AbbVie. Dr. Nahas has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eli Lilly. Dr. Nahas has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Nahas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Theranica. Dr. Nahas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pfizer. Dr. Nahas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Tonix. Dr. Nahas has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology Learning Network. Dr. Nahas has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer. Dr. Nahas has received publishing royalties from a publication relating to health care. Dr. Nahas has received publishing royalties from a publication relating to health care. Dr. Nahas has received personal compensation in the range of $500-$4,999 for serving as a expert/talent for CME event with Medscape/WebMD.
Kristina M. Fanning, PhD (MIST Reserach)	The institution of Kristina Fanning has received research support from Abbvie. The institution of Kristina Fanning has received research support from NYC Langone Health . The institution of Kristina Fanning has received research support from Allay Lamp. The institution of Kristina Fanning has received research support from Juva Health.
Janette Contreras-De Lama	Janette Contreras-De Lama has received personal compensation for serving as an employee of AbbVie. Janette Contreras-De Lama has stock in AbbVie.
Brittany L. Jordan, PharmD	Dr. Jordan has received personal compensation for serving as an employee of AbbVie. Dr. Jordan has received stock or an ownership interest from AbbVie.
Michael L. Reed, PhD (Vedanta Research)	The institution of Dr. Reed has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eli Lilly. The institution of Dr. Reed has received research support from Allergan. The institution of Dr. Reed has received research support from Dr Reddy's Labs/Promius. The institution of Dr. Reed has received research support from Allay Lamp. Dr. Reed has a non-compensated relationship as a Research Analyst with National Headache Foundation that is relevant to AAN interests or activities.
Dawn C. Buse, PhD (Dawn C. Buse, PhD)	Dr. Buse has received personal compensation for serving as an employee of Vector Psychometric Group. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie-Allergan. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Collegium. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie-Allergan. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Buse has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Current Pain and Headache Reports. The institution of Dr. Buse has received research support from Amgen. The institution of Dr. Buse has received research support from FDA. The institution of Dr. Buse has received research support from National Headache Foundation.
Richard B. Lipton, MD, FAAN (Albert Einstein College of Medicine)	Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biohaven. Dr. Lipton has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GlaxoSmithKline. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vedanta. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Grifols. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axon. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Satsuma. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cool Tech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BDSI. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Lipton has stock in Biohaven. Dr. Lipton has stock in Manistee. Dr. Lipton has stock in Axon. Dr. Lipton has stock in CoolTech. The institution of Dr. Lipton has received research support from Teva. The institution of Dr. Lipton has received research support from Amgen. The institution of Dr. Lipton has received research support from Allergan/Abbvie. The institution of Dr. Lipton has received research support from Gammacore. The institution of Dr. Lipton has received research support from Axsome. The institution of Dr. Lipton has received research support from Charleston Labs. The institution of Dr. Lipton has received research support from Eli Lilly. The institution of Dr. Lipton has received research support from Satsuma. The institution of Dr. Lipton has received research support from NIH . The institution of Dr. Lipton has received research support from Veterans Administration. Dr. Lipton has received publishing royalties from a publication relating to health care.