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Migraine Disorders: HELP
Articles by Ann I. Scher
Based on 23 articles published since 2009
(Why 23 articles?)

Between 2009 and 2019, A. Scher wrote the following 23 articles about Migraine Disorders.
+ Citations + Abstracts
1 Editorial Suicide risk is elevated in migraineurs who have comorbid fibromyalgia. 2015

Kurth, Tobias / Scher, Ann I. · ·Neurology · Pubmed #26296512.

ABSTRACT: -- No abstract --

2 Editorial Migraine and the social selection vs causation hypotheses: a question larger than either/or? 2013

Peterlin, B Lee / Scher, Ann I. ·From the Department of Neurology (B.L.P.), Johns Hopkins University School of Medicine, Baltimore · and Department of Preventive Medicine Biometrics (A.I.S.), Uniformed Services University, Bethesda, MD. ·Neurology · Pubmed #23990406.

ABSTRACT: For decades, the question of social selection vs social causation has been raised by public health researchers and social scientists to explain the association between socioeconomic factors and mood disorders.(1,2) The social selection or "downward drift" theory postulates that the disease itself limits an individual's educational and occupational achievements, leading to a lower socioeconomic status (SES). In contrast, the social causation hypothesis suggests that factors associated with low SES (e.g., stressful life events, poor health care access) increase the likelihood of disease onset or prolonged disease duration.(3,4) Simply stated, the end result of each hypothesis is as follows:

3 Editorial High migraine prevalence in Parma: why? 2012

Gudmundsson, Larus S / Scher, Ann I. · ·Cephalalgia · Pubmed #22436372.

ABSTRACT: -- No abstract --

4 Editorial Comment on Rubino et al., 'Association of the C677T polymorphism in the MTHFR gene with migraine: a meta-analysis'. 2009

Scher, A I. · ·Cephalalgia · Pubmed #19604253.

ABSTRACT: -- No abstract --

5 Review Adipokines and Migraine: A Systematic Review. 2016

Peterlin, B Lee / Sacco, Simona / Bernecker, Claudia / Scher, Ann I. ·Johns Hopkins University School of Medicine, Department of Neurology, Baltimore, MD, USA. · University of L'Aquila, Department of Applied Clinical Sciences and Biotechnology, Institute of Neurology, L'Aquila, Italy. · Medical University of Graz, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Graz, Austria. · Medical University of Graz, Department of Blood Group Serology and Transfusion Medicine, Graz, Austria. · Uniformed Services University, Bethesda, MD, USA. ·Headache · Pubmed #27012149.

ABSTRACT: BACKGROUND: Migraine is comorbid with obesity. Recent research suggests an association between migraine and adipocytokines, proteins that are predominantly secreted from adipose tissue and which participate in energy homeostasis and inflammatory processes. OBJECTIVES: In this review, we first briefly discuss the association between migraine and obesity and the importance of adipose tissue as a neuroendocrine organ. We then present a systematic review of the extant literature evaluating circulating levels of adiponectin and leptin in those with migraine. METHODS: A search of the PubMed database was conducted using the keywords "migraine," "adiponectin," and "leptin." In addition reference lists of relevant articles were reviewed for possible inclusion. English language studies published between 2005 and 2015 evaluating circulating blood concentration of adiponectin or leptin in those with migraine were included. CONCLUSIONS: While the existing data are suggestive that adipokines may be associated with migraine, substantial study design differences and conflicting results limit definitive conclusions. Future research utilizing carefully considered designs and methodology is warranted. In particular careful and systematic characterization of pain states at the time of samples, as well as systematic consideration of demographic (e.g., age, sex) and other vital covariates (e.g., obesity status, lipids) are needed to determine if adipokines play a role in migraine pathophysiology and if any adipokine represents a viable, novel migraine biomarker, or drug target.

