Changes of migraine aura with advancing age of patients.

Scutelnic, Adrian; Hristina, Drangova; Klein, Antonia; Slavova, Nedelina; Beyeler, Morin; Lippert, Julian; Silimon, Norbert; Meinel, Thomas R; Arnold, Marcel; Fischer, Urs; Riederer, Franz; Mattle, Heinrich P; Jung, Simon; Schankin, Christoph J (2023). Changes of migraine aura with advancing age of patients. The journal of headache and pain, 24(1), p. 100. BioMed Central 10.1186/s10194-023-01642-w

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Given the similar presentation of migraine aura and acute ischemic stroke, advancing patient age might change the characteristics of migraine with aura (MA) and be clinically important. Clinical data, however, are limited. Experimental studies indicate a decrease in the magnitude of cortical spreading depression (CSD), the pathophysiological correlate of migraine aura, with advancing age. Our study aimed to assess the influence of age on the clinical features of MA.


Three hundred and forty-three patients were interviewed using a structured questionnaire. The questions covered the headache characteristics and symptom types including the characteristics of the C-criterion, as defined by the International Classification of Headache Disorders 3rd Edition. The association of age with MA characteristics was assessed.


The median age was 29 (IQR 28-52) and 235 of the 343 patients were women (69%). Individual symptoms of the C-criterion such as gradual aura spreading over longer than 5 min (P < 0.001), two or more aura symptoms occurring in succession (P = 0.005), duration of at least one MA symptom for longer than 60 min (P = 0.004), and associated headache (P = 0.01) were more frequent in younger patients. The number of symptoms including the C-characteristics decreased with increasing age (P < 0.001). Patients with sensory (P < 0.001), motor (P = 0.004) and speech disturbance (P = 0.02) were younger, and older patients with headache had less photophobia (P = 0.04) and phonophobia (P = 0.03). Sensitivity analyses yielded similar results.


The frequency of typical characteristics of migraine aura and migraine headache including photophobia and phonophobia decreases with advancing patient age. This might have potentially difficult implications for the diagnosis of MA in the elderly.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Scutelnic, Adrian, Hristina, Drangova, Klein, Antonia, Slavova, Nedelina Bozhidarova, Beyeler, Morin, Lippert, Julian Peter, Silimon, Norbert, Meinel, Thomas Raphael, Arnold, Marcel, Fischer, Urs Martin, Riederer, Franz, Mattle, Heinrich, Jung, Simon, Schankin, Christoph Josef


600 Technology > 610 Medicine & health




BioMed Central




Pubmed Import

Date Deposited:

02 Aug 2023 10:14

Last Modified:

22 Aug 2023 15:39

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Uncontrolled Keywords:

Cortical spreading depression Differential diagnosis of migraine with aura and ischemic stroke in elderly Migraine with aura




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