Prodromes and predictors of migraine attack.
Premonitory symptoms of migraine include a wide and heterogeneous collection of cognitive, psychic and physical changes preceding and forewarning of an attack by a few hours to 2-3 days. To date, premonitory symptoms have received little attention in the literature, being treated more as a curiosity than as a primary feature of migraine. This paper provides an extensive critical review of this neglected area of migraine research in the light of the recent advances in our understanding of the pathogenetic mechanisms of migraine. Epidemiological and clinical studies that have investigated the premonitory symptoms of migraine lack scientific rigour, producing conflicting results, whilst genetic and pathophysiological investigations are still in their very early stages. There is evidence supporting the idea that premonitory symptoms could be used as a phenotypical marker to identify subgroups of migraineurs which could show correlations with specific clinical expressions of the disease, genotypes, or responses to treatments. Future studies are needed to clarify the clinical, pathophysiological and therapeutic significance of premonitory symptoms.
Rossi
Paolo
P
Headache Clinic, INI Grottaferrata, Rome, Italy. paolo.rossi90@tin.it
Ambrosini
Anna
A
Buzzi
M Gabriella
MG
D006801:Humans; D008881:Migraine Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D011237:Predictive Value of Tests