Most bothersome symptom in migraine and probable migraine: A population-based study

PLoS One. 2023 Nov 29;18(11):e0289729. doi: 10.1371/journal.pone.0289729. eCollection 2023.

Abstract

Recently, the most bothersome symptom has been recommended as a co-primary endpoint in clinical trials on the acute treatment of migraine. Probable migraine is a subtype of migraine that fulfills all but one criterion for migraine diagnosis. We aimed to compare the most bothersome symptom between probable migraine and migraine. This study analyzed data from a nationwide study conducted in Korea, and the most bothersome symptom was assessed by requesting the participants to select one of the four typical accompanying symptoms of migraine. Responses to acute treatment were evaluated using the migraine Treatment Optimization Questionnaire-6. Nausea was the most bothersome symptom, followed by phonophobia and vomiting in the migraine group (nausea, 61.8%; phonophobia, 25.3%; vomiting, 10.0%; and photophobia, 2.9%) and the probable migraine group (nausea, 82.2%; phonophobia, 9.5%; vomiting, 5.6%; and photophobia, 2.7%). In participants with migraine, vomiting (adjusted odds ratio = 6.513; 95% confidence interval, 1.763-24.057) and phonophobia (adjusted odds ratio = 0.437; 95% confidence interval, 0.206-0.929) were significantly associated with severe headache intensity and nausea was significantly associated with >3 headache days per 30 days (adjusted odds ratio = 0.441; 95% confidence, 0.210-0.927). Different patterns of associations were observed in probable migraine.

MeSH terms

  • Double-Blind Method
  • Headache / complications
  • Humans
  • Hyperacusis / epidemiology
  • Migraine Disorders* / complications
  • Migraine Disorders* / diagnosis
  • Migraine Disorders* / epidemiology
  • Nausea / drug therapy
  • Nausea / epidemiology
  • Photophobia* / complications
  • Photophobia* / epidemiology
  • Surveys and Questionnaires
  • Vomiting / complications

Grants and funding

This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (Grant No.: HV22C0106) and a National Research Foundation of Korea (NRF) grant from the Korean government (MSIT) (2022R1A2C1091767). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.