A recent study reports an improvement in migraine symptoms during a COVID-19 lockdown in the Netherlands. The findings suggest that lifestyle changes can substantially alter the course of migraine, opening the door for greater use of behavioural interventions alongside existing pharmacological therapies.

The shutdown caused by the COVID-19 pandemic dramatically altered both our clinical practices and the day-to-day lives of our patients. Patients’ jobs changed substantially or disappeared altogether. Months were spent sheltering in place at home, and in-person clinical visits and hospital therapies were cancelled or modified in accordance with government-imposed quarantine rules. In response, novel approaches, such as telemedicine services and electronic diaries, were introduced to enable patients to receive medical care in the absence of face-to-face services1,2.

Several studies have investigated the influence of lockdown on the behaviour and habits of individuals with migraine and have explored ways in which the new circumstances have altered exposure to typical migraine triggers and migraine-aggravating behaviours1,2,3,4. Interestingly, the results of a recent study by Verhagen et al.1 suggest that, in some ways, the change in lifestyle caused by the pandemic has been beneficial for individuals with migraine. In their study, Verhagen et al.1 used an electronic diary to collect data from 592 patients with migraine treated at a headache center in the Netherlands. On 12 March 2020, an ‘intelligent lockdown’ was adopted in the Netherlands, preventing gatherings and allowing only limited, socially distanced, outdoor activities. Further restrictions, including the closure of schools, sports clubs and restaurants, were introduced on 15 March 2020.

Verhagen et al.1 analysed participants’ electronic diary entries from 28 baseline days (13 February to 11 March 2020) and the first 28 days of lockdown (12 March to 8 April 2020). For a subset of participants, electronic diary data were available for 1 additional baseline month and 1 additional lockdown month. Perhaps surprisingly, the researchers found a decrease in the number of migraine days and acute medication intake days, and an increase in general well-being, during the first month of lockdown compared with the preceding month. In participants for whom extended electronic diary data were available, this change was maintained during the second month of lockdown.



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