Migraine sufferers, lace up your sneakers

Migraine sufferers often avoid exercise because they believe the exertion will trigger symptoms. But a recent study shows that regular exercise — even at a vigorous level — may offer some relief for those with the condition.

The study, conducted in Sweden, included 26 people who took part in a 40-minute indoor cycling exercise program three times a week for 12 weeks. Each session began with a 15-minute warm-up in the light to moderate range, segued into a 20-minute exercise bout that increased the intensity into a more challenging range, and ended with a five-minute cool-down.

Participants kept a diary of their migraine attacks, noting the days, the intensity of the pain, and how much medication was taken. They also filled out a questionnaire regarding quality of life. Researchers measured VO2Max, or the maximum amount of oxygen a person can use during intense exercise — a good measure of fitness.

By the end of the study, VO2Max increased considerably and study participants found their symptoms did not get worse during the study. They also had fewer migraines, less intense pain, and used less migraine medication during the last month.No one reported side effects, although one person did have a migraine attack immediately after exercising. Scores in the quality of life questionnaire also improved notably at the end of the study.

Dr. Emma Varkey, co-author of the study, said via a release: "While the optimal amount of exercise for patients with migraine remains unknown, our evaluated program can now be tested further and compared to pharmacological and non-pharmacological treatments to see if exercise can prevent migraine." The study apears in this month’s issue of Headache: The Journal of Head and Face Pain.

-- Jeannine Stein

Photo credit: Gary Friedman / Los Angeles Times

Does pollution cause migraines?*

High temperatures and low air pressure trigger migraines, according to a large study published online today in the journal Neurology. But researchers did not find a clear association between headaches and air pollution.

Triggers increase the probability of having a migraine attack. A variety are well-known: red wine, chocolate, soft cheese and the beginning of the menstrual cycle.

Weather -- especially changes in air pressure -- is frequently cited as a headache trigger but it had not previously been shown in such a large, well-designed study.

The researchers, from Boston's Beth Israel Deaconess Medical Center and the Harvard School of Public Health, were curious about pollution because fine particulate pollutants cause or complicate other health problems, including heart attacks, stroke, congestive heart failure and asthma.

The study included 7,054 headache patients of both genders and varying ages and ethnic groups who were seen at the medical center's emergency room between May 2000 and December 2007. Researchers looked at temperature levels, barometric pressure, humidity, fine particulate matter and other pollutants during the three days before each patient was seen in the ER and for a control day, in which the patient did not report a headache.

A rise in temperature was strongly associated with headaches: An increase of 5 degrees Celsius (9 degrees F, as a reader has so kindly pointed out below) increased the risk of migraine by 7.4%. Low air pressure, which often precedes storms, played a smaller role.

"This study provides pretty rigorous scientific proof that changes in temperature are migraine triggers, and that's something that's not been known before," said Dr. Richard Lipton of the Montefiore Headache Center in New York City.

Knowing what can trigger an attack gives migraine sufferers a measure of control, said Lipton, who was not associated with the study. One of his patients, for example, moved from New York City to Arizona because air pressure in the Southwest is less changeable.

Triggers often work in concert. So migraine sufferers could, for example, be especially careful to avoid red wine and chocolate on hotter days or when a storm is forecast.

Lipton was less convinced by the study's finding on ambient air pollution, which, he said, was harder than temperature to measure over a large region. But he also said that a similar study that found a correlation between particulate matter and asthma also used a central monitoring site.

The migraine study did find a borderline association between headaches and levels of nitrogen dioxide, found in smog and car exhaust. Given the role of fine particulate matter in cardiovascular disease, the researchers called for additional study on its relation to migraines.

-- Mary Engel

Photo credit: Janet Morgan Mol / Novartis Pharmaceuticals

D.M.G.Y.H.? (or, Do Mnemonics Give You Headaches?)

They do me. Maybe it's the memory of an unsuccessful U.K. 1970s road safety campaign that used the word "SPLINK." The I in SPLINK stood for "If traffic is coming..." The N was for "When there is no traffic near..." And the K? "Keep looking and listening for traffic." Kids, not surprisingly, did not pick it up very easily.

Hey, did I mention headaches? As it happens, the National Headache Foundation has just released its own mnemonic in honor of the 15th Annual National Headache Awareness Week, which kicks off June 1. Its aim is to hammer home coping tools --or, as the foundation puts it, to "get a Head S.T.A.R.T. on your headaches."  (Me, I'd sooner W.A.I.T. on my headaches.)

According to a release from the foundation, the S.T.A.R.T stands for:

Seek diagnosis — Obtaining the correct diagnosis for your headache is the first step toward effective treatment.
Triggers — Identify and track your triggers (e.g., foods, stress, hormonal and weather changes)         
by keeping a headache diary and share this information with your healthcare provider.
Advocate — Be an advocate. Be informed. Be a participant in your headache care.
Resources — Utilize the National Headache Foundation as a resource. Visit www.headaches.org
for the latest information about headache causes and treatments, or call (888) NHF-5552.
Treatment — Successful treatment may include medications and lifestyle changes. Work with your healthcare provider to find the right plan for you.

It's not fabulous, but it's better than SPLINK -- and at least anyone trying to recall it won't risk getting flattened by a truck.

You can find more about the events planned for National Headache Awareness Week at the foundation's website.

--Rosie Mestel

Illustration: Stephen Sedam