Patterns of Perceived Stress Throughout the Migraine Cycle: A Longitudinal Cohort Study Using Daily Prospective Diary...

Area of Science:

• Neurology
• Psychology
• Digital Health

Background:

• Migraine is a complex neurological disorder often influenced by various factors, including stress.
• Understanding the relationship between stress and the migraine cycle is crucial for effective management.

Purpose of the Study:

• To identify and describe distinct patterns of perceived stress throughout the different phases of the migraine cycle.
• To analyze these patterns both within individuals and across different migraine episodes.

Main Methods:

• Utilized data from 351 participants using the N1-Headache digital platform, who tracked migraine symptoms and lifestyle factors for 90 days.
• Categorized days into pre-migraine (Ppre), migraine (P0), post-migraine (Ppost), and interictal (Pi) phases.
• Applied cluster analysis to identify patterns of perceived stress variation across these phases.

Main Results:

• Identified three primary patterns of perceived stress: 'let down', 'flat', and 'stress as a trigger/symptom'.
• The 'flat' pattern, where stress remains relatively constant, was the most common (59.2% of episodes).
• On average, perceived stress peaked during the migraine pain phase (P0), but individual patterns varied significantly.

Conclusions:

• Perceived stress exhibits diverse patterns across the migraine cycle at the individual and episode level, not just an aggregate peak.
• Recognizing these distinct stress patterns offers potential for developing individualized treatment strategies for migraine.
• Further research into these patterns may illuminate migraine biology, triggers, and protective mechanisms.