6 Review Obesity and headache: part I--a systematic review of the epidemiology of obesity and headache. 2014

Chai, Nu Cindy / Scher, Ann I / Moghekar, Abhay / Bond, Dale S / Peterlin, B Lee. ·Johns Hopkins University School of Medicine, Baltimore, MD, USA. ·Headache · Pubmed #24512574.

ABSTRACT: Individually, both obesity and headache are conditions associated with a substantial personal and societal impact. Recent data support that obesity is comorbid with headache in general and migraine specifically, as well as with certain secondary headache conditions such as idiopathic intracranial hypertension. In the current manuscript, we first briefly review the epidemiology of obesity and common primary and secondary headache disorders individually. This is followed by a systematic review of the general population data evaluating the association between obesity and headache in general, and then obesity and migraine and tension-type headache disorders. Finally, we briefly discuss the data on the association between obesity and a common secondary headache disorder that is associated with obesity, idiopathic intracranial hypertension. Taken together, these data suggest that it is important for clinicians and patients to be aware of the headache/migraine-obesity association, given that it is potentially modifiable. Hypotheses for mechanisms of the obesity-migraine association and treatment considerations for overweight and obese headache sufferers are discussed in the companion manuscript, as part II of this topic.

7 Review Obesity and headache: Part II--potential mechanism and treatment considerations. 2014

Chai, Nu Cindy / Bond, Dale S / Moghekar, Abhay / Scher, Ann I / Peterlin, B Lee. ·School of Medicine - Neurology, Johns Hopkins University, Baltimore, MD, USA. ·Headache · Pubmed #24511882.

ABSTRACT: Obesity and headache are both associated with a substantial personal and societal impact, and epidemiologic studies have consistently identified a positive association between obesity and headache in general, as well as obesity and migraine specifically (see part I). In the current manuscript, we will discuss the potential mechanisms for the migraine-obesity association, with a focus on the central and peripheral pathophysiological pathways which overlap between migraine and those modulating the drive to feed. We then discuss surgical, behavioral, and pharmacological treatment considerations for overweight and obese migraineurs as well as for those with idiopathic intracranial hypertension. We close by briefly discussing where future research may be headed in light of this data.

8 Review The methodology of population surveys of headache prevalence, burden and cost: principles and recommendations from the Global Campaign against Headache. 2014

Stovner, Lars Jacob / Al Jumah, Mohammed / Birbeck, Gretchen L / Gururaj, Gopalakrishna / Jensen, Rigmor / Katsarava, Zaza / Queiroz, Luiz Paulo / Scher, Ann I / Tekle-Haimanot, Redda / Wang, Shuu-Jiun / Steiner, Timothy J. ·Norwegian National Headache Centre, Norwegian University of Science and Technology, and St, Olavs University Hospital, Trondheim, Norway. lars.stovner@ntnu.no. ·J Headache Pain · Pubmed #24467862.

ABSTRACT: The global burden of headache is very large, but knowledge of it is far from complete and needs still to be gathered. Published population-based studies have used variable methodology, which has influenced findings and made comparisons difficult. Among the initiatives of the Global Campaign against Headache to improve and standardize methods in use for cross-sectional studies, the most important is the production of consensus-based methodological guidelines. This report describes the development of detailed principles and recommendations. For this purpose we brought together an expert consensus group to include experience and competence in headache epidemiology and/or epidemiology in general and drawn from all six WHO world regions. The recommendations presented are for anyone, of whatever background, with interests in designing, performing, understanding or assessing studies that measure or describe the burden of headache in populations. While aimed principally at researchers whose main interests are in the field of headache, they should also be useful, at least in parts, to those who are expert in public health or epidemiology and wish to extend their interest into the field of headache disorders. Most of all, these recommendations seek to encourage collaborations between specialists in headache disorders and epidemiologists. The focus is on migraine, tension-type headache and medication-overuse headache, but they are not intended to be exclusive to these. The burdens arising from secondary headaches are, in the majority of cases, more correctly attributed to the underlying disorders. Nevertheless, the principles outlined here are relevant for epidemiological studies on secondary headaches, provided that adequate definitions can be not only given but also applied in questionnaires or other survey instruments.

