News on migraine: genetics, genetics, and aortic stiffness

Abstract

Migraine is the most frequent episodic neurological disorder. In Europe about 8% of males and 17% of females are affected. It has a complex pathophysiology, which also involves genetic factors. In contrast to hemiplegic migraine, for instance, the genetic background of migraine had so far not been identified. In a recent study published in Nature Genetics, a common susceptibility variant was found on chromosome 8q22.1. This is located between two genes which are involved in glutamate homeostasis. This seems quite appropriate, since an accumulation of glutamate most likely increases the susceptibility to migraine due to increased sensitivity to cortical spreading depression, the likely mechanism for migraine aura. In the second article, the frequency of de novo mutations in the CACNA1A and ATP1A2 genes in young subjects with early-onset sporadic hemiplegic migraine was evaluated. In the population of 25 patients, mutations were found in 19 patients, i.e. 76%. This is quite a high percentage that might be related to the patient group evaluated. However, it also shows that genetic testing is indicated in these patients. The third article deals with aortic stiffness and pulse wave reflection in young subjects with migraine. It shows a significantly higher aortic pulse wave reflection and aortic augmentation. Both are assumed to be risk factors for ischemic stroke and other cardiovascular events. These findings may be the link between the known increased risk of stroke and cardiovascular events in subjects suffering from migraine.