Stroke and migraine is there a possible comorbidity?

Spalice, Alberto; Balzo, Francesca Del; Papetti, Laura; Zicari, Anna Maria; Properzi, Enrico; Occasi, Francesca; Nicita, Francesco; Duse, Marzia

doi:10.1186/s13052-016-0253-8

Cited by 21 publications

(23 citation statements)

References 21 publications

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“…Due to a lack of prior clinical information, we cannot exclude other aetiologies for the ischaemic events, e.g. if they are due to environmental or lifestyle stresses, vasoconstrictive drugs used as a prior treatment or if another gene mutation not tested is the cause [45,47,48]. Another heterozygous gene mutation was identified in ATP1A2 in CAD-400 that is known to cause familial hemiplegic migraine type 2 (FHM2) (MIM#602481).…”

Section: Discussionmentioning

confidence: 99%

Investigating diagnostic sequencing techniques for CADASIL diagnosis

et al. 2020

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Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a cerebral small vessel disease caused by mutations in the NOTCH3 gene. Our laboratory has been undertaking genetic diagnostic testing for CADASIL since 1997. Work originally utilised Sanger sequencing methods targeting specific NOTCH3 exons. More recently, next-generation sequencing (NGS)-based technologies such as a targeted gene panel and whole exome sequencing (WES) have been used for improved genetic diagnostic testing. In this study, data from 680 patient samples was analysed for 764 tests utilising 3 different sequencing technologies. Sanger sequencing was performed for 407 tests, a targeted NGS gene panel which includes NOTCH3 exonic regions accounted for 354 tests, and WES with targeted analysis was performed for 3 tests. In total, 14.7% of patient samples (n = 100/680) were determined to have a mutation. Testing efficacy varied by method, with 10.8% (n = 44/407) of tests using Sanger sequencing able to identify mutations, with 15.8% (n = 56/354) of tests performed using the NGS custom panel successfully identifying mutations and a likely non-NOTCH3 pathogenic variant (n = 1/3) identified through WES. Further analysis was then performed through stratification of the number of mutations detected at our facility based on the number of exons, level of pathogenicity and the classification of mutations as known or novel. A systematic review of NOTCH3 mutation testing data from 1997 to 2017 determined the diagnostic rate of pathogenic findings and found the NGS-customised panel increases our ability to identify disease-causing mutations in NOTCH3.

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Section: Discussionmentioning

confidence: 99%

Investigating diagnostic sequencing techniques for CADASIL diagnosis

et al. 2020

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“…The territory of the posterior circulation is mostly involved (70-82%). Young women are more affected, probably with a bias of selection, since the migraine with aura by itself is more frequent in this population 31. The imaging examinations more often reveal single or multiple small lesions limited to an unique vascular territory 35.…”

Section: Discussionmentioning

confidence: 99%

Migrainous infarction: a rare and often overlooked diagnosis

Kreling¹,

Neto²,

Neto³

2017

Autops. Case Rep.

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Migraine is a neurological entity and a well-known independent risk factor for cerebral infarction, which mostly afflicts the young female population. Researching focal neurological signs in this subset of the population with the diagnosis of a neurological ischemic event should always take into account the migraine as the etiology or as an associated factor. The etiology of central nervous system (CNS) ischemia is considerable. Migraine, although rare, also may be included in this vast etiological range, which is called migrainous infarction. In this setting, the diagnostic criteria required for this diagnosis is extensive. Herein, we present the case of a female adolescent who submitted to the emergency facility complaining of diplopia, dysarthria, and imbalance, which started concomitantly with a migrainous crisis with aura—a challenging clinical case that required extensive research to address all possible differential diagnoses.

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“…Furthermore, subgroup analyses have revealed significant interactions for gender, age, smoking and oral contraceptive use with higher risk estimates in women, patients below age 45 years, smokers and women using oral contraceptives. 3 – 5 …”

Section: Introductionmentioning

confidence: 99%

“… 2 , 4 – 6 , 11 These mechanisms are shared with other vascular diseases and recently, migraine has also been associated with increased risk of ischemic heart disease 12 , 13 and it has been suggested that migraine should be viewed as a systemic disorder affecting the endovascular system. 5 , 6 , 11 However, while a number of studies have shown an association between migraine with aura and ischemic stroke, evidence is less consistent for hemorrhagic stroke, transient ischemic attacks (TIA), and ischemic heart disease as well for migraine without aura. In addition, many of the previous studies have only included a small number of confounding factors.…”

Section: Introductionmentioning

confidence: 99%

Migraine and risk of stroke and acute coronary syndrome in two case-control studies in the Danish population

Osler

Wium‐Andersen

Jørgensen

et al. 2017

CLEP

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IntroductionMigraine has consistently been associated with increased risk of ischemic stroke, while the evidence for a relation with other types of stroke or coronary outcomes is limited. We examined the association between migraine and stroke and acute coronary syndrome (ACS) subtypes and the influence of potential confounding factors.MethodsAll first-time hospital contacts for stroke (n=155,216) or ACS (n=97,799) were identified in Danish National Patient Registers and matched with 2 control groups of the background population. A hospital diagnosis of migraine and use of migraine medication were the main exposures and associations (odds ratios [OR]) were estimated using multiple logistic regression. Confounding was also addressed by including use of general headache medication as a negative control exposure.ResultsThe diagnosis of migraine was associated with increased odds of both stroke (ORcrude, age <50 years: 4.80 [95% CI: 3.75–6.21]; ORcrude, age ≥50 years:1.91 [95% CI: 1.67–2.19]) and ACS (ORcrude:1.88 [95% CI: 1.53–2.32]), while the ORs for the associations between migraine medication and stroke and ACS were lower. Patients with a diagnosis of migraine or redeemed migraine medication had increased ORs of all stroke subtypes (ischemic, hemorrhagic stroke and transient ischemic attacks). The diagnosis of migraine was also associated with both angina and myocardial infarction (ST-elevation Myocardial Infarction [STEMI], non-STEMI and unspecified) with the highest OR for angina. These associations were not fully explained by adjustment for confounding co-variables or when compared with the negative control exposure that were assumed to be influenced by similar confounding factors, but no shared pathogenesis.ConclusionHospital-diagnosed migraine was associated with all stroke and ACS subtypes, with ischemic stroke and angina having the highest odds. Confounding did not explain the associations.

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Stroke and migraine is there a possible comorbidity?

Cited by 21 publications

References 21 publications

Investigating diagnostic sequencing techniques for CADASIL diagnosis

Investigating diagnostic sequencing techniques for CADASIL diagnosis

Migrainous infarction: a rare and often overlooked diagnosis

Migraine and risk of stroke and acute coronary syndrome in two case-control studies in the Danish population

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