9 Article Fluctuations in episodic and chronic migraine status over the course of 1 year: implications for diagnosis, treatment and clinical trial design. 2017

Serrano, Daniel / Lipton, Richard B / Scher, Ann I / Reed, Michael L / Stewart, Walter Buzz F / Adams, Aubrey Manack / Buse, Dawn C. ·Endpoint Outcomes, Boston, MA, USA. daniel.serrano@endpointoutcomes.com. · The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA. Richard.Lipton@einstein.yu.edu. · Montefiore Headache Center; Department of Neurology and Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA. Richard.Lipton@einstein.yu.edu. · Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA. · Vedanta Research, Chapel Hill, NC, USA. · Sutter Health, Walnut Creek, CA, USA. · Allergan plc, Irvine, CA, USA. · Montefiore Medical Center, Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA. ·J Headache Pain · Pubmed #28980171.

ABSTRACT: BACKGROUND: Relatively little is known about the stability of a diagnosis of episodic migraine (EM) or chronic migraine (CM) over time. This study examines natural fluctuations in self-reported headache frequency as well as the stability and variation in migraine type among individuals meeting criteria for EM and CM at baseline. METHODS: The Chronic Migraine Epidemiology and Outcomes (CaMEO) Study was a longitudinal survey of US adults with EM and CM identified by a web-questionnaire. A validated questionnaire was used to classify respondents with EM (<15 headache days/month) or CM (≥15 headache days/month) every three months for a total of five assessments. We described longitudinal persistence of baseline EM and CM classifications. In addition, we modelled longitudinal variation in headache day frequency per month using negative binomial repeated measures regression models (NBRMR). RESULTS: Among the 5464 respondents with EM at baseline providing four or five waves of data, 5048 (92.4%) had EM in all waves and 416 (7.6%) had CM in at least one wave. Among 526 respondents with CM at baseline providing four or five waves of data, 140 (26.6%) had CM in every wave and 386 (73.4%) had EM for at least one wave. Individual plots revealed striking within-person variations in headache days per month. The NBRMR model revealed that the rate of headache days increased across waves of observation 19% more per wave for CM compared to EM (rate ratio [RR], 1.19; 95% CI, 1.13-1.26). After adjustment for covariates, the relative difference changed to a 26% increase per wave (RR, 1.26; 95% CI, 1.2-1.33). CONCLUSIONS: Follow-up at three-month intervals reveals a high level of short-term variability in headache days per month. As a consequence, many individuals cross the CM diagnostic boundary of ≥15 headache days per month.Nearly three quarters of persons with CM at baseline drop below this diagnostic boundary at least once over the course of a year. These findings are of interest in the consideration of headache classification and diagnosis, the design and interpretation of epidemiologic and clinical studies, and clinical management.

10 Article Comorbid pain and migraine chronicity: The Chronic Migraine Epidemiology and Outcomes Study. 2017

Scher, Ann I / Buse, Dawn C / Fanning, Kristina M / Kelly, Amanda M / Franznick, Dana A / Adams, Aubrey M / Lipton, Richard B. ·From the Department of Neurology (D.C.B., R.B.L.), Albert Einstein College of Medicine, Bronx, NY · Montefiore Medical Center (D.C.B., R.B.L.), Bronx, NY · Vedanta Research (K.M.F.), Chapel Hill, NC · Complete Healthcare Communications (A.M.K., D.A.F.), Chadds Ford, PA · Allergan plc (A.M.A.), Irvine, CA. affiliated with the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University of the Health Sciences, Bethesda, MD. ·Neurology · Pubmed #28679597.

