Risk Of Migraine Research Articles

Association of Higher Migraine Risk Among Female and Younger Chronic Osteomyelitis Patients: Evidence from a Taiwan Cohort of One Million

Inflammation may trigger migraine development through neurovascular reactions in the brain. Most of the migraine patients, particularly the younger ones, do not have any risk factors for this disease. Hence, we assessed whether chronic osteomyelitis (COM), a chronic inflammatory disease, increases the risk of migraine. We aim to evaluate the risk of migraine among female and middle-age COM patients with a large patient sample. A retrospective cohort study was conducted in this study. The data used in this study were extracted from the Taiwan National Health Insurance (NHI) Research Database. A study group with 2,012 COM patients and 8,048 randomly chosen gender- and age-matched controls were chosen from the Taiwan NHI Research Database (NHIRD) from the start of 2000 to the end of 2009. The risk of migraine was estimated with Cox proportional regression model. Both COM and control groups were followed-up until the occurrence of migraine during the study period (2000-2011). Prevalent covariates, such as age, gender, hypertension, diabetes, hyperlipidemia, stroke, coronary artery disease, depression, anxiety, sleep disorder, bipolar disorder, and epilepsy, were included for further evaluation. The hazard ratio (HR) of migraine was measured with Cox proportional hazard regression model. The primary outcome was the overall migraine risk among COM patients, and the secondary outcome was the migraine risk among COM patients lacking the comorbidities. Additional outcomes included migraine risk among COM patients in different age and gender subgroups. The overall migraine risk was increased in COM patients (adjusted hazard ratio [aHR] 1.74, 95% confidence interval [CI] 1.14-2.65). Even without any prevalent comorbidities, COM patients still exhibited an increased risk of migraine (aHR 2.05, 95% CI 1.06-3.97) than the controls did. Moreover, this risk was relatively higher in COM patients aged < 40 and 45-54 years (aHR 2.07, 95% CI 0.97-4.46 and aHR 2.11, 95% CI 0.97-4.57, respectively) than in their counterparts. Female COM patients had a relatively higher migraine risk (aHR 1.85, 95% CI 1.05-3.24) than male patients did (aHR 1.68, 95% CI 0.89-3.16). The messages about personal behaviors were unavailable in the Taiwan NHIRD. Other neurovascular risk factors that might increase migraine cannot be excluded completely in this research. An association between COM and increased risk of migraine was shown in this study. The results suggest that COM is a significant migraine predictor, and thus imply the necessity for rigorous migraine prevention in COM patients, especially female and younger ones. Inflammation, migraine, chronic osteomyelitis, Taiwan National Health Insurance Research Database.

Lifestyle factors and risk of migraine and tension-type headache. Follow-up data from the Nord-Trøndelag Health Surveys 1995-1997 and 2006-2008.

The aim of this population-based historical cohort study was to investigate the influence of lifestyle factors on the risk of developing migraine or tension-type headache (TTH). Data from the Nord-Trøndelag Health Study performed in 1995-1997 and 2006-2008 was used. A total of 15,276 participants without headache at baseline were included. A Poisson regression was used to evaluate the associations between lifestyle factors and risk ratios (RRs) of migraine and TTH 11 years later. Precision of the estimates was assessed by 95% confidence interval (CIs). Increased risk of migraine (RR 1.30, 95% CI 1.11-1.52) was found in smokers (past or current) compared to those who had never smoked. Hard physical exercise 1-2 hours per week reduced the risk of migraine (OR 0.71, 95% CI 0.54-0.94) compared to inactivity, and the risk of migraine was also lower among those who consumed alcohol (RR 0.73, 95% CI 0.57-0.94) compared to abstainers. No association was found between smoking, physical activity, alcohol use and risk of TTH. The main finding was that current and previous smoking was associated with increased risk of migraine, but not of TTH.

