One of the most challenging aspects of living with migraine is how unpredictable attacks can be. While things like tracking triggers are helpful, all too often headache and other symptoms set in with no warning. Given how debilitating these things can be, there’s no doubt that knowing in advance an attack is going to happen is going to provide benefits, but it’s proven difficult to pin down an effective way to do so. Recently, however, a team of researchers under the lead of Dr. Timothy Houle at Boston’s Massachusetts General Hospital, found a potential breakthrough in migraine prediction. [1, 2]
Making a Model
With the wide range of triggers that exist—everything from certain foods to atmospheric patterns can bring on headache and other symptoms—the researchers decided to focus on a specific but very common culprit: stress. The challenge for the researchers was to figure out a way to create a means of measuring stress to create a predictive model for migraine. As Dr. Houle and the team put it, “no evidence is available to support forecasting headache attacks within individuals using any of the candidate’s headache triggers.” 
As such, the researchers decided to employ the Daily Stress Inventory, which allows users to log their levels regularly. They recruited 100 participants with episodic migraine and tracked them by taking daily stress tests and looking out for when headaches set in. From this information, the team was able to create individual headache forecasts, with which they could test the accuracy of their model.  The study was longitudinal—meaning it gathered data for a long time (over several years)—to provide a wide-ranging view of how effective stress measurements might be in predicting attacks.
With every participant tracking their stress levels and attacks, it was found that migraine arose on 38.5% of days. Dr. Houle and the team found that their predictive model, based on either occurrence of “stressful events” or “perceived intensity” of stress, was quite accurate.  Looking at all of the data, the participants generally experienced low to moderate stress; however, levels were significantly elevated in the days leading up to attacks. This was just as their model posited.
Clearly, this team is on to something. If patients and doctors are able to get a real sense of when migraine are coming on, preventative measures could be taken, minimizing impact. Taking away the unpredictability of migraine, in many ways, would make this difficult condition much easier to manage. Furthermore, this kind of research helps fill in the picture when it comes to our overall understanding of what causes migraine and how it works.
The Path Forward
Was this model perfect? Is a predictive ability like this soon to be commonplace? There’s more work to be done, and the authors themselves acknowledge that their work is just a beginning. As Dr. Houle and his colleagues put it, “[t]he model we developed in this study is a very good start to helping people forecast the chances they will experience a headache attack, but work is needed to make the prediction models more accurate before they will be of widespread clinical use.” 
Still, given how widespread migraine is worldwide, millions of people stand to benefit from better predictive capability. Other researchers will build off of the work of Dr. Houle and his team to further refine methods, approach and understanding of the condition. As a result, individual migraineurs will be able to have more control, and less uncertainty and suffering, in their lives. The future, in this sense, is brighter than ever.
If you or a loved one are suffering from migraine headache and other symptoms, the team at Migraine Treatment Centers of America can help. Employing the latest advances in technology and methods, they’ve helped countless patients find effective relief. Learn more by calling a Patient Care Manager at (855) 980-7530 today!
Houle, Timothy T., Dana P. Turner, Adrienne N. Golding, John A. H. Porter, Vincent T. Martin, Donald B. Penzien, and Charles H. Tegeler. 2017. “Forecasting Individual Headache Attacks Using Perceived Stress: Development Of A Multivariable Prediction Model For Persons With Episodic Migraine”. Headache: The Journal Of Head And Face Pain57 (7): 1041-1050. Wiley-Blackwell. doi:10.1111/head.13137.