Cardiovascular, Psychiatric Comorbidity Patterns Evident in Migraine
Detecting the natural endophenotypes of migraine may enable better biological as well as genetic characterization and individualization of migraine therapy.
|The following article is part of conference coverage from the 2018 American Headache Society Annual Scientific Meeting in San Francisco, California. Neurology Advisor's staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from AHS 2018.|
SAN FRANCISCO — A total of 8 underlying comorbidity patterns appear to be frequent among patients with migraine, yet the number of comorbidities in these patients are highly variable, according to a prospective study presented by Richard Lipton, MD, of the Albert Einstein College of Medicine in New York, at the 60th Annual Scientific Meeting of the American Headache Society. The comorbidities commonly reported in patients with migraine include those involving cardiovascular, psychiatric, pain, and respiratory conditions, the researchers reported.
In this study. Dr Lipton and colleagues sought to identify endophenotypes of migraine using patient profiles of concomitant conditions and comorbidities.
Researchers administered a web-based survey to 12,810 patients meeting the modified criteria for the International Classification of Headache Disorders, 3rd edition, beta version (ICHD-3β). The survey questioned US participants regarding the course of their migraine as well as the presence of related comorbidities. A total of 62 comorbidities were included in the survey. In addition, respondents were asked if they received a doctor-confirmed diagnosis of their condition(s). The investigators used a latent class analysis (LCA), which “modeled the optimal number of classes and a parsimonious set of comorbidities” in this cohort.
Among survey respondents, 11,837 reported having ≥1 comorbid condition in addition to migraine. Based on the 22 comorbidities included in the final analysis, the researchers constructed an 8-class model, with each class demonstrating a well-defined pattern of comorbidity.
In class 1, respondents reported multiple comorbidities, whereas class 2 reported comorbidities that were respiratory and/or psychiatric in nature. Class 3 and 4 included respiratory/pain and respiratory-only comorbidities, respectively. Finally, classes 5, 6, 7, and 8 were comprised of psychiatric-related, cardiovascular-related, pain-related, and few comorbidities, respectively. Approximately one-third of respondents reported few comorbidities and were subsequently categorized into class 8, whereas <10% of respondents reported multiple comorbidities (class 1).
“LCA modeling identified 8 underlying patterns of comorbid health problems among people with migraine,” the researchers concluded. “These classes show differences in headache features and treatment patterns not used to form the classes. Subsequent research will assess prognostic differences among the classes.”
Lipton R, Fanning, KM, Buse DC, et al. Identifying natural subgroups of migraine based on profiles of comorbidities and concomitant conditions: results of the Chronic Migraine Epidemiology and Outcomes study. Presented at: 2018 American Headache Society Annual Scientific Meeting. June 28-July 1, 2018; San Francisco, CA. Abstract 448983.For more coverage of AHS 2018, click here.