Achoo Syndrome <-> Migraine

Comorbidity UNKNOWN CURATED
Structured from a prose association previously recorded only in `Achoo_Syndrome.yaml`'s free-text `notes:` (see dismech#7263). A single Japanese web-based cross-sectional cohort (n=11,840) found photic sneeze syndrome (PSS) associated with migraine (OR=1.97) and with psychological distress (K6>=5: OR=1.40; K6>=13: OR=1.49). Migraine is modeled here as the comorbidity; the psychological-distress finding from the same study is recorded in this entry's notes rather than as a second MONDO-anchored comorbidity, since psychological distress (assessed via the Kessler K6 scale) is a symptom-scale construct rather than a discrete disease entity. Directionality is UNKNOWN: the study is cross-sectional self-report and cannot establish which condition (if either) precedes the other. This is a single-cohort finding, not yet replicated - treat the effect sizes as preliminary.
A

Disease A

Achoo Syndrome
Slug:Achoo_Syndrome
B

Disease B

Migraine
Slug:Migraine
G

Causal Mechanism Graphs

Achoo Syndrome

graph LR
    Optic_Trigeminal_Cross_Activation["Optic-Trigeminal Cross-Activation"]
    Nasal_Prickling_Sensation["Nasal Prickling Sensation"]
    Parasympathetic_Generalization["Parasympathetic Generalization"]
    Enhanced_Visual_and_Somatosensory_Cortical_Responses["Enhanced Visual and Somatosensory Cortical Responses"]
    General_Sneeze_Execution_Circuit["General Sneeze Execution Circuit"]
    Abrupt_Bright_Light_Stimulation["Abrupt Bright-Light Stimulation"]
    Light_Triggered_Sneezing["Light-Triggered Sneezing"]

    Abrupt_Bright_Light_Stimulation --> Enhanced_Visual_and_Somatosensory_Cortical_Responses
    Abrupt_Bright_Light_Stimulation --> Optic_Trigeminal_Cross_Activation
    Abrupt_Bright_Light_Stimulation --> Parasympathetic_Generalization
    Enhanced_Visual_and_Somatosensory_Cortical_Responses --> Nasal_Prickling_Sensation
    Enhanced_Visual_and_Somatosensory_Cortical_Responses --> General_Sneeze_Execution_Circuit
    Optic_Trigeminal_Cross_Activation --> General_Sneeze_Execution_Circuit
    Parasympathetic_Generalization --> General_Sneeze_Execution_Circuit
    General_Sneeze_Execution_Circuit --> Light_Triggered_Sneezing

    style Optic_Trigeminal_Cross_Activation fill:#dbeafe
    style Nasal_Prickling_Sensation fill:#fef3c7
    style Parasympathetic_Generalization fill:#dbeafe
    style Enhanced_Visual_and_Somatosensory_Cortical_Responses fill:#dbeafe
    style General_Sneeze_Execution_Circuit fill:#dbeafe
    style Abrupt_Bright_Light_Stimulation fill:#dbeafe
    style Light_Triggered_Sneezing fill:#fef3c7

Migraine

graph LR
    Central_Sensitization["Central Sensitization"]
    Cortical_Spreading_Depression["Cortical Spreading Depression"]
    Trigeminovascular_Activation["Trigeminovascular Activation"]
    CGRP_Pathway["CGRP Pathway"]

    Cortical_Spreading_Depression --> Trigeminovascular_Activation
    Trigeminovascular_Activation --> CGRP_Pathway
    CGRP_Pathway --> Central_Sensitization

    style Central_Sensitization fill:#dbeafe
    style Cortical_Spreading_Depression fill:#dbeafe
    style Trigeminovascular_Activation fill:#dbeafe
    style CGRP_Pathway fill:#dbeafe
S

Association Signals

Signal 1
LITERATURE LITERATURE_ASSOCIATION UNKNOWN
Population:Japanese web-based questionnaire cohort (Health Data Lab / Yahoo! Japan Corporation), self-reported photic sneeze syndrome and migraine, n=11,840.
Temporal: A before B: , B before A: , Same time:
OR: 1.97
CI: 1.57 - 2.48
p: 2.18e-09
FDR:
Odds of self-reported migraine among individuals with photic sneeze syndrome vs. those without, unadjusted, cross-sectional.
PMID:31287245 (SUPPORT)
Source: HUMAN_CLINICAL
"likely to suffer from migraine (odds ratio = 1.97, P = 2.18 × 10-9 )"
Primary quantitative result establishing the PSS-migraine association, with the effect size flagged in dismech#7263 as needing snippet verification against the abstract before curation.
H

