This article provides a review of the epidemiology and risk factors for migraine in population studies, as well as patterns for healthcare use. The burden and costs of migraine, as well as risk factors for disease progression, are also discussed. Although migraine is a remarkably common cause of temporary disability, many persons with migraine, even those with disabling headache, have never consulted a physician for the problem. Prevalence is highest in women, in persons between the ages of 25 and 55 years, and, at least in the United States, in individuals from lower income households. However, prevalence is high in groups other than these high-risk groups. In a subgroup of patients, migraine may be a progressive disorder.
"Headache prevalence in females tends to increase with age . After about 12 years of age the female to male ratio is 1:3 for migraine and 4:5 for TTH [41-43]. This is most likely due to hormonal changes during puberty [44,45] but may also be related to gender differences in cognitive and social reactions to pain . "
[Show abstract][Hide abstract] ABSTRACT: Background
Though migraine and tension type headache are both commonly diagnosed in childhood, little is known about their determinants when diagnosed prior to puberty onset. Our aim was to determine psychosocial- and health-related risk factors of migraine and tension-type headache in 11 year old children.
871 New Zealand European children were enrolled in a longitudinal study at birth and data were collected at birth, 1, 3.5, 7, and 11 years of age. Primary headache was determined at age 11 years based on the International Headache Society. Perinatal factors assessed were small for gestational age status, sex, maternal smoking during pregnancy, maternal perceived stress, and maternal school leaving age. Childhood factors assessed were sleep duration, percent body fat, television watching, parent and self-reported total problem behaviour, being bullied, and depression.
Prevalence of migraine and tension-type headache was 10.5% and 18.6%, respectively. Both migraine and TTH were significantly associated with self-reported problem behaviour in univariable logistic regression analyses. Additionally, migraine was associated with reduced sleep duration, and both sleep and behaviour problems remained significant after multivariable analyses. TTH was also significantly associated with antenatal maternal smoking, higher body fat, and being bullied. For TTH, problem behaviour measured at ages 3.5 and 11 years both remained significant after multivariable analysis. Being born small for gestational age was not associated with either headache group.
Although they share some commonality, migraine and tension-type headache are separate entities in childhood with different developmental characteristics. The association between primary headache and problem behaviour requires further investigation.
The Journal of Headache and Pain 09/2014; 15(1):60. DOI:10.1186/1129-2377-15-60 · 2.80 Impact Factor
"Migraine is a chronic disorder that affects a large proportion of the population, with a female-to-male ratio ranging from 2:1 to 3:1. This condition predominantly affects middle-aged women and has a complex pathophysiology involving both neuronal and vascular mechanisms [1-4]. Migraine is often characterized by recurrent attacks of moderate to severe pulsating headache, which may be localised in the frontotemporal, unilateral or bilateral areas. "
[Show abstract][Hide abstract] ABSTRACT: Studies suggest a higher prevalence of unfavourable cardiovascular risk factors amongst migraineurs, but results have been conflicting. The aim of this study was to investigate traditional and newly recognized risk factors as well as other surrogate markers of cardiovascular risk in obese and normal weight women with migraine.
Fifty-nine adult female probands participated in this case--control study. The sample was divided into normal weight and obese migraineurs and age- and body mass index-matched control groups. The following cardiovascular risk factors were analyzed: serum levels of lipids, fasting glucose, and insulin; insulin resistance; blood pressure; smoking (categorized as current, past or never); Framingham 10-year risk of general cardiovascular disease score; C-reactive protein; family history of cardiovascular disease; physical activity; sleep disturbances; depression; and bioelectrical impedance phase angle. The means of continuous variables were compared using Student's t-test for independent samples or the Mann--Whitney U-test (for 2 groups) and ANOVA or the Kruskal-Wallis test (for 4 groups) depending on the distribution of data.
All migraineurs were sedentary irrespective of nutritional status. Migraineurs had higher depression scores and shorter sleep duration, and obese migraineurs, in particular, had worse sleep quality scores. Insulin resistance and insulinaemia were associated with obesity, and obese migraineurs had lower HDL-c than normal weight controls and migraineurs. Also, the Framingham risk score was higher in obese migraineurs.
These findings suggest that female migraineurs experience marked inactivity, depression, and some sleep disturbance, that higher insulin resistance and insulinaemia are related to obesity, and that obesity and migraine probably exert overlapping effects on HDL-c levels and Framingham 10-year cardiovascular risk.
The Journal of Headache and Pain 09/2013; 14(1):75. DOI:10.1186/1129-2377-14-75 · 2.80 Impact Factor
"Migraine prevalence is in general, 3- to 4-fold higher among women  and several hypotheses have been raised for this female predominance [7,8]. We have also shown in the Portuguese population that gender is a critical risk factor for migraine and a gender-biased transmission is observed . "
[Show abstract][Hide abstract] ABSTRACT: Migraine is a common neurological episodic disorder with a female-to-male prevalence 3- to 4-fold higher, suggesting a possible X-linked genetic component. Our aims were to assess the role of common variants of gamma-aminobutyric acid A receptor (GABAAR) genes, located in the X-chromosome, in migraine susceptibility and the possible interaction between them. An association study with 188 unrelated cases and 286 migraine-free controls age- and ethnic matched was performed. Twenty-three tagging SNPs were selected in three genes (GABRE, GABRA3 and GABRQ). Allelic, genotypic and haplotypic frequencies were compared between cases and controls. We also focused on gene-gene interactions. The AT genotype of rs3810651 of GABRQ gene was associated with an increased risk for migraine (OR: 4.07; 95% CI: 1.71-9.73, p=0.002), while the CT genotype of rs3902802 (OR: 0.41; 95% CI: 0.21-0.78, p=0.006) and GA genotype of rs2131190 of GABRA3 gene (OR: 0.53; 95% CI: 0.32-0.88, p=0.013) seem to be protective factors. All associations were found in the female group and maintained significance after Bonferroni correction. We also found three nominal associations in the allelic analyses although there were no significant results in the haplotypic analyses. Strikingly, we found strong interactions between six SNPs encoding for different subunits of GABAAR, all significant after permutation correction. To our knowledge, we show for the first time, the putative involvement of polymorphisms in GABAAR genes in migraine susceptibility and more importantly we unraveled a role for novel gene-gene interactions opening new perspectives for the development of more effective treatments.
PLoS ONE 09/2013; 8(9):e74087. DOI:10.1371/journal.pone.0074087 · 3.23 Impact Factor
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