A prevalence study of 9000 Swedish school children conducted in 1955 showed that nearly 4% had migraine. The prevalence of migraine was 1.4% at 7 years of age and 5.3% at 15 years of age. From the age of 11 there was a gradual increase of migraine headache and a predominance among girls. A subgroup of 73 children with pronounced migraine and an average onset of 6 years was followed during a period of 40 years. The results showed that 23% of the children were migraine-free before the age of 25, boys significantly more often than girls. However, around the age of 50, more than half of the migraine group still had migraine attacks. A recall bias was found in that a number of the subjects in their middle-life (41%) could not remember that they had had aura symptoms previously. Of those who had become parents, 52% have in their present or previous families had one child or more who had developed recurrent headache, probably of the migraine-type.
There are only few small studies assessing potential risk factors, comorbidity, and prognostic factors in adult spontaneous cervicocerebral artery dissection (CAD).
We conducted a retrospective, hospital-based analysis on the prognostic factors and association of CAD with vascular risk factors in 301 consecutive Finnish patients, diagnosed from 1994 to 2007.
Two thirds of the patients were men (68%). Women were younger than men. Migraine (36% of all patients), especially with visual aura (63% of all migraineurs), and smoking were more common in patients with CAD compared with the general Finnish population. At 3 months, 247 (83%) patients reached a favorable outcome. Occlusion of the dissected artery, internal carotid artery dissection (ICAD), and recent infection in infarction patients were associated with a poorer outcome. ICAD patients had less often brain infarction, but the strokes they had were more severe. Seven (2.3%) patients died during the follow-up (mean 4.0 years, 1186 patient years). Six (2%) patients had verified CAD recurrence.
This study provides evidence for the association of CAD with male sex, and possible association with smoking and migraine. Occlusion of the dissected artery, ICAD, and infection appear to be associated with poorer outcome.
A variety of environmental factors have been identified as possible triggers for migraine and other headache syndromes.
We analyzed associations between air pollution and emergency department (ED) visits for migraine and headache.
Analysis was based on 56,241 ED visits for migraine and 48,022 ED visits for headache to Edmonton hospitals between 1992 and 2002. A Poisson model of counts hierarchically clustered by day of week, month, and year was applied using generalized linear mixed models. Temperature and relative humidity were included as covariates.
Females accounted for 78.5% of migraine visits and 56.3% of headache visits. An interquartile range (IQR) increase (6.2 microg/m3) in daily average particulate matter of median aerodynamic diameter less than 2.5 microm (PM2.5) was associated with increases in visits of 3.3% for migraine (95% confidence interval [CI]: 0.6-6.0), lagged 2 days, and 3.4% for headache (95% CI: 0.3-6.6), lagged 0 days, among females in the cold season (October-March). PM2.5 was also associated with cold season migraine visits among females at lag 0 and 1 day (P
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.
The relationship between blood pressure and headache in youth has not been explored and the objective of the present study was to provide data on this association in an adolescent population. Cross-sectional data from a large population-based survey, the Young-HUNT study, on 5,847 adolescents were used to evaluate the association between blood pressure (systolic, diastolic, mean arterial and pulse pressure) and recurrent headache, including migraine and tension-type headache. Increasing pulse pressure was inversely related to recurrent headache prevalence, and both tension-type headache and migraine. For systolic blood pressure such an inverse relationship was present for recurrent headache and tension-type headache prevalence. For migraine, the results were not significant, although there was a tendency in the same direction (p = 0.05). High-pulse pressure has previously been found to be inversely related to the prevalence of migraine and tension-type headache in an adult population. This inverse relationship has now been demonstrated to be present among adolescents also, supporting the results from a previous study in adults, that blood pressure regulation may be linked to the pathophysiology of headache.
The association between eating disorders and migraine remains unclear.
We identified women with lifetime diagnoses of anorexia nervosa (AN) (N?=?55) and bulimia nervosa (BN) (N?=?60) and their co-twins from the FinnTwin16 cohort born in 1975-1979 (N?=?2,825 women). Eating disorder and major depressive disorder (MDD) diagnoses were obtained from clinical interviews and data on migraine by self-report questionnaire. The women with eating disorders were compared with their unaffected co-twins and with unrelated women from the same birth cohorts.
