Background: Migraine trigger factors are precipitating factors that can contribute to an attack by increasing the probability of a migraine occurring. For some migraineurs, the headache phase is preceded by a transient disturbance in neurological function (an aura). An aura could be visual or sensory in nature. There are medications that can be used to treat a migraine attack when it occurs (acute medication) and medication that can be used to reduce frequency and severity of migraine attacks (prophylactic medication). Objectives: The primary aim of the study was to identify if there was a relationship between migraine trigger factors, auras and treatment. Methods: The study was conducted in 2014 in Port Elizabeth and consisted of two self-administered questionnaire-based surveys, one for pharmacists and one for migraine patients. Migraine patient questionnaires were distributed to migraine patients who frequented pharmacies, physiotherapy practices and health shops. A total of 18 pharmacist questionnaires and 173 migraine patient questionnaires were analysed. Results: Experiencing an aura before a migraine attack was reported by 43.9% of respondents and only “sometimes” by 22.5% of respondents. Visual auras were experienced by 92.0% of respondents who indicated that they suffered from migraine with aura and sensory auras were experienced by 71.5% of respondents, with 62.8% of respondents experiencing both visual and sensory auras. Trigger factors were experienced by 89.0% of respondents. There was no statistical relationship between aura and trigger factors, but there was a statistical relationship between trigger factors and visual aura at the 5% level (Chi-square = 7.966, d.f. = 1, p-value = 0.005). Cramér’s V showed a small practical significance at 0.218. About 80.0% of respondents used over-the-counter (OTC) medication and only 12.6% used migraine specific medication to abort a migraine attack. There was no statistical relationship between aura (visual or sensory) and abortive medication. There was a statistical relationship between abortive medication and the presence of trigger factors (Chi-square = 8.775, d.f. = 3, p-value = 0.032). Cramér’s V showed a small practical significance at 0.244. There was no statistical relationship in the presence of trigger factors between aura and abortive medication. Conclusion: Migraine is a complex disease which affects people of all ages. There appears to be a statistical relationship between visual auras and trigger factors and between abortive medication and trigger factors. There was, however, no statistical relationship between aura and abortive medication in the presence of trigger factors. Further studies need to be conducted to substantiate these findings.

EEG biofeedback training, known as neurofeedback, has been explored as a nonpharmacologic prophylaxis for migraines. Based on the conceptual model of disregulation of central arousal function, the Othmers proposed a protocol in migraine prophylaxis by raising the sensory motor rhythm (SMR, 12- 15 Hz), accompanied by an inhibition of theta ( 4- 7 Hz) frequency. Relaxation with music, on the other hand, is another type of nonpharmacologic prophylaxis for migraines and is used to reduce perceived psychological and/or physiological stress and pain. Studies showed that an effective relaxation with music program is one that integrates certain relaxing musical characteristics and personal factors. Six female participants (29 to 57 years of age) previously diagnosed with migraines participated in this single-subject design study. This study employed two independent variables- the SMR/theta training and music therapy, and the dependent variables were the SMR and theta recording registration. Each participant first participated in the EEG Base-rate recording session, and was then randomly assigned to the following treatment conditions: SMR/Theta training only, music therapy only, and SMR/Theta training and music therapy." Counterbalancing of the treatment conditions was applied across participants, two sessions weekly for a total of 13 sessions, 30 minutes each session. In SMR/Theta training only, participants were instructed to raise their SMR while inhibiting theta. In music therapy only, participants were instructed to select their relaxation CD music to be played during the sessions. The SMR and theta data were graphed for each participant and implications were discussed. Graph analysis indicated that two participants were responsive to SMR/Theta training and music therapy and SMR/Theta training only respectively. Overall, all participants acquired relaxation skills and seemed better at adapting themselves to a stressful environment.

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Cloninger’s Psychobiological Theory of Personality proposes four temperament dimensions, each underpinned by a different neurotransmitter system. The serotonergic system is purportedly linked to Harm Avoidance (HA). The aim of this study was to explore the relationship between HA and serotonin in migraine without aura (MO). A second aim was to explore the personality profile of MO patients. Sixty-six participants completed an online questionnaire and donated blood samples. Results indicated no significant association between HA and serotonin and a significant relationship between MO and HA. This study indicates that both Cloninger’s Psychobiological Theory of Personality and the Tridimensional Personality Questionnaire used for its assessment have value in South African personality research. In addition, the findings of the study reveal support for personality influences on the processes involved in migraine. This not only produces worthwhile avenues of research but also an alternative perspective for clinical practice. / Psychology / M.A. (Psychology (Research Consultation))