Migraine Aura Status Research Articles

Near-death experiences are associated with rapid eye movement (REM) sleep intrusions in migraine patients, independent of migraine aura.

Migraine aura, near-death experiences (NDEs), and rapid eye movement (REM) sleep intrusions might share common mechanisms. Here, we investigated the prevalence of NDEs and REM sleep intrusions in people with migraine. We hypothesized that NDEs and REM sleep intrusions are more prevalent in migraine patients with aura than in those without. We conducted a prospective cross-sectional cohort study at a tertiary headache center, based on a prespecified sample size (n = 808). Migraine patients completed a series of questionnaires, including questions about demographic and headache characteristics, the 16-item Greyson NDE scale, four questions about REM sleep intrusions, and the Depression, Anxiety, and Stress Scale 21 (DASS-21). Of 808 migraine patients (mean age 44.4 ± 13.3 years, 87.0% women), 353 (43.7%) had a current or previous history of migraine aura. Prevalence of NDE was 2.7% and not different in patients with and without aura (2.8% vs. 2.6%; p > 0.999). REM sleep intrusions were reported by 5.4% of participants and in a similar proportion of patients with and without aura (6.3% vs. 4.9%; p = 0.43). However, participants with REM sleep intrusions had had an NDE more often than participants without REM sleep intrusions (n = 5/44, 11.4% vs. n = 17/754, 2.2%; p = 0.005). Higher DASS-21 scores were associated with REM sleep intrusions (p < 0.001). In this tertiary center cohort study, the prevalence of NDE and REM sleep intrusions was not influenced by migraine aura status. However, we identified an association between NDE and REM sleep intrusions, which corroborates the notion that they might share pathophysiological mechanisms.

Associations between migraine and major cardiovascular events in type 2 diabetes mellitus.

Migraine is one of the most common primary headache disorders and a well-known risk factor for cardiovascular disorders. We aimed to investigate the association between migraine and major cardiovascular outcomes, including myocardial infarction (MI), ischemic stroke (IS), and cardiovascular death (CVD) in people with type 2 diabetes. A total of 2,229,598 people from the nationwide Korean National Health Insurance Service database with type 2 diabetes but without a previous history of MI and IS were included in this study. We identified patients over 20years of age with migraine using the claim data of International Statistical Classification of Diseases Related Health Problems, Tenth Revision (ICD-10) code G43. The patients with migraine were divided according to their migraine aura status. Migraine was present in 6.3% of the study population. Cases observed for MI, IS, CVD, and all-cause death were 2.6%, 3.6%, 5.9%, and 7.9%, respectively. The diagnosis of migraine was significantly associated with an increased risk of MI, IS, and CVD. The results remained significant after adjusting for covariates, including age, sex, body mass index, alcohol intake, smoking habits, physical activity, economic status, hypertension history, dyslipidemia, and duration of type 2 diabetes (MI, adjusted hazard ratio [aHR]: 1.182, 95% confidence interval [CI]: 1.146-1.219; IS, aHR: 1.111, 95% CI 1.082-1.14; CVD, aHR: 1.143, 95% CI 1.12-1.167). In particular, the presence of aura was associated with a higher risk of MI development compared to the non-aura group. The difference became more prominent with progressing age. In this nationwide population-based study, people with type 2 diabetes and migraines were found to be at a significantly higher risk for major cardiovascular events, including MI, IS, and CVD. The risk of MI and CVD significantly increased with the presence of aura symptoms among patients with migraine.