Gamma-aminobutyric acid (GABA) receptors GABRA4, GABRE, and GABRQ gene polymorphisms and risk for migraine

Several biochemical, pharmacological, neurophysiological and experimental data suggest a possible role of gamma-aminobutyric acid (GABA) in the pathogenesis of migraine. We investigated the possible association of the most common single nucleotide polymorphisms (SNPs) in the GABA receptor alpha4 (GABRA4), epsilon (GABRE), and theta (GABRQ) genes with the risk for migraine. A TaqMan-based qPCR assay designed to detect the most common SNPs in the GABRA4 (rs2229940), GABRE (rs1139916), and GABRQ (rs3810651) was performed in 197 migraine patients and 394 age- and gender-matched controls. The possible influence of gender, age at onset of migraine, positive family history of migraine, presence or absence of aura, and triggering of migraine by ethanol on the frequency of the genotypes was also studied. The frequency of GABRE rs1139916AA genotype was significantly lower in the migraine group only in the female gender, but the differences did not reach statistical significance after correction for multiple comparisons. The mean±SD age at onset of migraine was significantly lower in patients with GABRQ rs3810651AA as compared with the other two genotypes. Positive family history of migraine and presence or absence of aura did not influence the frequencies of the genotypes of the three SNPs studied. Triggering of migraine by ethanol was significantly less frequent in patients with GABRA4 rs2229940GG and more frequent in patients with GABRQ 3810651TT genotype, but the differences lost statistical significance after correction for multiple comparisons. GABRQ rs3810651 could play a role in the modification of age at onset of migraine.

The rs4846049 polymorphism in the 3'UTR region of the MTHFR gene increases the migraine susceptibility in an Iranian population.

IntroductionMigraine is a painful complex neurovascular disease characterized by recurrent moderate-to-severe headaches. Increased level of homocysteine is related to dilation of cerebral vessels and endothelial injury that could trigger migraine attacks. Functional polymorphisms in the MTHFR gene affect homocysteine metabolism and, therefore, play an important role in the etiology of the disease.ObjectivesWe aimed to investigate the possible association between MTHFR gene rs4846049, C677T, and A1298C polymorphisms and the risk of migraine in Iranian population.MethodsIn this genetic association study, 498 individuals were enrolled, including 223 migraine patients and 275 healthy controls. Genotyping was performed using tetra-primer ARMS-PCR for rs4846049 and PCR-restriction fragment length polymorphism for C677T and A1298C polymorphisms.ResultsThe association between rs4846049 and C677T polymorphisms and migraine was observed. For the rs4846049 polymorphism, the association was detected under a dominant model (P=0.007; odds ratio [OR] =0.60; 95% confidence interval [CI], 0.41–0.87), and for the C677T polymorphism, the TT genotype frequency was significantly different in the studied groups (P=0.009; OR =2.48; 95% CI, 1.25–4.92). No significant differences in the genotype or allele frequencies were found for the A1298C polymorphism between the migraineurs and controls.ConclusionPresent data provide evidence for the association of rs4846049 and C677T polymorphisms in the MTHFR gene and migraine. Further studies are required to validate the significance of the studied genetic variations in diverse ethnic populations.

Restless legs syndrome is associated with increased risk of migraine

Migraine and restless legs syndrome (RLS) are common disorders that are associated with a high level of individual suffering and major comorbidities. The aetiologies of the disorders are largely unknown, although both migraine and RLS have been linked to disturbances in the dopaminergic system and sleep issues, suggesting a relationship between the disorders. This study examines the association between RLS and migraine in a large population of otherwise healthy adults who are not taking medication. Cross-sectional study that included 20,938 participants enrolled in the Danish Blood Donor Study from 1 May 2015 to 1 February 2017. The study included complete information on migraines, the Cambridge-Hopkins RLS questionnaire, the Major Depression Inventory Scale, sex, age, body mass index (BMI), educational level, smoking status and alcohol consumption. Associations between RLS and migraine, with and without aura, were examined using multivariable logistic regression analysis. Among the participants, 4827 were self-reported migraine sufferers and 1091 were classified as suffering from RLS. Individuals with RLS had an increased risk of migraine compared to non-RLS sufferers, with an odds ratio (OR) = 1.52 (95% confidence interval: 1.33–1.73). For the investigated subtypes of migraine, this association was found to be OR = 1.55 (1.31–1.83) for migraines with aura and OR = 1.29 (1.09–1.52) for migraines without aura. We found a significantly increased occurrence of migraine in individuals with RLS. This risk was independent of sex, age, BMI, educational level, smoking status, alcohol consumption and depressive disorder. Our findings suggest that RLS and migraine may have a common aetiology.

Diabetes is associated with decreased migraine risk: A nationwide cohort study.

