Study Outlines Incidence of Comorbidities Among Migraineurs

Researchers found patients with migraine were significantly more likely to report multiple comorbidities such as anxiety, insomnia, and depression, according to a study published in The Journal of Headache and Pain.

The Migraine in American Symptoms and Treatment (MAST) study included data from 15,133 individuals with migraine and over 77,000 controls. Data from this prospective, longitudinal study were collected between October 2016 and January 2017. Migraineurs and controls filled out an online survey providing information on cardiovascular disorders, psychiatric disorders, neurologic diseases, sleep conditions, inflammatory conditions, and chronic pain conditions.

In addition to headache pain intensity and monthly headache day (MHD) frequency, sociodemographic characteristics were recorded, including age, marital status, race, employment status, and total annual household income.

Recorded comorbidities must have been confirmed by a diagnosis from a healthcare professional. Through multivariable binary logistic regression, researchers calculated odds ratios (OR) and 95% confidence intervals for each condition between the two groups, and adjusted for sociodemographic factors.

Specifically, the MAST study found individuals with migraine compared with non-migraineurs were more than 3 times more likely to experience:

• Insomnia (OR 3.79 [3.6, 4.0])
• Depression (OR 3.18 [3.0, 3.3])
• Anxiety (OR 3.18 [3.0, 3.3])
• Gastric ulcer/GI bleeding (OR 3.11 [2.8, 3.5])

The same cohort was at least 2 times more likely to experience:

• Peripheral artery disease (OR 2.69 [2.3, 3.1])
• Angina (OR 2.64 [2.4, 3.0])
• Allergies/hay fever (OR 2.49 [2.4, 2.6])
• Epilepsy (OR 2.33 [2.0, 2.8])
• Arthritis (type unknown) (OR 2.20 [2.1, 2.4])
• Stroke or Transient Ischemic Attack (OR 2.18 [1.9, 2.5])
• Rheumatoid arthritis (OR 2.11 [1.9, 2.4])
• Asthma (OR 2.03 [1.9, 2.1])
• Vitamin D deficiency (OR 2.00 [1.9, 2.1])

Researchers also found headache pain intensity was associated with a higher risk for comorbidities. Additionally, greater MHD frequency “was associated with increased risks for nearly all conditions.”

Because the study relies on self-reported information, researchers note future studies should take place to differentiate the causal sequence (direct causality, reverse causality, shared underlying disposition) of comorbidities and migraine. Additional studies could also identify shared risk factors, the potential confounding roles of migraine treatments, and potential detection bias.

“Identification of common comorbidities can enhance accurate diagnosis, effective treatment, adherence to treatment, prognosis, and minimization of disease burden,” researchers said.

Reference

Buse DC, Reed ML, Fanning KM, et al. Comorbid and co-occurring conditions in migraine and associated risk of increasing headache pain intensity and headache frequency: results of the migraine in America symptoms and treatment (MAST) study. J Headache Pain. 2020;21(23). doi:10.1186/s10194-020-1084-y.