ABSTRACT: OBJECTIVE: To identify patterns of noncephalic pain comorbidity in people with episodic migraine (EM; <15 headache-days per month) and chronic migraine (CM; ≥15 headache-days per month) and to examine whether the presence of noncephalic pain is an indicator for the 3-month onset or persistence of CM. METHODS: Data from the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study, a prospective, web-based study with cross-sectional modules embedded in a longitudinal design, were analyzed at baseline and the 3-month follow-up. Relationships between the number of noncephalic pain sites and 3-month onset of CM or persistent CM were assessed. RESULTS: Of 8,908 eligible respondents, 8,139 (91.4%) had EM and 769 (8.6%) had CM at baseline. At 3 months, the incidence of CM among those with baseline EM was 3.4%. When adjusted for demographics and headache-day frequency, the odds of CM onset among those with baseline EM increased by 30% (95% confidence interval [CI] 1.21-1.40, CONCLUSIONS: These results suggest that noncephalic pain may be a marker for headache chronicity that could be used to identify people with EM at risk of the onset of CM and people with CM at risk of persistent CM.

11 Article Which Matters More? A Retrospective Cohort Study of Headache Characteristics and Diagnosis Type in Soldiers with mTBI/Concussion. 2017

Finkel, Alan G / Ivins, Brian J / Yerry, Juanita A / Klaric, John S / Scher, Ann / Sammy Choi, Y. ·Womack Army Medical Center (WAMC), Ft. Bragg, NC, USA. · Defense and Veterans Brain Injury Center, Silver Spring, MD, USA. · Carolina Headache Institute, Durham, NC, USA. · University of North Carolina School of Medicine, Chapel Hill, NC, USA. · Veterans Administration Hospital, Fayetteville, NC, USA. · Uniform Services University, Bethesda, MD, USA. ·Headache · Pubmed #28239838.

ABSTRACT: OBJECTIVE: To describe the diagnostic types and characteristics of headaches in soldiers with mild traumatic brain injury during the wars in Afghanistan and Iraq. BACKGROUND: Persistent post-traumatic headache interferes with returns to activity or duty. The most commonly cited headache diagnosis after concussion is migraine. We hypothesize that headache diagnosis type, eg, migraine, is not sufficient to predict relationships with occupational outcomes after concussion. METHODS: The study sample consisted of all new patients referred for headache evaluation at the Brain Injury Center at Womack Army Medical Center over a 1-year time period. The design was retrospective and observational. Clinical data reported included demographics, causes of injury, headache characteristics, and headache diagnosis type. After reviewing records for retention or severance from military service, the primary occupational outcome measure was departure from service due to medical cause as determined by a Medical Evaluation Board (MEB). The primary outcome measure was to test the strength of association between leaving service for MEB and headache characteristics or diagnosis. RESULTS: A total of 95 patients (94% male) with concussion described 166 distinct headache types, the most common being migraine (60%) and trigeminal autonomic cephalalgia (24%). A total of 25% of all patients remained on active duty. A continuous headache of any type was present in 75% of patients and of these, 23% remained on active duty. Of the 51% of patients who had both a continuous and non-continuous headache, 17% remained on active duty (P < .001). Therefore, we report that a continuous headache, regardless of diagnosis type was associated with negative occupational outcomes. Regardless of headache duration, headache diagnosis type alone was not associated with soldiers' separations from service. CONCLUSIONS: Persistent post-traumatic headache is most likely to present with continuous pain. Migraine is the most common primary diagnosis type. The presence of a continuous headache was strongly associated with negative occupational outcomes. Primary headache diagnosis type was not. Headache characteristics, therefore, may be more important than diagnosis type when determining active duty status. Further prospective research is indicated.

12 Article The Impact of Post-Traumatic Stress Disorder on the Burden of Migraine: Results From the National Comorbidity Survey-Replication. 2015

Rao, Aruna S / Scher, Ann I / Vieira, Rebeca V A / Merikangas, Kathleen R / Metti, Andrea L / Peterlin, B Lee. ·Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. · Uniformed Services University, Bethesda, MD, USA. · Department of Psychology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. · National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA. · Metti Consulting, Pittsburgh, PA, USA. ·Headache · Pubmed #26473981.