Background Results from studies on diabetes and migraine risk are conflicting, which may be due to methodological limitations. Prospective studies with long follow-up could increase our understanding of the relationship between the two diseases. Method We performed a cohort study including the whole Norwegian population alive on 01.01.2004, using prescriptions registered in the Norwegian prescription database to identify individuals developing type 1 diabetes, type 2 diabetes and migraine during follow-up (10 years). We used Cox proportional hazards regression to estimate rate ratios with corresponding 95% confidence intervals for the effect of diabetes on migraine risk, adjusting for age, sex, and educational level. Result We identified 7,883 type 1 diabetes patients and 93,600 type 2 patients during the study period. Type 1 diabetes was significantly associated with a subsequent decreased migraine risk during follow-up in the age- and sex-adjusted analyses (0.74; 0.61-0.89). Type 2 diabetes was also associated with a significantly lower migraine risk (0.89; 0.83-0.95). Further adjustment for educational level yielded similar results for both diabetes. Conclusion Both type 1 and type 2 diabetes were significantly associated with a decreased risk of migraine. This suggests that diabetes or diabetes treatment may have a protective effect on the development of migraine.

Migraine and subsequent chronic kidney disease risk: a nationwide population-based cohort study

ObjectiveWe compared the incidence and risk of chronic kidney disease (CKD) between subjects with new-onset migraine and matched controls without migraine in this large-scale retrospective cohort study.DesignPopulation-based cohort study.Setting8880 subjects...

Migrainomics - identifying brain and genetic markers of migraine.

Migraine is one of the world's most prevalent and disabling disorders and imposes an enormous socioeconomic burden. The exact causes of migraine are unknown, and no recognizable diagnostic pathological changes have been identified. Specific identifiable markers of migraine would aid diagnosis and could provide insight into the pathogenesis of the condition, with the potential to direct development of new therapeutics. In the past few years, advances in neuroimaging and genetic studies have provided the most substantial progress towards the identification of markers. A growing number of brain imaging studies have provided important insights into the brain mechanisms that underlie migraine symptoms during and between migraine attacks. Similarly, large-scale genome-wide association studies have identified genetic variants associated with the common forms of migraine - migraine with aura and migraine without aura. In total, 44 independent single-nucleotide polymorphism loci have been robustly associated with the risk of migraine and provide new evidence for the involvement of vascular mechanisms. Both imaging and genetics, therefore, have excellent potential as markers of migraine. In this Review, we provide a summary of results regarding current and potential neuroimaging and genetic markers of migraine, consider what conclusions can be drawn from these markers about migraine mechanisms and discuss the potential of combining imaging and genetics.

Migraine and invasive epithelial ovarian cancer risk in the Nurses' Health Study II and the Women's Health Study.

Migraine is a common primary headache disorder, which predominantly impacts women. Recently, migraine has been hypothesized to be associated with hormonally related cancers; however, the potential association between migraine and ovarian cancer has not been studied. Therefore, we evaluated the association between migraine and invasive epithelial ovarian cancer risk in two prospective cohorts, the Nurses' Health Study II (NHSII) and the Women's Health Study (WHS). Our prospective analysis included 113,124 NHSII participants aged 25-42 at study baseline as well as 33,490 participants in the WHS who were 45 years or older at study entry. We used Cox proportional hazards models to estimate the hazard ratios (HR) and 95% confidence intervals (CIs) for the association between migraine and ovarian cancer risk in each cohort. In secondary analyses, we stratified by age and menopausal status. After adjusting for potential covariates, there was no statistically significant association between migraine and ovarian cancer risk in either the NHSII (HR = 1.29, 95%CI: 0.96, 1.74) or the WHS (HR = 0.60, 95%CI: 0.34, 1.06). In stratified analysis in the NHSII, there was a statistically significant positive association between migraine and ovarian cancer risk among women <45 years of age (HR = 1.76, 95%CI: 1.01, 3.07). We did not observe a clear association between migraine and ovarian cancer risk in two large prospective cohort studies.

