Аннотация
A BSTRACT Objective: This study investigated the clinical characteristics and trigger patterns of migraine, focusing on caffeine’s dual role as a withdrawal trigger and quantitative lifestyle variable in episodic migraine (EM) and chronic migraine (CM). Materials and Methods: This cross-sectional study enrolled 100 migraine patients from a tertiary hospital (EM: n = 72; CM: n = 28; mean age: 39.5 ± 8.9 years; 88% – female). Data on clinical profiles, lifestyle factors (daily coffee/tea consumption), and reported triggers were collected. Caffeine withdrawal was defined as a migraine attack following the omission of habitual morning caffeine, while tyramine-rich foods were defined as aged cheeses and smoked or cured meats. Statistical analysis included group comparisons, Spearman’s correlation, and principal component analysis (PCA) with Varimax rotation to identify latent trigger patterns. Statistical significance was set at P < 0.05. Results: Caffeine withdrawal was a significantly more prevalent trigger in EM (52.8%) than in CM (14.3%; P adj = 0.006). In the CM group, a strong inverse correlation was found between daily coffee intake and pain intensity ( rs = −0.77, P < 0.001). PCA revealed a single sensory–environmental component in EM. In contrast, CM exhibited a more complex two-component structure: a dietary component and a sensory–caffeine component, where caffeine withdrawal loaded alongside sensory hypersensitivities. Conclusions: Caffeine’s role shifts during migraine chronification: from a withdrawal trigger in EM to an element of maladaptive sensory processing in CM, where consumption correlates with lower pain intensity. This reorganization supports “trigger-based phenotyping.” Management should be subtype-specific, focusing on caffeine habit and dietary modulation in CM while addressing environmental sensitivities in EM.