1
|
Huang SY, Salomon M, Eikermann-Haerter K. Advanced brain MRI may help understand the link between migraine and multiple sclerosis. J Headache Pain 2023; 24:113. [PMID: 37596546 PMCID: PMC10439604 DOI: 10.1186/s10194-023-01645-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/04/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND There is a clinical association between migraine and multiple sclerosis. MAIN BODY Migraine and MS patients share similar demographics, with the highest incidence among young, female and otherwise healthy patients. The same hormonal constellations/changes trigger disease exacerbation in both entities. Migraine prevalence is increased in MS patients, which is further enhanced by disease-modifying treatment. Clinical data show that onset of migraine typically starts years before the clinical diagnosis of MS, suggesting that there is either a unidirectional relationship with migraine predisposing to MS, and/or a "shared factor" underlying both conditions. Brain imaging studies show white matter lesions in both MS and migraine patients. Neuroinflammatory mechanisms likely play a key role, at least as a shared downstream pathway. In this review article, we provide an overview of the literature about 1) the clinical association between migraine and MS as well as 2) brain MRI studies that help us better understand the mechanistic relationship between both diseases with implications on their underlying pathophysiology. CONCLUSION Studies suggest a migraine history predisposes patients to develop MS. Advanced brain MR imaging may shed light on shared and distinct features, while helping us better understand mechanisms underlying both disease entities.
Collapse
Affiliation(s)
- Susie Y Huang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Marc Salomon
- Department of Radiology, New York University Langone Medical Center, 660 First Ave, New York, NY, 10016, USA
| | - Katharina Eikermann-Haerter
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
- Department of Radiology, New York University Langone Medical Center, 660 First Ave, New York, NY, 10016, USA.
| |
Collapse
|
2
|
Wang M, Gu Y, Meng S, Kang L, Yang J, Sun D, Liu Y, Wan Z, Shan Y, Xue D, Su C, Li S, Yan R, Liu Y, Zhao Y, Pan Y. Association between TRP channels and glutamatergic synapse gene polymorphisms and migraine and the comorbidities anxiety and depression in a Chinese population. Front Genet 2023; 14:1158028. [PMID: 37303955 PMCID: PMC10250607 DOI: 10.3389/fgene.2023.1158028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/17/2023] [Indexed: 06/13/2023] Open
Abstract
Background: Genetic and environmental factors contribute to migraine and the comorbidities of anxiety and depression. However, the association between genetic polymorphisms in the transient receptor potential (TRP) channels and glutamatergic synapse genes with the risk of migraine and the comorbidities of anxiety and depression remain unclear. Methods: 251 migraine patients containing 49 comorbidities with anxiety and 112 with depression and 600 controls were recruited. A customized 48-plex SNPscan kit was used for genotyping 13 SNPs of nine target genes. Logistic regression was conducted to analyze these SNPs' association with the susceptibility of migraine and comorbidities. The generalized multifactor dimension reduction (GMDR) was applied to analyze the SNP-SNP and gene-environment interactions. The GTEx database was used to examine the effects of the significant SNPs on gene expressions. Results: The TRPV1 rs8065080 and TRPV3 rs7217270 were associated with an increased risk of migraine in the dominant model [ORadj (95% CI): 1.75 (1.09-2.90), p = 0.025; 1.63 (1.02-2.58), p = 0.039, respectively]. GRIK2 rs2227283 was associated with migraine in the edge of significance [ORadj (95% CI) = 1.36 (0.99-1.89), p = 0.062]. In migraine patients, TRPV1 rs222741 was associated with both anxiety risk and depression risk in the recessive model [ORadj (95% CI): 2.64 (1.24-5.73), p = 0.012; 1.97 (1.02-3.85), p = 0.046, respectively]. TRPM8 rs7577262 was associated with anxiety (ORadj = 0.27, 95% CI = 0.10-0.76, p = 0.011). TRPV4 rs3742037, TRPM8 rs17862920 and SLC17A8 rs11110359 were associated with depression in dominant model [ORadj (95% CI): 2.03 (1.06-3.96), p = 0.035; 0.48 (0.23-0.96), p = 0.042; 0.42 (0.20-0.84), p = 0.016, respectively]. Significant eQTL and sQTL signals were observed for SNP rs8065080. Individuals with GRS (Genetic risk scores) of Q4 (14-17) had a higher risk of migraine and a lower risk of comorbidity anxiety than those with Genetic risk scores scores of Q1 (0-9) groups [ORadj (95% CI): 2.31 (1.39-3.86), p = 0.001; 0.28 (0.08-0.88), p = 0.034, respectively]. Conclusion: This study suggests that TRPV1 rs8065080, TRPV3 rs7217270, and GRIK2 rs2227283 polymorphism may associate with migraine risk. TRPV1 rs222741 and TRPM8 rs7577262 may associate with migraine comorbidity anxiety risk. rs222741, rs3742037, rs17862920, and rs11110359 may associate with migraine comorbidity depression risk. Higher GRS scores may increase migraine risk and decrease comorbidity anxiety risk.
