Abstract
Migraine is considered to be a neurovascular disease that manifests as a throbbing headache, possibly caused by the activation of the trigeminovascular system. Several studies have supported the role of inflammation in the pathogenesis of migraine. Chronic periodontitis (CP) is an infectious inflammatory disease triggered by bacterial products evoking an immune response which could result in the destruction of the periodontium. However, little is known about the longitudinal association between CP and migraine. In this study, we designed a nationwide population-based cohort study to investigate the risk of migraine and CP exposure in Taiwan. In total, 68,282 patients with CP were identified from the National Health Insurance Research Database (NHIRD), and 68,282 comparisons were randomly captured and matched by age, sex, monthly income, urbanization and comorbidities. The association between CP exposure and migraine risk was evaluated by Cox proportional hazards regression models. In this study, 785 migraine patients were identified in the CP cohort, and 641 migraine cases were found in the non-CP cohort. The incidence rate of migraine was significantly higher in the CP cohort than the non-CP cohort (adjusted HR: 1.21, 95% CI: 1.09–1.34, p < 0.001) during the 13-year follow-up period. Females had a 2.69-fold higher risk for migraine than males (95% CI: 2.38–3.04, p < 0.001). In summary, CP is associated with an increased risk of subsequent migraine in Taiwan.
Highlights
Migraine is a neurological disorder that involves a throbbing headache on one side, usually accompanied by nausea, allodynia and sensitivity to sound or light [1,2]
The results revealed that the prevalence of Chronic periodontitis (CP) was significantly higher in patients with chronic migraine than those without chronic migraine
By the logistic regression analysis, the results demonstrated that the prevalence of self-reported periodontitis was significantly higher in chronic migraine patients
Summary
Migraine is a neurological disorder that involves a throbbing headache on one side, usually accompanied by nausea, allodynia and sensitivity to sound or light [1,2]. Migraine is usually further divided into two subtypes: with or without aura. The definition of aura is recognized as a transient neurological visual, sensory or language symptom that may precede or accompany the headache attack [4]. The exact mechanisms of the pathogenesis of migraine still remain to be determined. Neuroinflammation via the trigeminovascular pathway is hypothesized to activate several inflammatory mediators triggering the onset of migraine [5]. The upregulation of these inflammatory factors was found to contribute to the pathogenesis of psoriasis [6], cardiovascular disease [7] and psychiatric disorders [8]
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