Visual snow: a neuro-ophthalmic syndrome

Background: The visual snow syndrome (VSS) is a rare disease characterized by persistent positive visual phenomena that are enigmatic and may be underestimated. It manifests as the perception of tiny, simultaneous, diffuse, and mobile dots frequently throughout the visual field. Although it affects brain networks, ocular examination is also indicated. This paper was aimed to review recent studies on VSS to identify the best clinical approach.&#x0D; Methods: In this narrative review, PubMed/Medline, Directory of Open Access Journals, and Embase were searched using the following terms: “Visual snow”, “Persistent aura”, “Persistent positive visual phenomena”, “Visual aura”, “Migraine”, “TV static”, “Migraine aura status”, and “Visual disturbance”. We searched relevant publications from January 2014 to January 2021 to find the best clinical approach. &#x0D; Results: VSS may be reconstituted as a distinct entity, although the symptoms may be consistent with typical migraine visual aura. For approximately two-thirds of patients, symptoms worsen and reduce their ability for activities of daily living. It often causes psychogenic detriment of the patient and their capacity to function socially and vocationally. Comprehensive history-taking and ocular examination are required to rule out other causes. However, all ocular and radiological findings may be normal. &#x0D; Conclusions: VSS is a neuro-ophthalmic disorder characterized by continuous chronic and recurrent visual disturbances that involve the entire visual field and may respond to empiric antimigraine or anti-seizure treatments. It may reduce the ability for activities of daily living; therefore, proper diagnosis by eye care professionals is necessary to determine its diagnosis and management.

Olfactory acuity based on Brief Smell Identification Test (BSITⓇ) in migraine patients with and without aura: A cross-sectional, controlled study

ObjectiveThe aim of this study was to evaluate olfactory acuity in migraine patients with and without aura (MwA and MwoA) Material and methodsThe study included 30 MwA patients, 30 MwoA patients, and 30 age- and gender-matched controls. Demographic features and odor-related symptoms (osmophobia, odor offensiveness, and odor-triggered attack status) were noted. Olfactory acuity was measured using the Brief Smell Identification Test (BSIT®), a 12-item derivative of the University of Pennsylvania Smell Identification Test (UPSIT®). BSIT® scores were compared between the migraine patients and controls. ResultsThe mean BSIT® score did not differ significantly between the MwA patients (8.7 ± 0.9) and MwoA (9.17 ± 0.9) patients (P = 0.094); however, the mean score in the control group was higher (10.4 ± 0.6) than in the MwA and MwoA patients (P < 0.001). The mean BSIT® score did not differ significantly between patients with and without odor-triggered migraine attacks (9 ± 0.9 and 8.8 ± 0.8, respectively) (P = 0.4). Osmophobia and odor-triggered attacks were more common in the MwA patients than in the MwoA patients (odor-triggered attacks: 66% vs. 40% [P = 0.04]; osmophobia: 76.6% vs. 60% [P = 0.16]) ConclusionOlfactory acuity is lower during attack-free periods in migraine patients, as compared to controls. Migraine aura status does not affect olfactory acuity. Odor-triggered attacks, osmophobia, and offensive odors between attacks were more common in the MwA patients than in the MwoA patients.

Persistent monocular visual loss in migraine patients.

The relationship between migraine and vision is complex. Besides migraine aura status and persistent visual aura without infarction, recognized by International Headaches Classification 3, cases of persistent monocular alterations have been described in migraineurs. To discuss the role of migraine as a risk factor for persistent monocular visual loss. We present five new cases of persistent monocular visual loss in migraineurs, discuss the differential diagnosis and possible relationship with migraine. Five young healthy patients are reported (three women) with a history of migraine (four with visual aura), that developed persistent monocular visual defects, four during an episode of migraine with aura. All patients were submitted to an extensive investigation. In three patients the scotoma was identified on automated perimetry; one of these patients had retinal hemorrhagic lesions, with fluorescein angiography revealing an isolated retinal vasculitis. In two patients fundoscopy revealed transient cotton wools spots. Except for the patient with retinal vasculitis, etiologic investigation was not conclusive. Monocular visual loss can occur in the setting of multiple pathologies that affect the eye and related structures. Although diseases requiring emergent intervention should always be excluded, we propose migraine should be considered as a contributing factor for unexplained monocular persistent scotoma.Monocular visual loss can occur in the setting of multiple pathologies that affect the eye and related structures. Although diseases requiring emergent intervention should always be excluded, we propose migraine should be considered as a contributing factor for unexplained monocular persistent scotoma.

