Changes of migraine aura with advancing age of patients

The Journal of Headache and Pain

Research

Simon Jung¹  Antonia Klein¹  Heinrich P. Mattle¹  Norbert Silimon¹  Adrian Scutelnic¹  Morin Beyeler¹  Thomas R. Meinel¹  Nedelina Slavova¹  Marcel Arnold¹  Hristina Drangova¹  Franz Riederer¹  Julian Lippert¹  Christoph J. Schankin¹  Urs Fischer² 

[1] Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland;Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland;Department of Neurology and Stroke Centre, University Hospital Basel and University of Basel, Basel, Switzerland;

关键词: Cortical spreading depression;    Migraine with aura;    Differential diagnosis of migraine with aura and ischemic stroke in elderly;   

DOI  :  10.1186/s10194-023-01642-w

 received in 2023-06-23, accepted in 2023-07-27,  发布年份 2023

来源: Springer

【 摘 要 】

AimGiven 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.MethodsThree 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 3rd Edition. The association of age with MA characteristics was assessed.ResultsThe 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 including the C-characteristics decreased with increasing age (P < 0.001). Patients with sensory (P < 0.001), motor (P = 0.004) 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.ConclusionThe 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.

【 授权许可】

CC BY   
© The Author(s) 2023

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