Migraine Comorbidity May Increase Depression Risk in Patients With Focal Epilepsy

migraine headache
migraine headache
Patients with focal epilepsy and comorbid migraine may have greater depressive symptoms compared with individuals without the comorbidity.
The following article is part of conference coverage from the American Epilepsy Society’s Annual Meeting in New Orleans, LA. The 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 AES 2018.

NEW ORLEANS — Patients with focal epilepsy and comorbid migraine may have greater depressive symptoms compared with individuals without migraine, according to research presented at the 72nd Annual Meeting of the American Epilepsy Society, held November 30 to December 4, 2018.

In this prospective multicenter study, investigators assessed the presence of psychiatric and migraine comorbidities in patients newly diagnosed with focal epilepsy at baseline using data from the Human Epilepsy Project. Patients with and without migraine were compared using univariate descriptive analyses, and patients with migraine were assessed for differences between those with and without aura.

Anxiety was assessed with the Generalized Anxiety Disorder 7-item (GAD-7) and depression was evaluated with the Center for Epidemiologic Studies Depression Scale (CES-D), and the Neurological Disorder Depression Inventory for Epilepsy (NDDIE). Demographic factors (eg, gender, age, and race) were controlled for when evaluating differences in psychiatric comorbidities.

Of the 450 patients with epilepsy, 82 patients (18.2%) had a migraine diagnosis, 53 (64.6%) of whom had migraine with aura. The mean Migraine Disability Assessment (MIDAS) score for patients with both epilepsy and migraine was 11.6±19.1 (mean MIDAS score: migraine with aura, 14.6; migraine without aura, 6.0).

CES-D depression scores were found to be higher in participants with epilepsy and comorbid migraine vs those without migraine (mean: 14.4 vs 10.7, respectively; =.013). Depression scores were higher in participants with migraine with vs without aura (mean N-DDIE score: 12.3 vs 9.8, respectively; =.020; mean CES-D score: 16.6 vs 10.3, respectively; =.036).

Controlling for covariates, younger vs older patients with epilepsy had higher suicidality scores (=.025).

“Clinicians should be alert for signs of depression in epilepsy patients with migraine. Given the paucity of studies evaluating the comorbidity between epilepsy, migraine, and other associated psychiatric conditions, further studies should be performed,” concluded the study authors.

Disclosures: The Human Epilepsy Project study receives support from the Epilepsy Study Consortium, a non-profit organization funded by foundations, philanthropy, and industry, including Eisai, Lundbeck, Pfizer, Sunovion, and UCB Pharma.

For more coverage of AES 2018, click here.


Minen M, India S, French JA, et al. Migraine and psychiatric comorbidities in patients with epilepsy. Presented at: the 72nd Annual Meeting of the American Epilepsy Society; November 30-December 4, 2018; New Orleans, LA. Abstract 3.268.