Volumetric brain changes in migraineurs from the general population.

To assess volumetric brain changes in migraineurs from the general population compared with controls. Structural brain changes in migraineurs from the general population-based MRI Cerebral Abnormalities in Migraine, an Epidemiologic Risk Analysis (CAMERA)-2 observational cohort study were assessed by state-of-the-art voxel-based morphometry. T1-weighted MRIs of 84 migraineurs (52 with aura, 32 without aura) and 35 headache-free controls were evaluated. Regional volumes were compared voxelwise, corrected for age, sex, and total intracranial volume, with region-of-interest and whole-brain analyses. In region-of-interest analyses, migraineurs showed decreased gray matter volume in the visual areas V3 and V5 of the right occipital cortex compared to controls (p < 0.05, familywise error correction). Post hoc analyses revealed that similar changes were present regardless of migraine aura status, disease activity (>1 year attack-free [inactive] vs ≥1 attack within the last year [active] and attack frequency [≤1 (low) vs ≥1 attack per month [high]). In exploratory whole-brain analyses (p < 0.001, uncorrected for multiple comparisons), we identified additional structural differences in migraineurs in other cortical and subcortical areas, including white matter tracts, that are particularly involved in visual processing. Migraineurs from the general population showed small volumetric brain changes, mainly in cortical areas involved in visual motion processing, compared to controls. The presence of morphologic changes regardless of the presence of migraine aura or disease activity suggests that migraines with and without aura share common pathophysiologic pathways and suggests that these changes are (partially) irreversible or might have been present throughout life.

Migraine Subclassification via a Data-Driven Automated Approach Using Multimodality Factor Mixture Modeling of Brain Structure Measurements.

The current subclassification of migraine is according to headache frequency and aura status. The variability in migraine symptoms, disease course, and response to treatment suggest the presence of additional heterogeneity or subclasses within migraine. The study objective was to subclassify migraine via a data-driven approach, identifying latent factors by jointly exploiting multiple sets of brain structural features obtained via magnetic resonance imaging (MRI). Migraineurs (n=66) and healthy controls (n=54) had brain MRI measurements of cortical thickness, cortical surface area, and volumes for 68 regions. A multimodality factor mixture model was used to subclassify MRIs and to determine the brain structural factors that most contributed to the subclassification. Clinical characteristics of subjects in each subgroup were compared. Automated MRI classification divided the subjects into two subgroups. Migraineurs in subgroup #1 had more severe allodynia symptoms during migraines (6.1±5.3 vs. 3.6±3.2, P=.03), moreyears with migraine (19.2±11.3years vs 13±8.3years, P=.01), and higher Migraine Disability Assessment (MIDAS) scores (25±22.9 vs 15.7±12.2, P=.04). There were not differences in headache frequency or migraine aura status between the two subgroups. Data-driven subclassification of brain MRIs based upon structural measurements identified two subgroups. Amongst migraineurs, the subgroups differed in allodynia symptom severity,years with migraine, and migraine-related disability. Since allodynia is associated with this imaging-based subclassification of migraine and prior publications suggest that allodynia impacts migraine treatment response and disease prognosis, future migraine diagnostic criteria could consider allodynia when defining migraine subgroups.

Persistent and Repetitive Visual Disturbances in Migraine: A Review.

