More on Migraine, Flying, and Current Research

There is a lot of interesting research out there regarding headaches and airplane travel. The fact is, there are probably various causes and types of headache that are brought on during flight, and there isn’t always agreement on what the cause is.

Airplane travelResearch has been going on at Aalborg University (Denmark) to better understand and better treat these headaches.

Last year, a study of 254 passengers found that 35% had headaches during travel. However, wanting to specifically study airplane headache, they evaluated each person and found that only 8.3% had actual airplane headache as defined by The International Classification of Headache Disorders, 3rd edition (beta version).

Still, that’s almost 1 in 10, with more than 1 in 3 suffering from some kind of headache!

Earlier this year, research was published in an attempt to find a cause for these headaches. An increasingly important testing method was used – testing saliva for certain chemicals.

In this case, participants were on a flight simulator. Regular saliva samples were taken. The patients with headache were found to have higher levels of cortisol and PGE2.

Now cortisol is a common indicator of stress. Were these people anxious about flying, even though it was just a simulation? Or is there another reason for the high levels?

PGE2, otherwise known as dinoprostone, may be at increased levels to fight inflammation. It could be that changes in cabin pressure may actually cause inflammation, leading to the release of PGE2.

PGE2 has been linked to migraine before, and it is leading to other possible migraine treatments. So there could be a connection here between airplane headache and migraine, leading to better treatments of both.

The next step of research is indeed to find treatments. It has been noted that triptans can help with airplane headache, so researcher Sebastian Bao Dinh Bui wants to test patients taking triptans – again using saliva samples.

Triptans may be something to try, along with nasal decongestants, vitamin C, and simply staying hydrated.

To find out more: Researchers aim to cure headache during flight


Staying Hydrated when Flying

A recent article at Lifehacker has a good reminder for those prone to migraine attacks – stay hydrated when you fly.

flight over water

Water on the outside, dry on the inside!

We’ve discussed tips for avoiding “airplane headache” here before. But airplane headache is, oddly enough, not the only type of headache you can get from flying. You may also trigger another type of headache from changes in pressure, not moving around enough, or not staying hydrated.

The Lifehacker article notes that airplanes are extremely dry. Plus, added sweating and activity before and after travel, and limited access to fluids – it’s very easy to get dehydrated.

I’ll let you read their tips for yourself. These tips alone could help many people avoid headache on travel days, although it will depend on what type of headache you have.

However, as you’re motivated to stay more hydrated on your next flight, you might also want to plan ahead – and get an isle seat. Just sayin’.

How to Keep Properly Hydrated on a Long Flight (Lifehacker)


Yawning and Migraine: New Insights

Yawning is a common symptom of migraine, in both adults and children. A new study has confirmed the link once again, and is giving us more insight into what kinds of attacks are connected to yawning.

Yawning and MigraineThe study looked at 339 patients, of which 45.4% reported repetitive yawning as a part of their migraine attacks. 11.2% reported yawning as a “warning sign” before an attack, with the rest experiencing yawning as either a symptom during the headache phase or a symptom both before and during.

An interesting aspect of the study was how yawning was associated with other symptoms. The symptoms that were more associated with yawning included:

  • Aura
  • Nausea and/or vomiting
  • Osmophobia (hypersensitivity to odors)
  • Cutaneous allodynia
  • Sleepiness
  • Irritability/anxiety
  • Changes in appetite

The most associated were aura and nausea and/or vomiting.

As the researchers understood, yawning may be associated with drops in dopamine levels. It may be that, for some patients, dopamine drops during a migraine attack (read Why Migraine Attacks may make you withdraw Into Darkness (or, Your Brain on the Holodeck).

Interestingly, yawning is also related to hypoglycaemia/hypoglycemia. Low sugar levels have a complex relationship with migraine, but both have been associated with yawning – and low dopamine levels.

For more, check out this article on Migraine and Hypoglycaemia.

To read the abstract of the recent study, see Migraine and Yawning.

For more strange symptoms of migraine, check out this infographic – Are these the 10 Strangest Migraine Symptoms?


Coming Soon: The “ADAM” System for Zolmitriptan

Triptan medications have helped a lot of people with both migraine and cluster, and as the technology and research improves, more people who can benefit are able to use them.

Zolmitriptan in particular has been useful for both migraine and cluster headache, even for children with cluster headache.

A new delivery system for zolmitriptan is being tested under the drab name of M207, but also using the magnificent name The Adhesive Dermally Applied Microarray (ADAM) Zolmitriptan System.

Most of that simply means that it’s a sticker or patch. “Microarray” actually refers to a system of tiny needles – a word that is understandably avoided. Actually, from what I’ve heard so far, most patients do not experience pain from this patch (some of you who have been in the trials may want to comment).

How does it work? You take a small unit and apply the small round patch to your arm (it kind of reminds me of one of those bingo daubers – but of course it applies a sticker in this case). The patch gets the medication into your system very quickly – which is the main point.

ADAM System for Zolmitriptan - Application

ADAM System for Zolmitriptan - AppliedFor both migraine and cluster headache, you want the medication to get into your system as efficiently and quickly as possible. Many people have not benefited from zolmitriptan simply because they’ve taken it orally – and the medicine hasn’t gotten to where it needs to go on time – if ever.

So far the results have been good. Many patients have experienced full relief within an hour, more than half within three hours. This is with a dose of 3.8mg.

These results tell us that most people should benefit, but more importantly a few people should experience significant relief very quickly.

We’re talking about cluster headache, even though that is not the focus of the current trials. Finding better ways to administer this medication should help people with cluster as well, so we’ll watch for future developments.

There will be a new trial of the ADAM System for Zolmitriptan opening soon for adults with episodic migraine. The trial will investigate safety over 12 months, and see how the patch does in treating other symptoms such as nausea, photophobia and phonophobia.

If you’re interested in the trial, find out more here: A Study to Evaluate the Long-Term Safety of M207 in the Acute Treatment of Migraine (ADAM)


Making Invisible Migraine Visible

We usually talk about migraine as an “invisible illness”. It’s not always easy (for the layperson especially) to see that someone is having a migraine attack. And it’s even harder to see the burden of migraine that is still on the shoulders of someone who is not currently in the middle of a migraine attack.

Seeing Migraine in the BrainResearchers have been looking for ways to make migraine visible. That is, a way to test for migraine in a lab.

For example, we’re very interested to know if a reliable blood test could be developed for migraine – maybe even a test that tells us what type of migraine that person has, and therefore what the best treatment would be.

In June, a report in the journal Cephalalgia went a different direction. What about an MRI for migraine?

This MRI was actually a rs-fMRI – which stands for resting-state functional magnetic resonance neuroimaging (for all you health care geeks who want to impress your friends). The test was very simple. Could the MRI distinguish between a healthy individual and a migraine patient?

33 regions of the brain were studied, and the test turned out – not bad. It wasn’t 100% accurate (not many tests are!), but it managed to reach 86.1%. For those who had suffered from migraine for 14 years or more, the accuracy reached 96.7%.

Tests like this can give us an improving understanding of the progression and biology of migraine, and may in the future allow us to test for migraine in a non-invasive way, leading to faster and more accurate diagnosis.

For more, see the study abstract here: Migraine classification using magnetic resonance imaging resting-state functional connectivity data