Migraine triggers in Asian countries: a narrative review - PubMed
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Review
Migraine triggers in Asian countries: a narrative review
Chisato Iba et al. Front Neurol. 2023.
Abstract
Background: Migraine is one of the most common neurological disorders worldwide. Clinical characteristics of migraine may be somewhat different across ethnic groups. Although factors such as stress, lack of sleep, and fasting are known as migraine triggers, the discussion about geographical differences of migraine triggers in Asia is lacking.
Methods: In this study, we performed a narrative review on migraine triggers in Asia. We searched PubMed for relevant papers published between January 2000 and February 2022.
Results: Forty-two papers from 13 Asian countries were included. Stress and sleep are the most frequently reported migraine triggers in Asia. There were some differences in migraine triggers in Asian countries: fatigue and weather common in Eastern Asia and fasting common in Western Asia.
Conclusion: Majority of the common triggers reported by patients with migraine in Asia were stress and sleep, similar to those reported globally, thus showing they are universally important. Some triggers linked to internal homeostasis are influenced by culture (e.g., alcohol, food/eating habit), and triggers related to environmental homeostasis, such as weather, are highly heterogenous between regions.
Keywords: Asia; migraine; sleep; stress; triggers.
Copyright © 2023 Iba, Ohtani, Lee, Huh, Watanabe, Nakahara, Peng and Takizawa.
Conflict of interest statement
ML reports being a consultant/advisor for Eli Lilly. ML received speaker's fee from Abbvie, Eli Lilly, YuYu Pharma, SK Chemical, Teva, and Sanofi-Aventis Korea Co. K-PP received speaker's honorarium from Teva. TT reports being a consultant/advisor for Eli Lilly Japan, Otsuka, and Amgen. TT received speaker's fees from Daiichi Sankyo, Eli Lilly Japan, Amgen, Otsuka, Kowa, UCB Japan, Santen, Eisai, and Kyowa Kirin, and research fund from Eli Lilly Japan and Tsumura outside the submitted work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Figures

The flowchart of the narrative review. The inclusion and exclusion criteria of the study are shown.

The categorization of Asian countries based on the United Nations Statistics Division.

The prevalence of migraine triggers in Asian countries. Countries are listed in order of regions in Asia: Eastern Asia, South-eastern Asia, Southern Asia, and Western Asia. When multiple items belonged to a group, the highest proportion was applied to the figure. The assigned colors are determined according to the ranking in each study (i.e., darker colors represent factors recognized by more respondents). Age was not available in some studies. The provided information about the background of the studied group is shown below [age; mean (range)]. N/A, not available, (i) elementary/junior high school students, (ii) junior high school students, (iii) university students, (iv) medical students, (v) medical students and interns.
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The publication of this article was supported by JSPS KAKENHI (grant number 19K16989 to TT) and Keio Global Research Institute Start-up grant (to TT).
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