Study Identifies High Number of Comorbidities in Patients With Migraine

In addition to comorbidity frequency, the researchers also studied the comparison of comorbidities between men and women with migraine.

Data from a recent study suggest that patients seeking treatment for migraine had higher prevalence of smoking and medical, psychiatric, and pain conditions than healthy controls not seeking treatment for migraine.

A greater proportion of patients with migraine with aura smoked (n = 67; 15.5%) than healthy controls (n = 57; 11.5%; P = .013). More of these patients had medical conditions (n = 91; 7.2% vs n = 14; 2.8%; P = .006), psychiatric conditions (n = 79; 6% vs n = 13; 2.6%; P = .031), and pain-related conditions (n = 101; 8% vs n = 16; 3.2%; P = .006) than healthy controls.

“It is important to understand the specific comorbidities in migraine. First, the recognition of migraine comorbidities may help to identify the genetic or biological mechanisms that promote the development of new therapies and facilitate disease management. Second, it can improve the prognosis,” wrote first author Jiu-Haw Yin, MD, department of neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, and colleagues.

Yin and colleagues conducted a cross-sectional study of 1257 patients with migraine between the ages of 20 and 65 years from a headache outpatient clinic in Taiwan and 496 controls without migraine. More of the patients with migraine enrolled were women and were younger, and those with migraine had lower body-mass index scores than controls (P < .001 for all). Subgroup analyses revealed that patients with chronic migraine had more aura (n = 135; 43.4%) than patients with episodic (n = 296; 31.3%; P <.001). Patients with chronic migraine also had lower educational level than those with episodic (P <.001).

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The investigators found that the prevalence of thyroid disease (P = .006), peptic ulcer disease (P = .015), mitral valve prolapse (P = .020), depression (P = .031), anxiety (P <.001), insomnia (P <.001), subjective memory complaints (P <.001), fibromyalgia (P = .006), irritable bowel syndrome (P = .004), chronic fatigue syndrome (P <.001), and glaucoma (P = .035) was significantly higher in the migraine group than in the control group. 

Subgroup analyses suggest that chronic migraine was associated with higher risks of peptic ulcer disease (P = .007), mitral valve prolapse (P = .001), asthma (P = .025), depression (P <.001), anxiety (P <.001), insomnia (P <.001), subjective memory complaints (P <.001), fibromyalgia (P <.001), irritable bowel syndrome (P = .004), and chronic fatigue syndrome (P <.001) compared to episodic migraine.

A greater proportion of patients with migraine with aura smoked (n = 67; 15.5%) than healthy controls (n = 57; 11.5%; P = .013). Migraine without aura was associated with greater risks of thyroid disease (P = .024), anxiety (P = .001), insomnia (P <.001), subjective memory complaints (P <.001) and chronic fatigue syndrome (P <.001).

Patients with migraine with aura had higher prevalence of peptic ulcer disease, mitral valve prolapse, asthma, anxiety, insomnia, subjective memory complaints, fibromyalgia, dysmenorrhea, irritable bowel syndrome, chronic fatigue syndrome, and glaucoma than patients with migraine without aura (all P <.033). 

Women with migraine had higher prevalence of thyroid disease, peptic ulcer disease, mitral valve prolapse, anxiety, insomnia, subjective memory complaints, irritable bowel syndrome, and chronic fatigue syndrome then men (all P <.043). Men with migraine had higher risks of anxiety, insomnia, subjective memory complaints, and chronic fatigue syndrome (all P <.013) than women.

More men with migraine had smoked, were current smokers, non-frequent and frequent drinkers than women (all P <.003). Hypertension (P <.001) was significantly higher among men than women with migraine. Women were more likely to have thyroid disease, peptic ulcer disease, mitral valve prolapse, anxiety, fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome (all P <.035).

“The results of this study indicate the importance of evaluating medical-, psychiatric-, and pain-related comorbidities in patients with migraine, particularly those with aura, those who are female, and those with chronic migraine in clinical practice. Pharmacological therapies for migraine prevention may decrease the headache frequency and migraine-related burden,” Yin and colleagues wrote.

“In particular, understanding the relationship between migraine and comorbid diseases may help to provide optimal medical care as well as improve the patient's quality of life,” they concluded.

REFERENCE
Yin JH, Lin YK, Yang CP, et al. Prevalence and association of lifestyle and medical‐, psychiatric‐, and pain‐related comorbidities in patients with migraine: A cross‐sectional study. Headache. 2021:00:1-12. doi: 10.1111/head.14106