title: Premonitory symptoms in migraine: A cross-sectional study in 2714 persons.
abstract: OBJECTIVE
  To describe the frequency and number of premonitory symptoms (PS) in migraine, the co-occurrence of different PS, and their association with migraine-related factors.
  
  
  METHODS
  In this cross-sectional study, a validated questionnaire was sent to Finnish migraine families between 2002 and 2013 to obtain data on 14 predefined PS, migraine diagnoses, demographic factors, and migraine characteristics. The estimated response rate was 80%.
  
  
  RESULTS
  Out of 2714 persons, 2223 were diagnosed with migraine. Among these, 77% reported PS, with a mean number of 3.0 symptoms compared to 30% (p < 0.001) and 0.5 symptoms (p < 0.001) among 491 persons with non-migraine headaches. Yawning was the most commonly reported symptom (34%) among migraineurs. Females reported PS more frequently than males (81 versus 64%, p < 0.001) and experienced a higher number of different symptoms (mean 3.3 versus 1.8, p < 0.001). All measures of migraine severity were associated with a higher burden of PS. Light and sound sensitivity showed the highest co-occurrence (kappa = 0.51, 95% CI 0.47-0.55). In a generalized linear model, age, gender, higher frequency, duration and intensity of headache, reduced working capacity, most aura symptoms, and associated symptoms of the headache phase were significantly associated with an increased in the number of PS.
  
  
  CONCLUSIONS
  PS are experienced by a majority of migraineurs. More severe migraine is associated with a higher burden of PS. Since the material was not entirely representative of the general population of migraineurs, caution should be exercised in generalizing the results.
authors.affiliation: Department of Pharmacology and Clinical Neuroscience, Umeå University, Sweden Katarina.Laurell@neuro.umu.se.
authors.forename: Katarina
authors.initials: K
authors.lastname: Laurell
authors.affiliation: Department of Neurology, Helsinki University Central Hospital, Finland.
authors.forename: Ville
authors.initials: V
authors.lastname: Artto
authors.affiliation: Department of Neurology, Danish Headache Centre, Glostrup Hospital, Denmark University of Copenhagen, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Bendtsen
authors.affiliation: Norwegian National Headache Centre, Trondheim University Hospital, Norway Department of Neurosciences, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Knut
authors.initials: K
authors.lastname: Hagen
authors.affiliation: Department of Pharmacology and Clinical Neuroscience, Umeå University, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Häggström
authors.affiliation: Norwegian National Headache Centre, Trondheim University Hospital, Norway Department of Neurosciences, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Mattias
authors.initials: M
authors.lastname: Linde
authors.affiliation: Unit of Research, Education and Development, Östersund Hospital, Region Jämtland Härjedalen, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Söderström
authors.affiliation: Norwegian National Headache Centre, Trondheim University Hospital, Norway Department of Neurosciences, Norwegian University of Science and Technology, Trondheim, Norway Department of Neurology, Trondheim University Hospital, Norway.
authors.forename: Erling
authors.initials: E
authors.lastname: Tronvik
authors.affiliation: Institute of Genetics, Folkhälsan Research Center, Finland Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Finland.
authors.forename: Maija
authors.initials: M
authors.lastname: Wessman
authors.affiliation: Department of Neurology and FORMI, Oslo University Hospital and University of Oslo, Norway.
authors.forename: John Anker
authors.initials: JA
authors.lastname: Zwart
authors.affiliation: Department of Neurology, Helsinki University Central Hospital, Finland.
authors.forename: Mikko
authors.initials: M
authors.lastname: Kallela
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D053609:Lethargy / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D015000:Yawning / Q000502:physiology; D055815:Young Adult
keywords: Headache; aura; migraine; premonitory symptoms