Collapse
Affiliation(s)
- Mingxue Wang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, China
| | - Yujia Gu
- Chronic Disease Prevention and Treatment Clinic, Heilongjiang Provincial Center for Disease Control and Prevention, Harbin, China
| | - Shuhan Meng
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, China
| | - Lixin Kang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, China
| | - Jing Yang
- Department of Neurology, Beidahuang Group Hongxinglong Hospital, Shuangyashan, China
| | - Degang Sun
- Department of Neurology, Beidahuang Group Hongxinglong Hospital, Shuangyashan, China
| | - Yuxing Liu
- Catheterization Room, Beidahuang Group Hongxinglong Hospital, Shuangyashan, China
| | - Ze Wan
- Science and Education Section, Beidahuang Group Hongxinglong Hospital, Shuangyashan, China
| | - Yi Shan
- Physical Examination Section, Beidahuang Group Baoquanling Hospital, Hegang, China
| | - Dongjie Xue
- Department of Neurology, Hegang He Mine Hospital, Hegang, China
| | - Chang Su
- Department of Internal Medicine, Baoquanling Farm Hospital, Hegang, China
| | - Shufen Li
- Vaccination Clinic, Baoquanling Farm Hospital, Hegang, China
| | - Ran Yan
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, China
| | - Yu Liu
- Chronic Disease Prevention and Treatment Clinic, Heilongjiang Provincial Center for Disease Control and Prevention, Harbin, China
| | - Yashuang Zhao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, China
| | - Yonghui Pan
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| |
Collapse
|
3
|
Abstract
Migraine is a common, chronic, disorder that is typically characterized by recurrent disabling attacks of headache and accompanying symptoms, including aura. The aetiology is multifactorial with rare monogenic variants. Depression, epilepsy, stroke and myocardial infarction are comorbid diseases. Spreading depolarization probably causes aura and possibly also triggers trigeminal sensory activation, the underlying mechanism for the headache. Despite earlier beliefs, vasodilation is only a secondary phenomenon and vasoconstriction is not essential for antimigraine efficacy. Management includes analgesics or NSAIDs for mild attacks, and, for moderate or severe attacks, triptans or 5HT1B/1D receptor agonists. Because of cardiovascular safety concerns, unreliable efficacy and tolerability issues, use of ergots to abort attacks has nearly vanished in most countries. CGRP receptor antagonists (gepants) and lasmiditan, a selective 5HT1F receptor agonist, have emerged as effective acute treatments. Intramuscular onabotulinumtoxinA may be helpful in chronic migraine (migraine on ≥15 days per month) and monoclonal antibodies targeting CGRP or its receptor, as well as two gepants, have proven effective and well tolerated for the preventive treatment of migraine. Several neuromodulation modalities have been approved for acute and/or preventive migraine treatment. The emergence of new treatment targets and therapies illustrates the bright future for migraine management.
Collapse
|