Allostatic Load in Perimenopausal Women With Migraine

Abstract

Objective: There is very limited data on women with migraine disease as they age and transition to menopause. Despite evidence for the increased burden of the disease during this transition, there is no data on the association between migraine and allostatic load as a marker of cumulative biological risk. We aimed to determine whether women with migraine suffer from higher levels of allostatic load during perimenopausal transition.Methods: A total of 2,105 perimenopausal women from the first wave of the Study of Women's Health Across the Nation (SWAN) were included in this study. Allostatic Load (AL) score was estimated for each participant from the measurements of: systolic and diastolic blood pressure, C-reactive protein level, high-density lipoprotein cholesterol level, total cholesterol level, waist-to-hip ratio, fasting serum glucose, triglycerides, and dehydroepiandrosterone levels.Results: Of the 2,105 participants included in the study, there were 369 migraineurs and 1,730 controls. Migraineurs had 63% higher odds of increased load score (odds ratio 1.63; 95% confidence interval, 1.17–2.29). Compared to controls, migraineurs were more likely to experience sleep problems in the univariate analysis, however despite the high burden of sleep problems, there were no significant associations between allostatic load and sleep disturbances in perimenopausal women with migraine after controlling for other factors.Conclusion: This is the first study to systematically and quantitatively examine allostatic load in migraine patients. The findings establish that migraineurs are more likely to experience higher allostatic load than their non-migraine counterparts during perimenopausal transition. The findings encourage new lines of investigation for lowering the burden of the disease through interventions that modify the levels of allostatic load biomarkers examined in this study.

Migraine chronification as an allostatic disorder: a proof-of-concept study

“…Our composite score has the advantage of concomitantly evaluating 20 biomarkers, reflecting all the systems above, and we validated it on a group of controls with no history of headache. Only one previous study assessed the allostatic load in migraine, yet it included patients based on self-administered questionnaires and confronted the index among perimenopausal migraine patients and controls with no stratification based on the disease burden [39]. Since external and internal stressors, namely the allostatic load, arguably influence the migraine burden and not the migraine incidence, we decided to assess the BALI score only among migraine patients, excluding controls in the analysis, to define its truly contributing role in aggravating the disease burden.…”

Daily spiritual experiences and allostatic load trajectories: a longitudinal study of midlife African American women

“…Thus, a higher AL score is indicative of a greater physiologic burden from prolonged exposure to stress 2-4 . This approach has been used in prior studies to assess AL; 26,27 this analysis included AL scores measured annually at seven time points (baseline [1996-1997] thru visit 7 [2003-2004]). AL scores could not be calculated at the second follow-up visit because total cholesterol, HDL-C, triglycerides, glucose, and CRP were not assessed.…”

Sex Differences of Periaqueductal Grey Matter Functional Connectivity in Migraine

“…Pain perception and pain-related unpleasantness alter during the menstrual cycle ( 3 ), and hormonal fluctuations make women more sensitive to migraine triggers ( 4 , 5 ). Furthermore, perimenopausal women with migraine have a higher allostatic load than non-migraineurs ( 6 ) that leads to maladaptive stress responses and reinforces the generation of migraine attacks ( 7 ).…”