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Dural Stimulation and Periorbital von Frey Testing in Mice As a Preclinical Model of Headache
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Natural experimentation is a challenging method for identifying headache triggers.

Timothy T Houle1, Dana P Turner

  • 1Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA. thoule@wakehealth.edu

Headache
|March 29, 2013
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Summary

Individuals cannot reliably identify headache triggers through natural experimentation alone. Daily variations in weather, hormones, and stress make it difficult to isolate the impact of specific headache causes.

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Area of Science:

  • Neurology
  • Epidemiology
  • Biostatistics

Background:

  • Headache sufferers often use natural experimentation to identify trigger potency.
  • The validity of this self-experimentation has not been previously investigated.
  • This study examines the assumption of trigger presentation constancy in real-world headache triggers.

Purpose of the Study:

  • To determine if individuals can identify headache trigger potency via natural experimentation.
  • To assess the feasibility of isolating headache triggers using daily life data.

Main Methods:

  • Analyzed day-to-day similarity of weather, ovarian hormones, and perceived stress over 4 years and 89 days, respectively.
  • Used Gower's index with a 90% similarity threshold to identify comparable days.
  • Examined 9 regularly cycling headache sufferers.

Main Results:

  • Substantial day-to-day variability in weather, hormones, and stress limits the identification of similar days for comparison.
  • A median of 2.3 weather-similar days per year were found.
  • Only 1.5-2.0 days per month met the similarity threshold for hormones and stress.

Conclusions:

  • Natural experimentation is often insufficient for identifying personal headache triggers due to high variability.
  • Formal experimentation or statistical methods may be necessary for accurate headache trigger assessment.