Sex differences in migraine attack characteristics: A longitudinal E-diary study

Area of Science:

• Neurology
• Women's Health
• Clinical Research

Background:

• Longitudinal studies are needed to confirm if women experience longer migraine attacks and more symptoms than men.
• Perimenstrual migraine attacks may differ significantly from non-perimenstrual attacks in women.
• Understanding sex-based differences in migraine is crucial for effective treatment.

Purpose of the Study:

• To compare migraine attack characteristics between men and women using a prospective cohort study.
• To investigate differences in attack duration and accompanying symptoms in perimenstrual versus non-perimenstrual migraine in women compared to men.
• To identify potential sex-specific patterns in migraine pathology.

Main Methods:

• Prospective cohort study at Leiden Headache Clinic.
• Utilized a validated electronic headache diary for data collection.
• Compared perimenstrual (Days -2 to +3) and non-perimenstrual attacks in women with attacks in men, adjusting for age, chronic migraine, and medication overuse headache.

Main Results:

• Perimenstrual migraine attacks in women were 1.62 times longer than in men; non-perimenstrual attacks were 1.15 times longer.
• Relapse risk was significantly higher for perimenstrual attacks (OR 2.39).
• Women's attacks were more frequently accompanied by photophobia, phonophobia, and nausea, but less often by aura.

Conclusions:

• Both perimenstrual and non-perimenstrual migraine attacks in women are longer and more symptomatic than in men.
• The findings underscore the necessity for sex-specific approaches in migraine treatment and research.
• Further investigation into hormonal influences on migraine pathophysiology is warranted.