Association of diamine oxidase and histamine N-methyltransferase polymorphisms with presence of migraine in a group of Mexican mothers of children with allergies

BackgroundLow histamine metabolism has been suggested to play a role in the pathogenesis of allergy and migraine. We investigated the possible association between 2 single-nucleotide polymorphisms (SNP), C314T HNMT and C2029G DAO, and the presence and severity of migraine and migraine-related disability. Materials and methodsWe studied the frequency of C314T HNMT and C2029G DAO allelic variants in 162 mothers of children with allergies (80 with migraine and 82 without) using a TaqMan-based qPCR Assay and a case–control model. We conducted a logistic regression analysis to examine the association between migraine and the allelic and haplotype variants. ResultsMutant C2029G DAO SNP was found significantly more frequently in the group of women with migraine than in controls (OR, 1.6; 95% CI, 1.1–2.1). No significant differences were found in frequencies of genotypes or alleles in the case of C314T HNMT SNP. Both mutated alleles were associated with migraine-related disability. Coexistence of alleles for both SNPs (haplotypes) showed a strong association with migraine. Haplotypes containing both mutated alleles (either heterozygous or homozygous) were very strongly associated with MIDAS grade IV migraine (OR, 45.0; 95% CI, 5.2–358). This suggests that mutant alleles of C314T for histamine N-methyltransferase (HNMT) and C2029G for diamine oxidase (DAO) polymorphisms may interact in a way that increases the risk and impact of migraine. ConclusionsWe suggest a synergistic association between HNMT and DAO functional polymorphisms and migraine; this hypothesis must be further confirmed by larger studies. However, the characteristics and ethnic differences between analysed populations should be considered when interpreting the results.

Long term outcome of childhood onset headache: A prospective community study.

Purpose To examine prevalence, course, and long-term outcome of childhood migraine and other headaches. Method Using questionnaires, 1185 children were followed for recurrent headaches at ages seven, 14 and 32 years, respectively. Results At age seven years, 4.0% of the 1185 children (girls 3.7%, boys 4.3%) had migraine and 24% (25%/23%) had nonmigrainous headache. In adulthood, 16% (22%/8%) had migraine and 60% (64%/54%) nonmigrainous headache. Childhood migraine persisted into adulthood in 65% of females and 21% of males, and nonmigrainous headache in 62% and 59%, respectively. After childhood, 17% of females and 7% of males started to have episodes of migraine. No recurrent headache during the follow-up was reported by 11% (6%/16%). In a multivariate analysis, compared with no childhood headache, childhood migraine increased the risk of adulthood migraine by 3.36-fold (95% CI 1.94-5.82) and that of nonmigrainous headache by 1.72-fold (1.14-2.60). Discussion and conclusions Headaches are generally as common in preschool girls as boys. From early school years, headaches steadily increase up to young adulthood, but among boys the prevalence levels off after adolescence. About two thirds of children experienced changes in their headache status during a 25-year follow-up. Any kind of recurrent headache at school entry predicts an increased risk of headache in young adulthood. Special attention should be paid to girls and particularly those girls who have recurrent headache when they start school.

The effect of anxiety and depression on the risk of irritable bowel syndrome in migraine patients

Bidirectional co-morbidity between migraine and depression has been observed. Mood disorders are associated with an increased risk of both migraine and irritable bowel syndrome (IBS). The aim of this study was to evaluate the risk of developing IBS in patients with migraine and to compare the risks between those with and without anxiety or depression.This research used the data contained in the National Health Insurance Research Database (NHIRD). A total of 2859 subjects with migraine and 5718 age-, sex-, hypertension-, diabetes-, mood disorder-matched controls were identified. Both cohorts excluded subjects with pre-existing catastrophic illness and IBS diagnosed before the index visit or within 30days after the index visit. All individuals of both cohorts were tracked until either having the diagnosis of IBS, loss of follow-up, or IBS free up to 7years. During the 7-year follow-up period, 8.4% of patients with migraine and 5.4% of control cohort developed IBS. Migraine is associated with an increased risk of developing IBS (HR=1.58, 95% CI: 1.33–1.87). When separating the cohort into those with mood disorder and without it, migraine is a significant risk factor of IBS in patients without mood disorders, but not in patients with co-existed mood disorders. The findings of this study suggest that migraine is a risk factor of future IBS development for those without comorbid anxiety or depression. However, migraine does not contribute significantly additional risk to IBS development in patients with comorbid anxiety or depression.