Visual disturbances in migraineurs, such as visual aura, are typically episodic, that is, associated with the headache attack, and overlaid by head pain and other symptoms that impact the patient. In some patients, however, visual symptoms are dominant due to frequency (migraine aura status), duration (persistent migraine aura and other persistent positive visual phenomena), or complexity (visual snow syndrome). These syndromes are more rare and challenging to classify in clinical practice resulting in a lack of systematic studies on pathophysiology and treatment. We aim at describing clinical features and pathophysiological concepts of typical migraine aura with a focus on cortical spreading depression and differentiation from non-typical migraine aura. Additionally, we discuss nomenclature and the specifics of migraine aura status, persistent migraine aura, persistent positive visual phenomena, visual snow, and other migrainous visual disturbances. The term migraine with prolonged aura might be a useful bridge between typical aura and persistent aura. Further studies would be necessary to assess whether a return of the classification category eventually helps diagnosing or treating patients more effectively. A practical approach is presented to help the treating physician to assign the correct diagnosis and to choose a medication for treatment that has been successful in case reports of these rare but disabling conditions.

Visual snow--persistent positive visual phenomenon distinct from migraine aura.

Patients with visual snow complain of uncountable flickering tiny dots in the entire visual field similar to the view of a badly tuned analogue TV channel (TV snow). The symptoms are often continuous and can persist over years. This condition is grouped among the persistent visual phenomena in migraine, although it clinically presents a unique entity distinct from persistent migraine aura or migraine aura status. Here, we review the recent literature leading to the identification of the visual snow syndrome. The additional visual and non-visual symptoms are described in detail, and criteria are presented for future studies. Using these criteria, the relationship to migraine and typical migraine aura was recently evaluated. Further, patients with visual snow differ from controls in respect of hypermetabolism in the supplementary visual cortex (lingual gyrus). This provides evidence that visual snow, despite being purely subjective in the individual patient, has a clear biological basis. The area of hypermetabolism overlaps with the functional correlates of photophobia in migraine supporting the close relationship of migraine and visual snow.

Is migraine a risk factor for pediatric stroke?

Our understanding of risk factors for childhood stroke is incomplete. In adults, migraine with aura is associated with a two-fold increase in ischemic stroke risk. In this cohort study we examine the association between migraine and stroke among children in Kaiser Permanente Northern California (KPNC). Children ages 2-17 years who were members of KPNC for ≥6 months between 1997 and 2007 were included. Migraine cohort members had one or more of: an ICD-9 code for migraine, migraine listed as a significant health problem, or a prescription for a migraine-specific medication. The comparison group was children with no evidence of headache. Main outcome measures included stroke incidence rates and incidence rate ratios (IR). Among the 1,566,952 children within KPNC during the study period, 88,164 had migraine, and 1,323,142 had no evidence of headache. Eight migraineurs had a stroke (three (38%) hemorrhagic; five (63%) ischemic). Eighty strokes occurred in children without headache (53 (66%) hemorrhagic; 27 (34%) ischemic). The ischemic stroke incidence rate was 0.9/100,000 person-years in migraineurs vs. 0.4/100,000 person-years in those without headache; IR 2.0 (95% CI 0.8-5.2). A post-hoc analysis of adolescents (12-17 years) showed an increased risk of ischemic stroke among those with migraine; IR 3.4 (95% CI 1.2-9.5). The hemorrhagic stroke incidence rate was 0.5/100,000 person-years in migraineurs and 0.9/100,000 person-years in those without headache; IR 0.6 (95% CI 0.2-2.0). There was no statistically significant increase in hemorrhagic or ischemic stroke risk in pediatric migraineurs in this cohort study. A post-hoc analysis found that ischemic stroke risk was significantly elevated in adolescents with migraine. Future studies should focus on identifying risk factors for ischemic stroke among adolescent migraineurs. Based on adult data, we recommend that migraine aura status should be studied as a possible risk factor for ischemic stroke among adolescent migraineurs.

Dietary patterns according to headache and migraine status: a cross-sectional study.

