Factors affecting fear of attacks in patients with episodic migraine – a cross-sectional study

Background Interictal burden impacts the quality of life of migraine patients especially the fear of the next attack. However, it is unclear which variables influence the fear of the development of a future migraine attack. Therefore, the aim of this study was to identify factors contributing to the fear of attacks in patients with episodic migraine and to investigate the differences between individuals with low and high attack anxiety. Methods Potential factors affecting fear of attacks were assessed by using the Headache Impact Test, Central Sensitization Inventory, Allodynia Symptom Checklist and the Neck Disability Index. Fear of attacks was quantified using Fear of Attacks in Migraine questionnaire. A multiple linear regression was used to evaluate which of these factors would explain the dependent variable fear of attacks. Results The included sample of patients with episodic migraine (n = 46) had a mean of 79.4 (21.2) points on the Fear of Attacks in Migraine Inventory questionnaire and according to its subscales; attention and anticipation had the highest score of 37.8 (9.3) points. Headache impact and allodynia symptoms explained 35.2% of the results of the fear of attacks questionnaire in episodic migraine (p < 0.001). High attack anxiety individuals had higher scores regarding headache impact, central sensitization, allodynia symptoms and neck disability, compared with low attack anxiety. Conclusion Allodynia and headache impact are major factors affecting the fear of attacks and might subsequently be addressed in the management the interictal burden of episodic migraine.