A genetic risk score is differentially associated with migraine with and without aura

Although a number of migraine-associated single-nucleotide polymorphisms (SNP) with small effect size have been identified, little is known about the additive impact of these variants on migraine risk, frequency and severity. We investigated to what extent a genetic risk score (GRS) based on recently published, novel migraine-associated SNPs is associated with migraine prevalence, subtypes and severity in a large population-based sample. The sample comprised 446 subjects with migraine and 2511 controls from the CoLaus/PsyCoLaus study. Fifty-four SNPs earlier associated with migraine were selected. SNPs with a low impact on migraine prevalence in our sample were excluded using random forest. We combined the remaining 21 SNPs into a GRS and analyzed the association with migraine using logistic regression models. The GRS was significantly associated with migraine (OR = 1.56, p = 0.02) and migraine without aura (MWOA) (OR = 2.01, p = 0.003), but not with migraine with aura (MWA). The GRS was not associated with migraine frequency, intensity or interference with daily activities. We show that a GRS combining multiple genetic risk variants is associated with MWOA but not MWA, suggesting a different genetic susceptibility background underlying the two forms of migraine.

Gamma-Aminobutyric Acid (Gaba) Receptors Rho (Gabrr) Gene Polymorphisms and Risk for Migraine.

The possible role of gammaaminobutyric acid (GABA) in the pathogenesis of migraine has been suggested by a number of biochemical, pharmacological, neurophysiological and experimental data. We investigated the possible association between the most common single nucleotide polymorphisms (SNPs) in the GABA receptor rho1, 2, and 3 genes (GABRR1, GABRR2, and GABRR3) and the risk of developing migraine. The frequency of GABRR1 rs12200969, GABRR1 rs1186902, GABRR2 rs282129, and GABRR3 rs832032 genotypes and allelic variants were studied in a case-control association study involving 197 patients with migraine and 278 healthy controls by means of a TaqMan-based qPCR Assay. We also studied the possible influence of gender, age at onset of migraine, positive family history of migraine, presence or absence of aura, and triggering of migraine by ethanol on the frequency of the genotypes. The frequencies of the genotypes and allelic variants of the 4 SNPs were similar in migraine patients and controls. Gender, positive family history of migraine, presence or absence of aura, and triggering of migraine attacks by ethanol did not influence the frequency of these genotypes. Carriers of the minor allele of the rs1186902 SNP showed a trend towards later onset of migraine. The most common polymorphisms in the GABRR genes seemed to be not associated with the risk for migraine in Caucasian Spanish people, although one of them (GABRR1 rs1186902) shows a statistically significant association with the age of onset of migraine.

Provocation of Migraine after Maximal Exercise: A Test-Retest Study

Background: Exercise is often recommended in migraine treatment, but strenuous physical activity is also reported as a migraine trigger. The main aim of this study was to evaluate whether migraine can be triggered by a maximal exercise test, using a prospective test-retest method. A secondary aim was to compare the participants who responded to the maximal exercise test with a migraine attack with those who did not suffer a migraine attack after the test. Methods: A total of 19 patients reporting exercise as a potential trigger for their migraines were included in the study. After a baseline period of 1 month with measurements of migraine frequency, a cycle ergometer test until exhaustion was used twice on each patient. Results: A total of 14 patients were test-retested, and of these, 3 reported migraine following both tests, 5 after one of the tests, and 6 did not report migraine after either test. We observed a higher risk of migraine after 1 or 2 tests in patients with a higher baseline migraine frequency (p = 0.036). Conclusion: In conclusion, the study showed that although maximal aerobic exercise can trigger migraine attacks, it does not always provoke an attack even in those who report exercise as a migraine trigger.

Evaluating the safety of β-interferons in MS: A series of nested case-control studies.

Objective:To examine the association between interferon-β (IFN-β) and potential adverse events using population-based health administrative data in British Columbia, Canada.Methods:Patients with relapsing-remitting multiple sclerosis (RRMS) who were registered at a British Columbia Multiple Sclerosis Clinic (1995–2004) were eligible for inclusion and were followed up until death, absence from British Columbia, exposure to a non–IFN-β disease-modifying drug, or December 31, 2008. Incidence rates were estimated for each potential adverse event (selected a priori and defined with ICD-9/10 diagnosis codes from physician and hospital claims). A nested case-control study was conducted to assess the odds of previous IFN-β exposure for each potential adverse event with at least 30 cases. Cases were matched by age (±5 years), sex, and year of cohort entry, with up to 20 randomly selected (by incidence density sampling) controls. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were estimated with conditional logistic regression adjusted for age at cohort entry.Results:Of the 2,485 eligible patients, 77.9% were women, and 1,031 were treated with IFN-β during follow-up. From the incidence analyses, 27 of the 47 potential adverse events had at least 30 cases. Patients with incident stroke (ORadj 1.83, 95% CI 1.16–2.89), migraine (ORadj 1.55, 95% CI 1.18–2.04), depression (ORadj 1.33, 95% CI 1.13–1.56), and hematologic abnormalities (ORadj 1.32, 95% CI 1.01–1.72) were more likely to have previous exposure to IFN-β than controls.Conclusions:Among patients with RRMS, IFN-β was associated with a 1.8- and 1.6-fold increase in the risk of stroke and migraine and 1.3-fold increases in depression and hematologic abnormalities.

