Innovative Trials are passionate about ensuring our diverse population is adequately represented within medical research. Whether it is wanting to see more people from underrepresented communities choosing science as a career and pushing for greater patient diversity in clinical trials or focusing on what we are doing internally to celebrate and promote equality and diversity, this month we celebrate Sickle Cell. So far the Equality, Diversity, and Inclusion Committee at Innovative Trials has written blogs to raise awareness surrounding several illnesses, their effects, and treatments such as World Lupus Day, Malaria, Pride Month, Sickle Cell, Endometriosis , Pancreatic Cancer Awareness Month , Parent Mental Health Day, International Day of Women and Girls in Science ,International Childhood Cancer Day and Sickle cell awareness month.

What is it and what are the facts?

Migraine is a neurological condition characterised by intense, debilitating headaches, often accompanied by other symptoms such as nausea, vomiting, and sensitivity to light or sound. These headaches can last anywhere from a few hours to several days and can significantly impact an individual’s quality of life. Migraines are more than just a bad headache; they represent a complex condition that requires careful management. 

Quick Facts1

  • According to the World Health Organization, migraines are the sixth most disabling illness in the world.
  • It is estimated that migraines affect around 1 in 7 people globally, making it one of the most common neurological conditions.
  • Women are three times more likely to suffer from migraines than men, likely due to hormonal influences.
  • The exact cause of migraines is still not fully understood, but it is believed to involve a combination of genetic, environmental, and neurological factors. 

Symptoms and Risk Factors2

Migraine symptoms can vary widely among individuals, but the most common symptoms include:

  • Severe Headache: Often described as throbbing or pulsating, typically on one side of the head.
  • Nausea and Vomiting: Many individuals experience gastrointestinal distress during a migraine attack.
  • Sensitivity to Light and Sound: Bright lights or loud noises can exacerbate the migraine symptoms.
  • Aura: Some people experience visual disturbances or other sensory symptoms before the onset of the headache. This can include seeing flashing lights, blind spots, or experiencing tingling sensations.
  • Fatigue and Dizziness: Feeling extremely tired or dizzy is common during or after a migraine episode. 

Risk Factors3

Risk factors for migraines include:

  • Genetics: A family history of migraines can increase your likelihood of developing the condition.
  • Gender: Women are more prone to migraines, particularly during periods of hormonal change such as menstruation, pregnancy, or menopause.
  • Stress: High levels of stress or anxiety can trigger migraines in susceptible individuals.
  • Diet: Certain foods and drinks, such as alcohol, caffeine, and aged cheeses, are known migraine triggers.
  • Sleep Patterns: Irregular sleep, either too much or too little, can contribute to the onset of migraines.
  • Environmental Factors: Changes in weather, bright lights, and strong smells can act as migraine triggers for some individuals. 

Migraines and Age4

Migraines can affect people of all ages, but their prevalence and presentation can vary significantly across different age groups. In children, migraines often manifest with shorter duration and may include symptoms such as abdominal pain, nausea, and dizziness, sometimes without the typical headache.

As children transition into adolescence, hormonal changes, particularly during puberty, can trigger the onset of more typical migraine patterns, with girls experiencing a higher prevalence due to the onset of menstruation. In adults, migraines tend to be more severe and disabling, often associated with chronic conditions like anxiety, depression, and sleep disturbances. 

As people age the frequency of their migraines may decrease, but they can still remain a significant health issue – especially in those who have suffered from them throughout their lives. Understanding how migraines impact individuals at different life stages is crucial for developing age-appropriate treatment and management strategies.

Innovative Trials has had the opportunity to support various acute and chronic migraine trials investigating alternative medications to Triptans (a widely used treatment), including trials for paediatric populations. The variety of the patient populations in these trials will hopefully contribute to improving age inclusivity and the number of treatment options for migraine.

Patient Recruitment Recommendations

By implementing age-specific recruitment strategies, clinical trials can ensure a more comprehensive understanding of migraine across the lifespan, ultimately leading to more effective and tailored treatment options for all age groups.

  • Symptom Recognition: Acknowledge that age may influence how people recognize and describe migraine symptoms. Educational materials should be relevant and accessible to diverse populations and be age-appropriate; materials aimed at paediatric patients themselves, as well as their guardians. 
  • Tailored Communication Strategies: Develop recruitment materials that are age-appropriate and accessible. For example, create engaging, easy-to-understand materials for children and adolescents, while providing more detailed information for adults, older patients and caregivers. Digital platforms, such as social media or mobile apps, resonate with younger demographics while traditional methods like brochures and community outreach can be used for older adults.
  • Parental and Caregiver Involvement: When recruiting children or adolescents, ensure that parents or caregivers are fully informed and involved in the decision-making process. Address their concerns about the safety and efficacy of the trial and provide them with resources to understand the potential benefits and risks.
  • Flexible Scheduling and Accessibility: Consider the scheduling needs of different age groups. For example, adolescents may have school commitments while older adults might require trials to be conducted closer to home or offer transportation support. Flexible scheduling and trial locations can reduce barriers to participation. 

Conclusion

Understanding migraines and the factors that influence their occurrence, and management is crucial for developing more effective and inclusive treatment strategies. Migraines are a common but often misunderstood condition that can have a profound impact on a person’s life. Through increased awareness, research, and age-sensitive healthcare practices, we can work towards better outcomes for all individuals living with migraines.

References

  1. Burch, R. C., Loder, S., Loder, E., & Smitherman, T. A. (2015). The Prevalence and Burden of Migraine and Severe Headache in the United States: Updated Statistics from Government Health Surveys. Headache: The Journal of Head and Face Pain, 55(1), 21-34. doi:10.1111/head.12482
  2. World Health Organization (WHO). (2022). Headache disorders. Available at: https://www.who.int/news-room/fact-sheets/detail/headache-disorders
  3. Goadsby, P. J., Holland, P. R., Martins-Oliveira, M., Hoffmann, J., Schankin, C., & Akerman, S. (2017). Pathophysiology of Migraine: From Genetics to Neurobiology. Nature Reviews Neurology, 13(11), 725-739. doi:10.1038/nrneurol.2017.101
  4. Onofri A, Pensato U, Rosignoli C, Wells-Gatnik W, Stanyer E, Ornello R, Chen HZ, De Santis F, Torrente A, Mikulenka P, Monte G, Marschollek K, Waliszewska-Prosół M, Wiels W, Boucherie DM, Onan D, Farham F, Al-Hassany L, Sacco S; European Headache Federation School of Advanced Studies (EHF-SAS). Primary headache epidemiology in children and adolescents: a systematic review and meta-analysis. J Headache Pain. 2023 Feb 14;24(1):8. doi: 10.1186/s10194-023-01541-0. PMID: 36782182; PMCID: PMC9926688.