Several potential dietary trigger factors for migraine have been proposed. However, few studies have examined the intake pattern of these dietary items compared to adequate control populations and whether intake levels may vary by migraine aura status or attack frequency. We conducted a cross-sectional study among participants in the Women's Health Study. We used logistic regression to evaluate the association between migraine and headache status and low intake of foods commonly reported to affect migraine. A total of 25,755 women reported no history of migraine or headache, 5573 reported non-migraine headache and 7042 reported any migraine. Those with non-migraine headache or any migraine were more likely to have low intake of total alcohol (OR = 1.22, 95% CI:1.14-1.29 and OR = 1.17, 95% CI:1.11-1.24, respectively). Migraineurs with aura were more likely to have low intake of chocolate, ice cream, hot dogs, and processed meats. Those who experience migraine at least once per week were more likely to have low intake of skim/low-fat milk and white and red wine. Intake of most suggested migraine dietary triggers differs by migraine aura status and attack frequency, a pattern not found for non-migraine headache.

Aura status: a not so frequent aura.

Migraine aura status is a variety of migraine aura with unvalidated research criteria. We conducted a systematic review of published cases and a retrospective analysis of 500 cases of migraine with aura to evaluate the applicability and clinical features of ICHD-III beta criteria, compared to a more liberal definition for its diagnosis: ≥3 aura episodes for up to three consecutive days. Many publications under this title correspond to persistent or formerly designated prolonged auras. Nine cases fulfilled ICHD-III beta status criteria. In our series, either 1.7% or 4.2% cases fulfilled ICDH-III beta or our definition, respectively. Regardless of the criteria, aura status patients were older at onset of status than those with typical aura, had a predominance of visual symptoms, normal neuroimaging and no sequelae. Status recurred in a few. Both criteria identify a similar population in terms of age, gender, main symptoms, imaging and outcome. Since patients with closely recurring auras might raise the same approach independently of the criteria, the use of more liberal criteria will allow more cases for detailed diagnosis and therapeutic analysis, eventually leading to the identification of subtypes.

Status migrainosus and migraine aura status in a French tertiary-care center: An 11-year retrospective analysis

Status migrainosus (SM) and migraine aura status (MAS) are two migraine complications. Few data exist in literature. This 11-year retrospective study in one French center describes patients' characteristics, modifications of the migraine before complication, evolution after the episode and management in patients who had SM or MAS according to International Classification of Headache Disorders, second edition (ICHD-II) criteria. Among 8821 patients, 24 had SM, three had MAS and one had both forms. Mean duration of SM was 4.8 weeks and four weeks for MAS. Stress and menstruation were the main precipitating factors for SM (68.8% and 31.3%, respectively). No precipitating factor was found for MAS. For a majority of patients, the frequency of migraine attack was the same before and after SM or MAS. SM and MAS occurred more frequently in patients with initial low-frequency migraine attacks. Eight patients had a relapse of SM and three of MAS. Fifteen were hospitalized for amitriptyline intravenous treatment. SM and MAS are rare. Our results highlight a high rate of relapse and a similar frequency of migraine attacks before and after SM.

Migraine and subsequent risk of breast cancer: a prospective cohort study

Previous studies have suggested that migraineurs are at decreased risk for developing breast cancer. Further prospective studies are warranted to confirm these results. In addition, studies evaluating migraine characteristics (e.g., migraine subtypes and frequency) are lacking. We conducted a prospective cohort study among 39,696 participants in the Women's Health Study who were 45years and older at study entry. Information on migraine was self-reported with good validation rates. Incident breast cancer cases were confirmed by medical record review. We distinguished the following major endpoints: any breast cancer, a combined endpoint of invasive and in situ cases, in situ breast cancer only, and invasive breast cancer only. Cox proportional hazards models were used to calculate age- and multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (95% CI). A total of 7,318 (18.4%) women reported any migraine. During a mean follow-up time of 13.6years, 432 in situ and 1,846 invasive breast cancer cases occurred. Migraine was not associated with breast cancer risk. The multivariable-adjusted HRs (95% CI) were 1.10 (0.99-1.22) for any breast cancer, 1.06 (0.83-1.35) for in situ breast cancer, and 1.11 (0.99-1.25) for invasive breast cancer. The risk for developing breast cancer differed according to hormone receptor status with a suggestion of increased risks for hormone receptor negative tumors (HR ER-/PR-: 1.28, 95% CI: 0.96-1.71). We did not observe meaningful differences with regard to histologic subtype or according to migraine aura status or migraine attack frequency. Results of our study do not support the hypothesis that migraineurs have a decreased risk for breast cancer.