Hypotheses

Hypothesis: shared trigeminal nerve hypersensitivity links photic sneeze syndrome (PSS) and migraine. PSS has been proposed to arise via optic-trigeminal summation, in which light-evoked activity in the optic pathways cross-activates the trigeminal nerve; trigeminal nerve hypersensitivity is also implicated in migraine and in the photophobia that commonly accompanies it. The authors hypothesize that trigeminal hypersensitivity in PSS confers susceptibility to migraine, but the cross-sectional design does not establish this mechanism directly.
PMID:31287245 (SUPPORT)
Source: HUMAN_CLINICAL
"Given the commonalities in the mechanisms underlying PSS, photophobia, and migraine, we hypothesized that hypersensitivity of the trigeminal system in individuals with PSS could confer susceptibility to migraine."
States the trigeminal-hypersensitivity hypothesis motivating the study's test of a PSS-migraine association.
Y

Raw YAML

Show YAML 
name: com_Achoo_Syndrome__Migraine
creation_date: "2026-07-31T10:39:09Z"
curation_status: CURATED
notes: >-
  Structured from a prose association previously recorded only in
  `Achoo_Syndrome.yaml`'s free-text `notes:` (see dismech#7263). A single
  Japanese web-based cross-sectional cohort (n=11,840) found photic sneeze
  syndrome (PSS) associated with migraine (OR=1.97) and with psychological
  distress (K6>=5: OR=1.40; K6>=13: OR=1.49). Migraine is modeled here as the
  comorbidity; the psychological-distress finding from the same study is
  recorded in this entry's notes rather than as a second MONDO-anchored
  comorbidity, since psychological distress (assessed via the Kessler K6
  scale) is a symptom-scale construct rather than a discrete disease entity.
  Directionality is UNKNOWN: the study is cross-sectional self-report and
  cannot establish which condition (if either) precedes the other. This is a
  single-cohort finding, not yet replicated - treat the effect sizes as
  preliminary.

disease_a:
  slug: Achoo_Syndrome
  preferred_term: Achoo syndrome
  term:
    id: MONDO:0007038
    label: Achoo syndrome

disease_b:
  slug: Migraine
  preferred_term: migraine
  term:
    id: MONDO:0005277
    label: migraine disorder

directionality: UNKNOWN
effect_direction: RISK

hypotheses:
- description: >-
    Hypothesis: shared trigeminal nerve hypersensitivity links photic sneeze
    syndrome (PSS) and migraine. PSS has been proposed to arise via
    optic-trigeminal summation, in which light-evoked activity in the optic
    pathways cross-activates the trigeminal nerve; trigeminal nerve
    hypersensitivity is also implicated in migraine and in the photophobia
    that commonly accompanies it. The authors hypothesize that trigeminal
    hypersensitivity in PSS confers susceptibility to migraine, but the
    cross-sectional design does not establish this mechanism directly.
  evidence:
  - reference: PMID:31287245
    reference_title: "Possible association between photic sneeze syndrome and migraine and psychological distress."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Given the commonalities in the mechanisms underlying PSS, photophobia,
      and migraine, we hypothesized that hypersensitivity of the trigeminal
      system in individuals with PSS could confer susceptibility to migraine.
    explanation: >-
      States the trigeminal-hypersensitivity hypothesis motivating the
      study's test of a PSS-migraine association.

association_signals:
- source: LITERATURE
  method: LITERATURE_ASSOCIATION
  population: >-
    Japanese web-based questionnaire cohort (Health Data Lab / Yahoo! Japan
    Corporation), self-reported photic sneeze syndrome and migraine, n=11,840.
  directionality: UNKNOWN
  effect_direction: RISK
  statistics:
    metrics:
    - metric_type: OR
      metric_value: 1.97
      metric_ci_lower: 1.57
      metric_ci_upper: 2.48
      p_value: 2.18e-9
      notes: >-
        Odds of self-reported migraine among individuals with photic sneeze
        syndrome vs. those without, unadjusted, cross-sectional.
    evidence:
    - reference: PMID:31287245
      reference_title: "Possible association between photic sneeze syndrome and migraine and psychological distress."
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: "likely to suffer from migraine (odds ratio = 1.97, P = 2.18 × 10-9 )"
      explanation: >-
        Primary quantitative result establishing the PSS-migraine
        association, with the effect size flagged in dismech#7263 as needing
        snippet verification against the abstract before curation.
  notes: >-
    Same cohort and paper also report PSS associated with clinically relevant
    psychological distress (K6>=5: OR=1.40, 95% CI 1.14-2.72, P=0.00143) and
    severe psychological distress (K6>=13: OR=1.49, 95% CI 1.00-2.23,
    P=0.0486). Both intervals are reproduced as printed in the source; note the
    K6>=5 interval is not symmetric about its point estimate. These two odds
    ratios are unadjusted. The separate finding that the PSS-distress
    relationship holds irrespective of migraine status comes not from these
    ORs but from a two-way/three-way factorial ANOVA on continuous K6 scores,
    in which PSS and migraine were independently associated with higher K6 and
    their interaction term was non-significant. Not modeled as a separate
    comorbidity here (see entry-level notes).
Source:GitHub