Trigger factors and mechanisms in migraine

Schoonman, G.G. (2008)

Doctoral Thesis

Migraine is a severe headache syndrome, affecting approximately 33% of females and 13% of males. Patients suffer from recurring headache episodes in combination with nausea, vomiting, phono and photophobia. It is a paroxysmal disorder for which several several trigger factors have been identified by patients. This thesis has focused on the relation between i) psychosocial stress, ii) nitroglycerin and iii) hypoxia and the occurrence of a migraine attack, as well as the mechanism of action. The first conclusion is that, in contrast to previous studies, we could not detect a correlation between psychosocial stress and migraine. The second conclusion is that normobaric hypoxia might be a trigger factor for migraine possibly through the development of mild cerebral edema. The third conclusion is that migraine can be triggered by nitroglycerin through a vascular effect without any indication of vasodilation in cerebral or meningeal arteries during the delayed provoked attack.

• Migraine
• Headache
• Trigger factors
• Nitroglycerin
• Hypoxia
• Stress

• All authors: Schoonman, G.G.
• Supervisor: Ferrari, M.D.
• Co-supervisor: Terwindt, G.M.; Grond, J. van der
• Qualification: Doctor (dr.)
• Awarding Institution: Leiden University Medical Center (LUMC), Leiden University
• Date: 2008-09-11
• ISBN (print): 9789071382475
• Sponsorship: Leiden University, Astra Zeneca B.V., Stichting Het Remmert Adriaan Laan Fonds, Janssen-Cilag B.V., Menarini Farma Nederland, Glaxo Smith Kline, Teva Pharma NL, Sanofi Aventis, Nederlandse Hoofdpijn Vereniging, JE Jurriaanse Stichting