Migraine, weight gain and the risk of becoming overweight and obese: A prospective cohort study

Some cross-sectional studies have suggested an association between migraine and increased body weight. However, prospective data on the association are lacking. We conducted a prospective cohort study among 19,162 participants in the Women's Health Study who had a body mass index (BMI) of 18.5- <25 kg/m(2) at baseline. Migraine was self-reported by standardized questionnaires. Main outcome measures were incident overweight (BMI ≥ 25 kg/m(2)), incident obesity (BMI ≥ 30 kg/m(2)) and mean weight change. Age- and multivariable-adjusted hazard ratios (HRs) were calculated for the association between migraine and incident overweight and obesity. Differences in weight change were evaluated by analysis of covariance (ANCOVA). A total of 3,483 (18.2%) women reported any migraine history. After 12.9 years of follow-up, 7916 incident overweight and 730 incident obesity cases occurred. Migraineurs had multivariable-adjusted HRs (95% confidence interval) of 1.11 (1.05-1.17) for becoming overweight and 1.00 (0.83-1.19) for becoming obese. These associations remained stable after censoring for chronic diseases and were similar according to migraine aura status. Multivariable-adjusted mean weight change from baseline to the end of study was +4.7 kg for migraineurs and +4.4 kg for women without migraine (p = 0.02). Results of this large prospective study of middle-aged women do not indicate a consistent association between migraine and incident overweight, obesity or relevant weight gain.

Migraine and the Risk of Becoming Overweight and Obese: A Prospective Cohort Study (P04.259)

Objective: To evaluate the association between migraine and the risk of becoming overweight and obese. Background Cross-sectional studies have suggested an association between migraine and increased relative body weight. However, the direction of the association remains unclear. Design/Methods: Prospective cohort study among 19,162 participants in the Women9s Health Study aged 45 years and older and who had a body mass index (BMI) Results: 3,483 (18.2%) reported any migraine history. After a total of 12.9 years of follow-up, 7,916 women became overweight and 730 obese. While women who reported any history of migraine had a slightly increased hazard ratio (95% confidence interval) of 1.12 (1.06, 1.19) for becoming overweight, they were not at increased risk for becoming obese (HR: 1.00, 95% CI: 0.83, 1.19). These associations remained stable after censoring women for incident chronic diseases (cancer, CVD). The lack of association was not modified by migraine aura status or by migraine frequency. Multivariable-adjusted mean weight chance from baseline until the end of study was +4.7kg for migraineurs and +4.4kg for participants without migraine (P=0.02). Conclusions: Results of the large prospective study of middle-aged women do not indicate a consistent association between migraine and incident overweight, obesity, or relevant weight gain. Our data do not support that migraine should be considered a risk factor for obesity. Supported by: The Women9s Health Study is supported by grants from the National Heart, Lung, and Blood Institute (HL-043851, HL-080467, HL-099355), and the National Cancer Institute (CA-47988). Disclosure: Dr. Winter has nothing to disclose. Dr. Buring has nothing to disclose. Dr. Kurth has received personal compensation for activities with Merck & Co. & MAP Pharmaceuticals as a speaker and participant on an expert panel. Dr. Kurth has received personal compensation in an editorial capacity for the British Medical Journal.

