Migraine is a primary headache disorder and ranked as one of the most disabling neurological diseases in adulthood. The one year prevalence of migraine is 6% in men and 18% in women. Typical headache attacks last several hours involving nausea and sensitivity to light or sound. In about one third of cases, transient neurological symptoms occurs, most often affecting the visual system, which are known as migraine aura. Migraine pathophysiology involves complex neuronal cascades that may be triggered by environmental, and genetic factors.
Parkinson’s disease (PD) is a neurodegenerative disease mainly affecting the motor system. It results from the death of dopamine-generating cells in the substantia nigra. The causes of this cell death are poorly understood. PD is the second most common neurodegenerative disorder after Alzheimer’s disease and affects approximately seven million people globally. The costs of Parkinson’s Disease to society are high.
As both migraine and PD are disorders of the brain and involve some similar mechanisms, it has been speculated that migraine may be a risk factor for PD. However, only recently a large population-based study found an association between the two neurological disorders. Confirmation of these findings are urgently needed as the care and treatment of patients with migraine may be affected (1).
As a PhD student in Public Health specialising in Neuroepidemiology my focus is to assess causes and consequences of migraine suffering. The main association I want to test in this study is whether migraine increases the risk of PD. In order to address this problematic I am conducting a longitudinal study on two large scale population-based cohorts, approved by the Internal Review Board of the Brigham and Women’s Hospital, the Physician Health Study and the Women’s health study.
The Physicians’ Health Study was a randomized, double-blind, placebo-controlled trial to test the benefits and risks of low-dose aspirin (325 mg) and beta-carotene (50 mg) in the primary prevention of cardiovascular disease (CVD) and cancer among 22,071 apparently healthy male physicians aged 40 to 84 years at baseline in 1982. Baseline information was self-reported and follow-up information was collected annually by mailed questionnaires.
The WHS was a randomized trial designed to test the benefits and risks of low-dose aspirin and vitamin E in the primary prevention of CVD and cancer on a total of 39,876 US female health professionals aged 45 years at study entry (1992–1995). Baseline information was self-reported and collected by a mailed questionnaire that asked about many cardiovascular risk factors and lifestyle variables. Participants were sent follow-up questionnaires asking about study outcomes and other information during the study period.
(1) Scher AI, Ross GW, Sigurdsson S, Garcia M, Gudmundsson LS, Sveinbjörnsdóttir S, et al. Midlife migraine and late-life parkinsonism: AGES-Reykjavik study. Neurology. 2014 Sep 30;83(14):1246–52.