Frequent Nausea Associated with Transformation to Chronic Migraine
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Despite the frequency with which Migraine patients experience nausea during their attacks, we haven’t known much about how this common symptom might influence the progression of Migraine Disease from episodic to chronic.

At the 2013 International Headache Congress in June, researchers shared the results of a study examining this issue. They learned patients whose Migraine Disease transformed from episodic to chronic were likely to experience frequent, persistent nausea with their attacks.

Using existing data from the 2007 and 2008 American Migraine Prevalence and Prevention Study (AMPP), the research team identified two subgroups meeting certain criteria.

  • Patients with episodic Migraine and no or low frequency nausea.
  • Patients with episodic Migraine and persistent, frequent nausea.

They then looked at 2009 data from the AMPP study to identify patients that met the criteria for chronic Migraine (15 or more days of headache a month for the last three months) to draw conclusions about the relationship between the intensity of the nausea and transformation from episodic to chronic Migraine.

Among the 3,182 patients in the study:

  • 43.7% of episodic Migraineurs experienced persistent, frequent nausea.
  • 3.4% of episodic Migraineurs with persistent, frequent nausea transformed to chronic status.
  • 27.6% of episodic Migraineurs experienced no or low frequency nausea.
  • 1.5% of episodic Migraineurs with no or low frequency nausea transformed to chronic status.
  • Patients who experienced persistent, frequent nausea were fully twice as likely to develop chronic Migraine.

Even after the research team controlled for demographics (such as gender), migraine symptoms and headache-related disability, patients who experienced persistent, frequent nausea were twice as likely as those who experienced no or low frequency nausea to develop chronic Migraine.

Each time we learn more about the risk factors that may contribute to the transformation of Migraine from episodic to chronic, we increase the likelihood fewer patients will have to deal with that change in their lives. This is because we can address many of those risk factors, such as treating comorbid depression, for example. But even information about risk factors we cannot change or influence gives researchers important clues about the Migraine process.

view references
1. Michael L. Reed, Kristina M. Fanning, Daniel Serrano, Dawn C. Buse, Richard B. Lipton. "Persistent Frequent Nausea as a Predictor of Progression to Chronic Migraine: Results from the American Migraine Prevalence and Prevention (AMPP) Study." Headache, 55(1): 76-87, 2015. https://www.ncbi.nlm.nih.gov/pubmed/25250833
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