Interictal osmophobia is associated with longer migraine disease duration

Abstract

Background: Sensitization to sensory stimuli is an essential feature of migraine attacks. The relationship between the clinical course of migraine and increased sensitivity to olfactory stimuli has been little studied so far.

Methods: We analyzed the frequency and quality of osmophobia depending on the phase of migraine in patients with episodic and chronic migraine treated in an tertiary headache center with regard to gender, age, medical history and migraine disability assessment score (MIDAS). Standardized diagnostic questions were used for the assessment of osmophobia.

Results: In our cross-sectional investigation (n = 113), 38.1% of the patients showed an increased preictal hypersensitivity to odors, whereas 61.9% described ictal and 31.9% interictal hypersensitivity to odors, odor-triggered migraine was described in 30.1%. Median migraine disease duration has been statistically significantly longer in patients who suffered from interictal hypersensitivity to odors (28.5 years vs. 20 years; p = 0.012). There was a significant correlation between interictal hypersensitivity and higher age (54.50 vs. 45; p = 0.015). Patients with higher migraine disability in MIDAS experienced more frequently preictal and interictal olfactory sensitization and odor triggered migraine attacks.

Conclusions: In patients with longer migraine disease duration and higher migraine-related impairment, osmophobia was more frequently observed. These results might support the hypothesis of increasing sensitization with increasing burden of migraine.

Keywords: MIDAS; Migraine; Migraine disorders; Migraine headache; Osmophobia; Sensitization.

Fig. 1

Frequencies of the main odorants involved in osmophobia. The questions asked to investigate osmophobia were: “Question 1) Are you sensitive to odors before a migraine attack?”, “Question 2) Are you sensitive to odors during a migraine attack?”, “Question 3) Are you sensitive to odors on days without migraine?” and “Question 4) Can odors trigger migraine attacks in you?“

Fig. 2

Mean migraine disability score and osmophobia behavior. The questions asked to investigate osmophobia were: “Question 1) Are you sensitive to odors before a migraine attack?”, “Question 2) Are you sensitive to odors during a migraine attack?”, “Question 3) Are you sensitive to odors on days without migraine?” and “Question 4) Can odors trigger migraine attacks in you?”