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Changes of migraine aura with advancing age of patients
AIM: Given the similar presentation of migraine aura and acute ischemic stroke, advancing patient age might change the characteristics of migraine with aura (MA) and be clinically important. Clinical data, however, are limited. Experimental studies indicate a decrease in the magnitude of cortical sp...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Milan
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10394819/ https://www.ncbi.nlm.nih.gov/pubmed/37528414 http://dx.doi.org/10.1186/s10194-023-01642-w |
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author | Scutelnic, Adrian Drangova, Hristina Klein, Antonia Slavova, Nedelina Beyeler, Morin Lippert, Julian Silimon, Norbert Meinel, Thomas R. Arnold, Marcel Fischer, Urs Riederer, Franz Mattle, Heinrich P. Jung, Simon Schankin, Christoph J. |
author_facet | Scutelnic, Adrian Drangova, Hristina Klein, Antonia Slavova, Nedelina Beyeler, Morin Lippert, Julian Silimon, Norbert Meinel, Thomas R. Arnold, Marcel Fischer, Urs Riederer, Franz Mattle, Heinrich P. Jung, Simon Schankin, Christoph J. |
author_sort | Scutelnic, Adrian |
collection | PubMed |
description | AIM: Given the similar presentation of migraine aura and acute ischemic stroke, advancing patient age might change the characteristics of migraine with aura (MA) and be clinically important. Clinical data, however, are limited. Experimental studies indicate a decrease in the magnitude of cortical spreading depression (CSD), the pathophysiological correlate of migraine aura, with advancing age. Our study aimed to assess the influence of age on the clinical features of MA. METHODS: Three hundred and forty-three patients were interviewed using a structured questionnaire. The questions covered the headache characteristics and symptom types including the characteristics of the C-criterion, as defined by the International Classification of Headache Disorders 3(rd) Edition. The association of age with MA characteristics was assessed. RESULTS: The median age was 29 (IQR 28–52) and 235 of the 343 patients were women (69%). Individual symptoms of the C-criterion such as gradual aura spreading over longer than 5 min (P < 0.001), two or more aura symptoms occurring in succession (P = 0.005), duration of at least one MA symptom for longer than 60 min (P = 0.004), and associated headache (P = 0.01) were more frequent in younger patients. The number of symptoms (P = 0.003) including the C-characteristics decreased with increasing age (P < 0.027). Patients with sensory (P < 0.001), motor (P = 0.04) and speech disturbance (P = 0.02) were younger, and older patients with headache had less photophobia (P = 0.04) and phonophobia (P = 0.03). Sensitivity analyses yielded similar results. CONCLUSION: The frequency of typical characteristics of migraine aura and migraine headache including photophobia and phonophobia decreases with advancing patient age. This might have potentially difficult implications for the diagnosis of MA in the elderly. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s10194-023-01642-w. |
format | Online Article Text |
id | pubmed-10394819 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Milan |
record_format | MEDLINE/PubMed |
spelling | pubmed-103948192023-08-03 Changes of migraine aura with advancing age of patients Scutelnic, Adrian Drangova, Hristina Klein, Antonia Slavova, Nedelina Beyeler, Morin Lippert, Julian Silimon, Norbert Meinel, Thomas R. Arnold, Marcel Fischer, Urs Riederer, Franz Mattle, Heinrich P. Jung, Simon Schankin, Christoph J. J Headache Pain Research AIM: Given the similar presentation of migraine aura and acute ischemic stroke, advancing patient age might change the characteristics of migraine with aura (MA) and be clinically important. Clinical data, however, are limited. Experimental studies indicate a decrease in the magnitude of cortical spreading depression (CSD), the pathophysiological correlate of migraine aura, with advancing age. Our study aimed to assess the influence of age on the clinical features of MA. METHODS: Three hundred and forty-three patients were interviewed using a structured questionnaire. The questions covered the headache characteristics and symptom types including the characteristics of the C-criterion, as defined by the International Classification of Headache Disorders 3(rd) Edition. The association of age with MA characteristics was assessed. RESULTS: The median age was 29 (IQR 28–52) and 235 of the 343 patients were women (69%). Individual symptoms of the C-criterion such as gradual aura spreading over longer than 5 min (P < 0.001), two or more aura symptoms occurring in succession (P = 0.005), duration of at least one MA symptom for longer than 60 min (P = 0.004), and associated headache (P = 0.01) were more frequent in younger patients. The number of symptoms (P = 0.003) including the C-characteristics decreased with increasing age (P < 0.027). Patients with sensory (P < 0.001), motor (P = 0.04) and speech disturbance (P = 0.02) were younger, and older patients with headache had less photophobia (P = 0.04) and phonophobia (P = 0.03). Sensitivity analyses yielded similar results. CONCLUSION: The frequency of typical characteristics of migraine aura and migraine headache including photophobia and phonophobia decreases with advancing patient age. This might have potentially difficult implications for the diagnosis of MA in the elderly. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s10194-023-01642-w. Springer Milan 2023-08-01 /pmc/articles/PMC10394819/ /pubmed/37528414 http://dx.doi.org/10.1186/s10194-023-01642-w Text en © The Author(s) 2023, corrected publication 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Scutelnic, Adrian Drangova, Hristina Klein, Antonia Slavova, Nedelina Beyeler, Morin Lippert, Julian Silimon, Norbert Meinel, Thomas R. Arnold, Marcel Fischer, Urs Riederer, Franz Mattle, Heinrich P. Jung, Simon Schankin, Christoph J. Changes of migraine aura with advancing age of patients |
title | Changes of migraine aura with advancing age of patients |
title_full | Changes of migraine aura with advancing age of patients |
title_fullStr | Changes of migraine aura with advancing age of patients |
title_full_unstemmed | Changes of migraine aura with advancing age of patients |
title_short | Changes of migraine aura with advancing age of patients |
title_sort | changes of migraine aura with advancing age of patients |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10394819/ https://www.ncbi.nlm.nih.gov/pubmed/37528414 http://dx.doi.org/10.1186/s10194-023-01642-w |
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