Increased familial risk and evidence of genetic factor in migraine

Russell, Michael Bjørn; Olesen, Jes

doi:10.1136/bmj.311.7004.541

Cited by 336 publications

(276 citation statements)

References 23 publications

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“…Taking into account that hereditary pattern [14,15] and hormonal fluctuations [18] are known and well established endogenous risk factors for migraine, our results seem to highlight the role of H. pylori infection as a probable independent environmental risk factor for migraine without aura, especially in patients that are not genetically or hormonally susceptible to migraine. We suggest that these cases should be more intensively examined for this infection and probably could have the best improvement with its eradication.…”

Section: Mf+ Mf-mentioning

confidence: 52%

“…The familial history was considered as positive if any of the first-degree relatives had a headache history estimated as migraine and was considered as negative if the headache history of all the first-degree relatives were either negative or indicative of another type of primary or secondary headache [14,15].…”

Section: Methodsmentioning

confidence: 99%

“…But the most important reason for selecting this migraine subgroup was the fact that migraine without aura seems to be caused by a combination of genetic and environmental factors whereas migraine with aura is probably determined largely or exclusively by genetic factors [14,15]. A previous study reported that spouses to probands with migraine without aura had a slightly increased risk of migraine without aura, while spouses to probands with migraine with aura had no increased risk of migraine with aura [15]. According to our results it is possible that the responsible environmental factor may be H. pylori infection.…”

Section: Mf+ Mf-mentioning

confidence: 99%

“…Migraine without aura seems to be caused by a combination of genetic and environmental factors, whereas migraine with aura is probably determined largely by genetic factors [14,15].…”

Section: Introductionmentioning

confidence: 99%

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Helicobacter pylori infection as an environmental risk factor for migraine without aura

et al. 2007

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Helicobacter pylori (H. pylori) infection has recently been associated with various extraintestinal pathologies and migraine. The aim of this study was to investigate the correlation of the H. pylori infection with the pathogenesis of migraine without aura, especially in cases not affected by endogenous risk factors, like hereditary pattern or hormonal fluctuations. A total of 49 outpatients (37 females and 12 males; age range: 19-47 years; mean age: 31,±14 years) affected by migraine without aura was evaluated. We divided them in 2 subgroups: a) with positive familial history, and/or with menstrual type of migraine b) with negative familial history and with menstrual unrelated type of migraine. H. pylori infection was diagnosed by the 13 C-urea breath test (INFAI -test). Control subjects consisted of 51 patients without any primary headache history (38 females; mean age of 32,±14,4 years; range 21-49 years), who underwent upper gastrointestinal (GI) endoscopy for investigation of anaemia or non ulcer dyspepsia. H. pylori detection was based on the histologic analysis of gastric mucosa biopsy. The prevalence of H. pylori infection was significantly higher in the migraineurs without aura compared to controls (p=0.016). The prevalence of H. pylori infection was significantly high in the mixed and in the female group of our patients without other predisposing factors for migraine without aura (81 and 87% respectively), while in the same groups with predisposing factors (menstruation and/or family history) the prevalence was only 36 and 37% respectively (p=0,001 for the first group and p=0,002 for the second group). Our results seem to highlight the role of H. pylori infection as a probable independent environmental risk factor for migraine without aura, especially in patients that are not genetically or hormonally susceptible to migraine.

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Section: Mf+ Mf-mentioning

confidence: 52%

Section: Methodsmentioning

confidence: 99%

Section: Mf+ Mf-mentioning

confidence: 99%

“…Migraine without aura seems to be caused by a combination of genetic and environmental factors, whereas migraine with aura is probably determined largely by genetic factors [14,15].…”

Section: Introductionmentioning

confidence: 99%

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Helicobacter pylori infection as an environmental risk factor for migraine without aura

et al. 2007

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“…Familiares de enxaquecosos sem aura têm um risco 1,9 vezes maior de ter esta desordem e apenas 1,4 vezes maior de sofrer enxaqueca com aura 51 . Familiares de pacientes com enxaqueca com aura não têm tendência maior à enxaqueca sem aura, sugerindo especificidade na transmissão 51 .…”

Section: Enxaqueca E Genéticaunclassified

Fisiopatologia da enxaqueca

Vincent

1998

Arq. Neuro-Psiquiatr.

