ArticleMedical research archives2025
Association Between Trigger Surprisal and Tension-Type Headache Attacks.
Article in Medical research archives, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
3 authors.
Funding
Abstract
Background: The causes of individual headache attacks are commonly sought, yet the multiple potential influences make this task difficult. Information theory provides a framework for addressing this challenge by quantifying how unexpected an exposure is through Aims: This study aimed to determine whether surprisal is associated with incident tension-type headache attacks among individuals with episodic migraine. Methods: This secondary analysis proceeded from a prospective daily diary study in which 109 participants with migraine recorded potential triggers, headache activity, and symptoms twice daily for up to 28 days. Surprisal values were computed from person-specific probability distributions of diary responses, aggregated to yield average surprisal scores per diary entry. Associations between current surprisal and the onset of headache attacks within 12- and 24-hour intervals were evaluated. Analyses were conducted for all headaches combined and separately for migraine-only and tension-type headache-only attack sets. Results: Headache attacks occurred in 1,345 of 4,530 (29.7%) of 12-hour and 2,122 of 4,947 (42.9%) of 24-hour windows. Stratified analyses showed a strong association for migraine attacks, OR: 2.18 (95%CI: 1.15 - 4.14) at 12 hours and OR: 2.88 (95%CI: 1.77 - 4.69) at 24 hours. In contrast, associations with tension-type headache were weak and nonsignificant, OR: 1.01 (95%CI: 0.45 - 2.23) at 12 hours and OR: 1.40 (95%CI: 0.69 -2.86) at 24 hours. Exploratory nonlinear and contextual analyses within the tension-type headache subset revealed no consistent gradients or effect modification by prior-day surprisal. Conclusions: Surprisal was associated with migraine but not tension-type headache attacks in this cohort. These findings suggest that migraine may be more sensitive to contextual unpredictability in the environment than tension-type headache. Future research should examine surprisal in populations with primary tension-type headache diagnoses to clarify whether the absence of association reflects true diagnostic differences or misclassification of attacks.
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Registered trials
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