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Gastrointestinal NursingVol. 15, No. 4 NewsNewsSue LearnerSue LearnerSearch for more papers by this authorSue LearnerPublished Online:18 May 2017https://doi.org/10.12968/gasn.2017.15.4.6AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Olivia Newton-John Cancer Wellness & Research Centre (2017) Tumour breakthrough boosts gastrointestinal cancer hopes. https://tinyurl.com/mb9e9jb (accessed 24 April 2017) Google ScholarPoh AR, Love CG, Masson F et al. (2017) Inhibition of hematopoietic cell kinase activity suppresses myeloid cell-mediated colon cancer progression. Cancer Cell 31(4): 563–75. https://doi.org/https://doi.org/10.1016/j.ccell.2017.03.006 Crossref, Google ScholarCancer Research UK (2017) Cancer incidence for common cancers. https://tinyurl.com/op8d9oa. (accessed 24 April 2017) Google ScholarCao Y, Wu K, Mehta R et al. (2017) Long-term use of antibiotics and risk of colorectal adenoma. Gut (online). https://doi.org/https://doi.org/10.1136/gutjnl-2016-313413 Crossref, Google ScholarBBC News (2017) Childhood obesity: cut unhealthy food multi-buy offers – MPs. http://tinyurl.com/kn8x4wo (accessed 24 April 2017) Google ScholarGelaye B, Sacco S, Brown WJ et al. (2017) Body composition status and the risk of migraine: a meta-analysis. Neurology (online). https://doi.org/https://doi.org/10.1212/wnl.0000000000003919 Crossref, Google ScholarScience Daily (2017) Majority of incontinence treatments deliver poor results. http://tinyurl.com (accessed 24 April 2017) Google ScholarCancer Research UK (2017) NHS England sets target of 5,000 more people each year surviving cancer. https://tinyurl.com/lpjnyv7 (accessed 24 April 2017) Google ScholarNHS England (2014) Five Year Forward View. https://tinyurl.com/oxq92je (accessed 24 April 2017) Google ScholarNHS England (2017) Next steps on the NHS Five Year Forward View. https://tinyurl.com/m8shskk (accessed 24 April 2017) Google Scholar FiguresReferencesRelatedDetails 2 May 2017Volume 15Issue 4ISSN (print): 1479-5248ISSN (online): 2052-2835 Metrics History Published online 18 May 2017 Published in print 2 May 2017 Information© MA Healthcare LimitedPDF download

Headache and arterial hypertension.

Elevated blood pressure (BP) and headache have long been linked in the medical literature. Headache associated with arterial hypertension is a main concern in emergency department. It is believed that headache may be a symptom attributed to arterial hypertension only if the BP values are very high or rise quickly. Many studies support the hypothesis that migraine patients have an increased risk of developing hypertension, while hypertensive subjects do not seem to have an increased risk of migraine or other types of headache. Conversely many studies found an inverse association. Hypertension has been identified as one of the most important factors of chronic transformation of episodic migraine and increases the cerebrovascular and cardiovascular risk of migraine patients. Migraine and arterial hypertension may share common mechanisms like endothelial dysfunction, deficiency of autonomic cardiovascular regulation and renin angiotensin system involvement. Preventive effects of migraine were described by several antihypertensive agents traditionally beta-blockers, and more recently angiotensin-converting-enzyme inhibitors and angiotensin II receptor blockers.

Brain-Derived Neurotrophic Factor Val66Met Gene Polymorphism Impacts on Migraine Susceptibility: A Meta-analysis of Case-Control Studies.

