Timothy C. Hain, MD, Chicago IL. • Page last modified: March 3, 2021
See also: sensory sensitivity in migraine •
Barosensitivity is commonly reported in patients with migraine, although little has been written about it. There are only 21 papers in Pubmed as of 2016 concerning "atmospheric pressure and migraine", and only about 10 are directly relevant.
We firmly hold the opinion that based on our experience with many thousands of migraine patients in Chicago, Illinois, there are a subgroup of migraine patients (we would estimate 20%), who have a strong sensitivity to low pressure fronts. These are the patients who say that "I can predict the weather" because of an increase liklihood of having a migraine. As genetics probably plays a substantial role in migraine triggers, let us say here that Chicago is a very large diverse city with roughly equal numbers of Caucasians, Hispanic, and African Americans.
It is part of the pervasive increased sensitivity to sensory input found in patients with migraine.
|Sound||Hyperacusis||Phonophobia||LDL||Correlates with smell sensitivity (Rocho-Filho et al, 2016)|
|Smell||Smell sensitivity||Osmophobia||Upsit, Sniffit|
|Weather||Barosensitivity||? Barophobia ?|
|Motion sensitivity||kinesiophobia||Motion sickness||Various questionnaires||Motion sickness can trigger smell sensitivity|
Although undoubtedly this has been observed in ancient history, Larmande et al (1996) is the first paper to come up in Pubmed who attempted to correlate weather and migraine. They report (in French) that "No correlations were found between climate parameters or variations there of and onset of migraine". So it appears that in the French, weather does not provoke migraine.
Similarly, Villeneuve et al (2006) reported (in Ottawa, 4039 ED visits) that "no associations were observed with changes in atmospheric pressure, wind speed, and relative humidity during the 24 hours preceding presentation." Here the group studied were Canadians who felt sick enough to go the the emergency departement. While this is easy data to collect, we are doubtful that this reflects the behavior of migraine in general. In fact, if a migraine were triggered by a low pressure front, perhaps as always, this would probably be a reason NOT to go to the ED.
Szyszkowicz (2008) reported a weak correlation between emergency department visits for headache (in Ottawa again, 8012 ED visits for headache), and air pollution. Similar comments as above.
Hoffman et al (2011), reported that 6 out of 20 migraine patients were "highly sensitive to changes of certain weather components". This is simply too few patients. Hoffman (2015) looked at 100 patients. They reported that there was no correlation in all migraine patients, but there was a subgroup with a significant weather sensitivity. This makes some sense as migraine is unlikely to be a single disease, and it seems very plausible that there could be a subgroup with weather sensitivity.
Okuma et al (2015), reported in Japan that in 34 patients (31 women), that patients developed migraines with low atmospheric pressure. This is a very small group, but it does reflect our experience in Chicago.
Overall, it our impression that patients with migraine are often (but not always) sensitive to atmospheric pressure. We suspect that this sensitivity reflects a genetic subgroup within migraine. It is well known that migraine is polygenetic.
Gurkov et al (2016) reported that Meniere's disease can be triggered by pressure changes. Only 56 subjects were studied. There was a very low correlation, which fits with our idea that Meniere's disease is not associated with atmospheric pressure.
On the other hand, Schmidt et al (2017) also reported that symptom prevalence was higher when atmospheric pressure was low, in the UK. The relative risk was about 30%. This was a much larger study, and is more plausible. We would wonder how many of these patients also fit the criteria for Migraine (about 50% of Meniere's patients also meet criteria for Migraine).
Although some patients are very certain that weather changes trigger their migraines, the Neurology headache establishment does not appear as certain about this. Pelligrino et al (2017), in a meta-analysis, reported an immense number of potential triggers. A recent paper by Turner et al (2018) on "Percieved migraine triggers", stated in a nice way of course, that they were dubious. They said "subjects' belief systems still play a role in metods of self report ...." In other words, they don't really buy it. These authors seem to assume that migraine is a disease, rather than just a collection of symptoms with many different genetic substrates.