Migraine, migraine aura, and cervical artery dissection: A systematic review and meta-analysis

We evaluated the current evidence on the association between migraine, including aura status, and cervical artery dissection. We performed a systematic review and meta-analysis of studies investigating the association between migraine or migraine subtypes (e.g. migraine with aura) and cervical artery dissection published through October 2010. We identified five case-control studies investigating the association between migraine and cervical artery dissection. In pooled analysis, migraine doubled the risk of cervical artery dissection (pooled odds ratio [OR]=2.06, 95% confidence interval [CI] 1.33-3.19). All studies allowed evaluation of migraine aura status. While the effect estimate for migraine without aura (pooled OR=1.94, 95% CI 1.21-3.10) was similar to overall migraine, the association was weaker for migraine with aura (pooled OR= 1.50, 95% CI 0.76-2.96). However, there is no evidence that aura status significantly modifies the association between migraine and cervical artery dissection (meta-regression on aura status p= .58). The risk does not appear to differ between women and men; however, only few studies presented gender-specific data. Heterogeneity among studies was low to moderate. In this meta-analysis migraine is associated with a two-fold increased risk of cervical artery dissection. This risk does not appear to significantly differ by migraine aura status or gender.

5-HTTLPR polymorphism in the serotonin transporter gene and migraine: A systematic review and meta-analysis

Data on the association between the SLC6A4 5-HTTLPR polymorphism and migraine are conflicting. We performed a systematic review and meta-analysis among studies published up to September 2009. For each study with genotype information, we calculated odds ratios (OR) and 95% confidence intervals (CI) assuming additive, dominant, and recessive genetic models. We then calculated pooled ORs and 95% CIs. Among the ten studies identified there was no overall association between the polymorphism and any migraine for Europeans or Asians. However, European women carrying the S allele had an increased risk for any migraine (dominant model: pooled OR=2.02; 95% CI 1.24-3.28). Results among Europeans further suggested an increased risk for migraine with aura among carriers of the S/S genotype (recessive model: pooled OR=1.41; 95% CI 0.83-2.40). While our results indicate no overall association between the SLC6A4 5-HTTLPR polymorphism and migraine among Europeans and Asians, gender and migraine aura status may have modifying roles among Europeans.

Migraine and risk of haemorrhagic stroke in women: prospective cohort study

Objectives To examine the association between migraine and migraine aura status with risk of haemorrhagic stroke. Design Prospective cohort study. Setting Women’s Health Study, United States. Participants 27 860 women...

A Candidate Gene Association Study of 77 Polymorphisms in Migraine

Population-based studies have established an association between migraine and cardiovascular disease (CVD). We sought to investigate whether genetic variants implicated in CVD are associated with migraine. We performed an association study among 25,713 women participating in the Women's Health Study, with information on 77 previously characterized polymorphisms. Migraine and migraine aura status were self-reported. We used logistic regression to investigate the genotype-migraine association. At baseline, 4705 (18.3%) women reported history of migraine; 39.6% of the 3306 women with active migraine indicated aura. Regarding any history of migraine, the multivariable-adjusted odds ratios (95% confidence intervals) for TNF rs673 were 0.52 (0.30 to 0.89), for TGFB1 rs1800469 0.93 (0.89 to 0.98), and for CCR2 rs1799864 1.12 (1.03 to 1.21). Among active migraine with aura, the odds ratios (95% confidence intervals) were 1.35 (1.0 to 1.81) for TNF rs1800750, 1.13 (1.02 to 1.26) for TNF rs1800629, and 1.22 (1.07 to 1.40) for CCR2 rs1799864; among active migraine without aura, 0.9 (0.84 to 0.97) for TGFB1 rs1800469, 1.13 (1.01 to 1.27) for NOS3 rs3918226, and 1.12 (1.02 to 1.24) for IL9 rs2069885. After correction for multiple testing using the false discovery rate, none of the results remained significant. Our data suggest an association of polymorphisms implicated in inflammatory pathways and migraine in women. TNF, CCR2, TGFB1, NOS3, and IL9 warrant further investigation. This article presents results from an association study of 77 polymorphisms, implicated in CVD, and migraine. Variants in TNF, CCR2, TGFB1, NOS3, and IL9 were found to be associated with migraine but did not remain significant after adjustment for multiple testing. Variations in these genes warrant further investigation.