Inconclusive results have been reported in studies investigating the association between the brain-derived neurotrophic factor (BDNF) rs6265 polymorphism and migraine. In the present study, we conducted a systematic review and meta-analysis on the published data in order to quantitatively estimate the relationship between rs6265 and migraine susceptibility. A comprehensive search was performed through PubMed, Web of Knowledge, and Cochrane databases up to October 2016. The pooled odds ratio (OR) with the corresponding 95% confidence interval (CI) was calculated to estimate the strength of the association with rs6265 under an additive, dominant, or recessive model of inheritance. A total of five studies including 1,442 cases and 1,880 controls were identified for the meta-analysis. The pooled data showed an increased risk of migraine for the allelic (OR: 1.17, 95% CI: 1.03–1.34, p = 0.014) or the dominant model of rs6265 (OR: 1.22, 95% CI: 1.05–1.41, p = 0.011). Statistical significance of rs6265 was lost when one single study was excluded from the analysis (dominant OR: 1.17, 95% CI: 1.00–1.38, p = 0.054; allelic OR: 1.14, 95% CI: 0.99–1.31, p = 0.067), suggesting lack of robustness of pooled estimates. When stratified by migraine type, a similar trend of association was detected with both MA and MO, but a statistically significant association of rs6265 was reached only with the MA subtype in the dominant model (OR: 1.22, 95% CI: 1.00–1.47, p = 0.047). The present meta-analysis supports that BDNF rs6265 may act as a genetic susceptibility factor for migraine. Nevertheless, large-scale studies are required to confirm our findings and to assess potential modifiers of the relationship between rs6265 and migraine.

Shared mechanisms of epilepsy, migraine and affective disorders.

Since the nineteenth century several clinical features have been observed in common between migraine and epilepsy (such as episodic attacks, triggering factors, presence of aura, frequent familiarity), but only in recent years researchers have really engaged in finding a common pathogenic mechanism. From studies of disease incidence, we understand how either migraine among patients with epilepsy or epilepsy among migraine patients are more frequent than in the general population. This association may result from a direct causality, by the same environmental risk factors and/or by a common genetic susceptibility. Ischemic events are the most frequent direct causes, especially among women and elderly people: migraine can lead to silent or clinically considerable strokes, and these ones could explain the increased risk of developing epilepsy in people with a history of migraine. Head injuries can lead headache, often with migraine characteristics, and seizures. But there are also many idiopathic cases. The comorbidity migraine-epilepsy might be explained in these cases by a neuronal hyperexcitability, which increases the risk of both diseases: a higher concentration of extracellular glutamate, the main excitatory neurotransmitter, leads in fact as a result a Cortical Spreading Depression (the pathophysiological mechanism at the base of aura) and convulsions; antiepileptic drugs such as topiramate are, therefore, used also in migraine prophylaxis. A genetic link between these two diseases is particularly evident in familial hemiplegic migraine: mutations of ATP1A2, SCN1A and CACNA1A genes, identified in this disease, have also been involved in different types of epilepsy and febrile seizures. The channelopathies, especially engaging sodium and potassium ions, can be the common pathogenic mechanism of migraine and epilepsy. Both migraine and epilepsy also have, compared to the general population, a higher prevalence and incidence of affective disorders such as anxiety, depression and suicidal ideation. Anxiety and depression can be part of symptoms that accompany migraine or seizures. Female patients with a long history of illness and frequent attacks are the most at risk. The impact of these diseases on the quality of life is the most obvious cause of these disorders, furthermore some antiepileptic drugs can have depressive effects on mood; the anxious-depressive disorders often result from the interaction between iatrogenic and psychosocial factor with common neurobiological pathogenesis. A chronic lowering of 5-HT (serotonin) levels has been demonstrated both in migraineurs and in depressed patients; amitriptyline and venlafaxine are the most indicated drugs in the treatment of migraine with comorbid depression currently. Likewise imbalance in dopamine levels has been also demonstrated: a D2 receptor genotype has been directly related to comorbidity migraine-depression. In women, hormonal fluctuations are also crucial, especially in the post-partum and late luteal phase, when the estrogenic reduction, associated with up-regulation of SNPs and down-regulation of serotonergic and GABAergic systems, increases the risk of migraine and depression. Furthermore, central sensitization phenomena have been highlighted in both diseases, and result in a progressive increase in the frequency of attacks up to chronicity and the consequent development of drug resistance and overuse. Further studies will be necessary to deepen the close relationship between these three diseases.