Migraine aura without headache compared to migraine with aura in patients with affective disorders

Abstract

The characteristics of psychiatric comorbidity in migraine have been studied in migraine with aura (MA) and migraine without aura (MO). Little information is available concerning patients with migraine aura without headache. In a study of 201 patients with major affective disorders (DSM–IV) we have described the clinical characteristics of patients with these three sub–types of migraine (IHS criteria) and compared the MA and migraine aura without headache groups. Compared to patients having MA ( n =57), the group with migraine aura without headache ( n =18) had a higher age of onset of migraine (28.5 vs . 19.2, p =0.001), significantly lower prevalences of affective temperaments (28% vs . 56%, p =0.036), suicide attempts (17% vs . 53%, p =0.013) and Raynaud’s syndrome (0% vs . 25%, p =0.017). These results indicate that there seem to be differences in the clinical characteristics found in patients with migraine with aura when compared to those having the migraine subtype without a headache phase. This may convey new information concerning the comorbid expression of migraine and affective disorders or concerning the processes that differentiates the migraine types with and without a subsequent pain attack.

Chronic migraine: comorbidities, risk factors, and rehabilitation

“…Compared with men, women often receive a diagnosis of both migraine (24 vs. 9%) and major depression (24 vs. 13%) by age 30, with the relative female risk increasing for migraine in late adolescence and for major depression after about age 20 [32]. MA is strongly associated with an early age of onset (OR 11.4, age \ 15 years, OR 5.6, age 15-24 years), and this variable explains the difference between the two migraine groups (MA vs. migraine aura without headache) better than the variables of suicide attempt (OR 3.2, p = 0.13, NS) or affective temperament (OR 4.0, P = 0.047) [33]. Migraine onset was earlier than mood disorder onset, and Franchini et al [34] found no difference in migraine distribution according to the polarity of mood disorder.…”

Psychiatric comorbidity and suicide risk in patients with chronic migraine

“…MA is strongly associated with an early age of onset (OR: 11.4, age <15 years, OR: 5.6, age 15–24 years), and this variable explains the difference between the two migraine groups (migraine aura versus migraine aura without headache) better than the variables of suicide attempt (OR: 3.2, P = 0.13, NS) or affective temperament (OR: 4.0, P = 0.047) 44. Migraine onset was earlier than mood disorder onset, and Franchini et al found no difference in migraine distribution according to the polarity of mood disorder,41 consistent with the findings of a previous study 51…”

“…Studying the relationship between subtypes of migraine headaches and affective disorders may be a way to explore further a possible common pathomechanism in both disorders 44. Disturbances in serotonergic systems are found in completed and attempted suicides,45 and the serotonergic systems are involved in the pathophysiology of both migraine and affective disorders 46,47…”

“…A history of MA, but not MwoA, is associated with increased frequency of suicidal ideation and suicide attempts in patients with major depression and with current or previous affective episodes 21,44,49,51,79. Oedegaard et al found that 17% of patients having migraine aura without headache (n = 18) had made a suicide attempt and had a lower frequency of the affective temperament as well as a higher age of onset of migraine aura compared with patients having MA (n = 57) 44.…”

“…Oedegaard et al found that 17% of patients having migraine aura without headache (n = 18) had made a suicide attempt and had a lower frequency of the affective temperament as well as a higher age of onset of migraine aura compared with patients having MA (n = 57) 44. However, the frequency of suicidal thoughts was approximately equal in the two groups 44…”