The following article is part of conference coverage from the Americas Committee for Treatment and Research in Multiple Sclerosis 2020 Forum in West Palm Beach, Florida. 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 the ACTRIMS 2020 Forum.
WEST PALM BEACH, FL — Migraine prevalence was significantly higher among patients with multiple sclerosis (MS) compared with healthy controls, with several genetic variants being shared between migraine and MS, according to research presented at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) 2020 Forum held from February 27 to 29, 2020, in West Palm Beach, Florida. Several variants were found to increase migraine risk but decrease MS risk; these findings may lead to improvements in targeted treatments and therapies.
Although symptoms and risk factors for migraine and MS often overlap, and up to 69% of patients with MS suffer migraine, it is unknown whether these 2 disorders are independent or have a common biological etiology, such as genetics. The current study used data on 1094 patients with MS and 12,176 control participants who were Kaiser Permanente Northern California Health Plan members to investigate if any genetic variants independently associated with migraine or MS could be identified from genome-wide association studies that are shared between both conditions.
Migraine status was determined via self-report and validated electronic health record algorithm. Prior genome-wide association studies of MS or migraine were used to identify variants, and after quality control, investigators analyzed 902 variants with minor allele frequency greater than 1%. Observed and permuted P for each phenotype were obtained from logistic regression and compared with identify variants associated with both phenotypes. Logistic regression models were adjusted for sex and ancestry among any variants that had significant associations with both phenotypes.
The migraine model was adjusted for a propensity score representing the probability of MS case-control status to account for potential ascertainment bias from obtaining a secondary phenotype from a case-control study.
Among the 1094 patients with MS, the mean age was 49.95 years old (SD=9.02) compared with 49.01 years old (SD=8.92) for controls. Women made up 79.98% of MS cases and 80.60% of controls. Median MS Severity Score was 3.21 (SD=2.43). Migraine incidence was significantly higher (P <.05) among MS cases (40%) compared with controls (29%). Preliminary results found 5 genetic variants (rs6677309, rs10801908, rs1335532, rs62420820, and rs17066096) that were significantly associated (P <.05) with both MS and migraine. Three of these were protective for MS (rs6677309, rs10801908, and rs1335532), and all variants increased odds of migraine.
Study investigators concluded, “Results showed the prevalence of migraine was significantly higher among individuals with MS compared [with] healthy controls….Several genetic variants were shared between MS and migraine, and implicated genes include CD58, which modulates regulatory T-cells, and several immune genes (IL20RA, IL22RA2, IFNGR1 and TNFAIP3) within the 6q23 chromosomal region. Because several variants increase risk of migraine but decrease risk of MS, there may be implications for targeted therapies and treatments.”
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Horton M, Robinson S, Shao X, et al. Discovery of shared genetic variants associated with multiple sclerosis and migraine. Presented at: 5th Annual Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum; February 27-29, 2020; West Palm Beach, FL. Abstract P140.