The prevalence of migraine was 12% in the general female population, but 22% for both AN and BN (odds ratio 2.0, p?=?.04). The prevalence of MDD was high in women with an eating disorder (42%). MDD was strongly associated with migraine (odds ratio 3.0, p?
To investigate whether sex-specific associations exist between migraine, lifestyle or socioeconomic factors. We distinguished between the subtypes migraine with aura (MA) and migraine without aura (MO). In 2002, a questionnaire containing validated questions to diagnose migraine and questions on lifestyle and socioeconomic factors was sent to 46,418 twin individuals residing in Denmark. 31,865 twin individuals aged 20-71 were included. The twins are representative of the Danish population with regard to migraine and other somatic diseases and were used as such in the present study. An increased risk of migraine was significantly associated with lower level of schooling and education, retirement, unemployment, and smoking. A decreased risk of migraine was significantly associated with heavy physical exercise and intake of alcohol. Direct comparison between the subtypes showed a decreased risk of MA compared to MO in subjects with low education or weekly intake of alcohol. The risk of MA was increased compared to MO in unemployed or retired subjects. Direct comparison between sexes showed a decreased risk of migraine for men compared to women in subjects who were low educated, unemployed or studying. The risk was increased for men compared to women in subjects with heavy physical exercise, intake of alcohol, and body mass index >25. Migraine was associated with several lifestyle and socioeconomic factors. Most associations such as low education and employment status were probably due to the negative effects of having migraine while others such as smoking were risk factors for migraine.
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Some previous studies have postulated an association between migraine and excessive daytime sleepiness (EDS). This study evaluated the association of EDS with migraine and headache frequency in a general population, after adjusting for potential confounding variables.
The study was a postal survey of a random age and gender-stratified sample of 40,000 persons aged 20 to 80 years old drawn by the National Population Register in Norway. The questionnaire included questions about migraine, headache, the Epworth sleepiness scale (ESS) and various comorbidities. EDS was defined as ESS?>?10. The association of EDS and migraine/headache were analysed by bivariate and multivariable logistic regression analyses.
A total of 21,177 persons responded to the ESS and were included in the analyses. The odds ratio (OR) for EDS was increased for migraineurs (1.42 (95% CI 1.31-1.54), p?179 days per year compared to those without headache in multivariable analysis.
In a general population, the odds for EDS increased significantly with the headache frequency, irrespective of migraine status. EDS was not associated with reported migraine in multivariable analysis.
The aim of the study was to evaluate the association between sleep disturbance and headache type and frequency, in a random sample of participants in the third Nord-Trøndelag Health Survey. The headache diagnoses were set by neurologists using the ICHD-2 criteria performing a semi structured face-to-face interview. Sleep problems were measured by the two validated instruments Karolinska Sleep Questionnaire (KSQ) and Epworth Sleepiness Scale (ESS). Among 297 participants, 77 subjects were headache-free, whereas 135 were diagnosed with tension-type headache (TTH), 51 with migraine, and 34 with other headache diagnoses. In the multivariate analyses, using logistic regression, excessive daytime sleepiness, defined as ESS >or= 10, was three times more likely among migraineurs compared with headache-free individuals (OR = 3.3, 95% CI 1.0-10.2). Severe sleep disturbances, defined as KSQ score in the upper quartile, was five times more likely among migraineurs (OR = 5.4, 95% CI 2.0-15.5), and three times more likely for subjects with TTH (OR = 3.3, 1.4-7.3) compared with headache-free individuals. Subjects with chronic headache were 17 times more likely to have severe sleep disturbances (OR = 17.4, 95% CI 5.1-59.8), and the association was somewhat stronger for chronic migraine (OR = 38.9, 95% CI 3.1-485.3) than for chronic TTH (OR = 18.3, 95% CI 3.6-93.0). In conclusion, there was a significant association between severe sleep disturbances and primary headache disorders, most pronounced for those with chronic headache. Even though one cannot address causality in the present study design, the results indicate an increased awareness of sleep problems among patients with headache.