The relevance of migraine in the clinical spectrum of mitochondrial disorders

Alberto Terrin,Elena Pegoraro,Massimo Zeviani,Valerio Carelli,Ferdinando Maggioni,Gianni Sorarù,Maria Lucia Valentino,Luca Bello,Leonardo Caporali

doi:10.1038/s41598-022-08206-z

Abstract

Recent scientific evidence suggests a link between migraine and brain energy metabolism. In fact, migraine is frequently observed in mitochondrial disorders. We studied 46 patients affected by mitochondrial disorders, through a headache-focused semi-structured interview, to evaluate the prevalence of migraine among patients affected by mitochondrial disorders, the possible correlations between migraine and neuromuscular genotype or phenotype, comorbidities, lactate acid levels and brain magnetic resonance spectroscopy. We explored migraine-related disability, analgesic and prophylactic treatments. Diagnoses were achieved according to International Classification of Headache Disorders, 3rd edition. Lifetime prevalence of migraine was 61% (28/46), with high values in both sexes (68% in females, 52% in males) and higher than the values found in both the general population and previous literature. A maternal inheritance pattern was reported in 57% of cases. MIDAS and HIT6 scores revealed a mild migraine-related disability. The high prevalence of migraine across different neuromuscular phenotypes and genotypes suggests that migraine itself may be a common clinical manifestation of brain energy dysfunction. Our results provide new relevant indications in favour of migraine as the result of brain energy unbalance.

Highlights

We found a one-year prevalence of migrainous headache of 41%, significantly greater than the prevalence reported in general population in the European countries[20,21], and higher than the 25.9% prevalence reported in a recent large Italian population s tudy[22]
Since our sample has a high mean age and migraine prevalence is known to decrease with increasing a ge[20], the prevalence in our patients’ cohort is more than threefold higher than expected in the general population[20] in both sexes, reaching 68% in female
CPEO and CPEO plus are the main phenotypes in our study population, with a subgroup prevalence of migraine of 53%, which is notably higher than the 21–40% prevalence previously reported among CPEO patients[27–29]

Summary

Introduction

10/46 patients (21.7% of cases) did not report any sort of recurrent headache in their life, despite a higher mean age (66.0 ± 13.9 years; range 42–83 years). 67% of MELAS patients were migraineurs (2/6 MO, 1/6 MA, 1/6 MO plus MA), while 83% of patients with other MM reported a migrainous headache (3/6 MO, 1 pMO, 1 HM).

Results

Conclusion