Relationship between food triggers and sensory hypersensitivity in patients with migraine

Abstract

Background The recognition of food as the trigger of attacks occurs in approximately 25% of individuals with migraine. However, differentiating migraine food triggers and prodrome symptoms is still a challenge.

Objective To understand the association of clinical characteristics of migraine with food triggers and to identify predictors of food triggers.

Methods Patients with migraine diagnosed according to the criteria of the third edition of the International Classification of Headache Disorders (ICHD-3) were evaluated for the presence or absence of food triggers.

Results In total, 502 patients with migraine were investigated, and they were divided into two groups: those with food triggers (58.4%) and those without food triggers (41.6%). The main food triggers were alcohol (44%), chocolate (42%), cheese (27.7%), excess carbohydrates (27.7%), coffee (21.8%), cold cuts (16%), and citrus fruits (11.9%). Aura and excessive use of analgesics were more frequent among patients with food triggers (p = 0.022). Photophobia and osmophobia were associated with the presence of a food trigger (p < 0.001). There was a greater impact of migraine in the presence of food triggers (p = 0.002). Through binary logistic regression, we identified clinical predictors of food triggers, such as photophobia and osmophobia.

Conclusion The presence of a food trigger was significantly associated with photophobia and osmophobia. Osmophobia might be another mechanism by which patients perceive foods as triggers for their migraine attacks.

Resumo

Antecedentes A percepção dos gatilhos alimentares ocorre em aproximadamente 25% dos indivíduos com migrânea. No entanto, diferenciar os desencadeantes alimentares da migrânea e os sintomas prodrômicos ainda é um desafio.

Objetivo Compreender a associação de características clínicas da migrânea com gatilhos alimentares, bem como identificar preditores destes gatilhos.

Métodos Pacientes com migrânea diagnosticados de acordo com os critérios da terceira edição da Classificação Internacional de Cefaleias (International Classification of Headache Disorders, third edition, ICHD-3, em inglês) foram avaliados quanto à presença ou ausência de gatilhos alimentares.

Resultados Foram investigados 502 pacientes com migrânea, que foram divididos em 2 grupos: aqueles com gatilhos alimentares (58,4%) e aqueles sem gatilhos alimentares (41,6%). Os principais desencadeantes alimentares foram álcool (44%), chocolate (42%), queijo (27,7%), excesso de carboidratos (27,7%), café (21,8%), embutidos (16%) e frutas cítricas (11,9%). Aura e uso excessivo de analgésicos foram mais frequentes entre pacientes com gatilhos alimentares (p = 0,022). Fotofobia e osmofobia estiveram associadas à presença de gatilho alimentar (p < 0,001). Houve maior impacto da migrânea na presença de gatilhos alimentares (p = 0,002). Por meio de regressão logística binária, foram identificados preditores clínicos de gatilhos alimentares, como fotofobia e osmofobia.

Conclusão A presença de um gatilho alimentar foi significativamente associada à fotofobia e à osmofobia. A osmofobia poderia ser outro mecanismo pelo qual os pacientes percebem os alimentos como gatilhos para suas crises de migrânea.

Keywords

Migraine Disorders - Photophobia - Hyperacusis - Olfaction Disorders - Precipitating Factors - Food - Sensation Disorders

Palavras-chave

Transtornos de Enxaqueca - Fotofobia - Hiperacusia - Transtornos do Olfato - Fatores Desencadeantes - Alimentos - Transtornos de Sensação

Authors' Contributions

AVS: conceptualization, data curation, formal analysis, investigation, methodology, project administration, resources, software, supervision, validation, visualization, writing – original draft, and writing – review & editing; VAB, RCPF, CECO, EMVR, BBB, DVRZ, BFK, RPSN: conceptualization, data curation, formal analysis, funding acquisition, investigation, methodology, project administration, resources, software, supervision, validation, visualization, writing – original draft, and writing – review & editing.

Support

The authors declare that they have received financial support to conduct the present study from scientific initiation scholarships granted by Pontifícia Universidade Católica do Paraná.

Editor-in-Chief: Hélio A. G. Teive.

Associate Editor: Pedro Augusto Sampaio Rocha Filho.

Publikationsverlauf

Eingereicht: 17. Mai 2024

Angenommen: 01. September 2024

Artikel online veröffentlicht:
10. Dezember 2024

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