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RESUMO -A fisiopatologia da enxaqueca ainda não foi completamente elucidada. As principais estruturas envolvidas parecem ser o sistema nervoso central (córtex e tronco cerebral), o sistema trigeminovascular e os vasos correspondentes, outras fibras autonômicas que inervam estes vasos, e os vários agentes vasoativos locais, como a SP, CGRP, NO, VIP, NPY, ACh, NA, NKA, entre outros. A depressão alastrante é o fenômeno neurológico que provavelmente justifica achados experimenais e clínicos na enxaqueca. Ela tem velocidade de propagação semelhante à aura, ativa o núcleo espinhal do trigêmeo e está relacionada à liberação de CGRP e NO. Alterações circulatórias detectadas por métodos complementares reforçam o papel da depressão alastrante. A identificação de anormalidades em pelo menos três loci (cromossomas 19 e 1) na enxaqueca hemiplégica familiar ocorreu recentemente. Elas estão relacionadas a anormalidades nos canais de cálcio voltagem dependentes tipo P/Q, específicos do sistema nervoso central, que regulam a liberação de vários neurotransmissores, incluindo possivelmente a serotonina. A exemplo de outras anormalidades neurológicas paroxísticas que resultam da hiperexcitabilidade da membrana plasmática, é possível que a enxaqueca ocorra devido a uma desordem de canais iônicos. PALAVRAS-CHAVE: enxaqueca, fisiopatologia. Migraine pathophysiologyABSTRACT -The pathophysiology of migraine is not yet fully understood. The most important structures involved seem to be the central nervous system (cortex and brain stem), the trigeminovascular system and related cranial arteries, other autonomic fibres innervating such vessels, and various local vasoactive agents, including SP, CGRP, NO, VIP, NPY, ACh, NA, NKA, among others. The spreading depression phenomenon may explain clinical as well experimental findings in migraine. Its propagation velocity mirrors what is found in clinical aura, it may activate the spinal trigeminal nucleus and may induce CGRP and NO release. Circulatory changes detected with various imaging procedures during migraine also support the pathophysiological role of spreading depression. Three abnormal loci (chromosomes 1 and 19) have been recently found in familial hemiplegic migraine. This produces abnormalities in the voltage-dependent P/Q Ca channel, specific for the central nervous system, which regulates the release of various neurotransmitters, probably including serotonin. It is possible that a channelopathy underlies the pathophysiology of migraine, as in other paroxysmal neurological disorders secondary to membrane hyperexcitability.KEY WORDS: migraine, pathophysiology.As cefaléias têm aumentado em importância quando comparadas aos grandes temas neurológicos. Sua prevalência elevada determina consequências significativas para bem-estar do indivíduo e para a produtividade de empresas, comunidades e nações. Não obstante, seu mecanismo fisiopatológico ainda não é completamente conhecido.Muitas foram as hipóteses, mecanismos e causas relacionadas às enxaquecas, tais como alimentos, alergias, vasoe...

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Analysis of 31 families with an apparently autosomal-dominant transmission of migraine with aura in the nuclear family

et al. 1997

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We analyzed 31 families selected for an apparently autosomal-dominant mode of inheritance of migraine with aura (MA) in the nuclear family. The nuclear families were expanded with first- and second-degree relatives. All interviews were made by physicians experienced in headache diagnoses. The criteria of the International Headache Society were used. The population relative risk among children in nuclear families was similar to the estimated population relative risk of MA assuming an autosomal-dominant mode of inheritance. The population relative risk tended to decrease among first-degree relatives outside nuclear families and further among second-degree relatives. Both first- and second-degree relatives outside the nuclear families had a statistically significant lower risk of MA than expected. Thus, autosomal-dominant inheritance with or without reduced penetrance was unlikely. Autosomal-recessive inheritance was unlikely because of the unequal sex distribution. Other modes of inheritance were considered as well. Mitochondrial and X-linked inheritance were excluded because of paternal transmission. The female preponderance was too low to explain sex-influenced inheritance. We conclude that MA most likely has a multifactorial inheritance even in high-risk families with MA.

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Increased familial risk and evidence of genetic factor in migraine

Cited by 336 publications

References 23 publications

Helicobacter pylori infection as an environmental risk factor for migraine without aura

Helicobacter pylori infection as an environmental risk factor for migraine without aura

Fisiopatologia da enxaqueca

Analysis of 31 families with an apparently autosomal-dominant transmission of migraine with aura in the nuclear family

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