ABSTRACT: BACKGROUND: Post-traumatic stress disorder (PTSD) has been linked with migraine in prior studies. OBJECTIVE: To evaluate the individual and joint burdens of migraine and PTSD in a population-based cohort. METHODS: The National Comorbidity Survey-Replication (NCS-R) is a general population study conducted in the United States from February 2001-April 2003. PTSD and migraine were assessed, and four groups defined based on their migraine and PTSD status. The four groups included those with no migraine and no PTSD (controls, n=4535), those with migraine and without PTSD (migraine alone, n=236), those with PTSD and without migraine (PTSD alone, n=244), and those with both migraine and PTSD (mig+PTSD, n=68). Logistic and Poisson regression models were used to assess the association between dichotomous/multilevel outcome variables indicating financial, health, and interpersonal burdens and each migraine/PTSD group. RESULTS: Compared to controls, those with Mig+PTSD were more likely to be in the low poverty index (48% vs 41%, AOR 2.16; CI: 1.10, 4.24) and were less likely to be working for pay or profit in the past week (50% vs 68%, AOR 0.42; CI: 0.24, 0.74) but not those with migraine or PTSD alone. Additionally, the number of days where work quality was cut due to physical or mental health or substance abuse in the past month was greater in all groups compared to controls: (1) migraine alone: mean 2.57 (SEM 0.32) vs mean 1.09 (SEM 0.08) days, ARR=2.39; CI: 2.19, 2.62; (2) PTSD alone: mean 2.43 (SEM 0.33) vs mean 1.09 (SEM 0.08) days, ARR=2.09; CI: 1.91, 2.29; (3) mig+PTSD: mean 8.2 (SEM 0.79) vs 1.09 (SEM 0.08) days, ARR 6.79; CI 6.16, 7.49; and was over 2.5-fold greater in those mig+PTSD than migraine alone (mean 8.0 [SEM 0.79] vs 2.6 days [SEM 0.72], ARR 2.77; CI: 2.45, 3.14). The likelihood of having difficulty getting along or maintaining a social life was also increased in all groups relative to controls: (1) migraine alone: 21% vs 5.4%, AOR 4.20; CI: 2.62, 6.74; (2) PTSD alone: 18% vs 5.4%, AOR 3.40; CI: 2.40, 4.82; (3) Mig+PTSD: 39% vs 5.4%, AOR 9.95; CI: 5.72, 17.32, and was 2-fold greater in those with Mig+PTSD as compared to those with migraine alone (AOR 2.32; CI: 1.15, 4.69). CONCLUSIONS: These findings support the need for those who treat migraine patients to be aware of the comorbidity with PTSD, as these patients may be particularly prone to adverse financial, health, and interpersonal disease burdens.

13 Article Ictal adipokines are associated with pain severity and treatment response in episodic migraine. 2015

Chai, Nu Cindy / Gelaye, Bizu / Tietjen, Gretchen E / Dash, Paul D / Gower, Barbara A / White, Linda W / Ward, Thomas N / Scher, Ann I / Peterlin, B Lee. ·From the Department of Neurology (N.C.C., L.W.W., B.L.P.), Johns Hopkins University School of Medicine, Baltimore, MD · Department of Anesthesia (N.C.C.), University of California, San Francisco · Department of Epidemiology (B.G.), Harvard School of Public Health, Boston, MA · Department of Neurology (G.E.T.), University of Toledo, OH · Department of Neurology (P.D.D.), Johns Hopkins Community Physicians, Baltimore, MD · Department of Nutrition Sciences (B.A.G.), University of Alabama at Birmingham · Department of Neurology (T.N.W.), Dartmouth Hitchcock Medical Center, Lebanon, NH · and Uniformed Services University (A.I.S.), Bethesda, MD. ·Neurology · Pubmed #25746563.

ABSTRACT: OBJECTIVE: To evaluate ictal adipokine levels in episodic migraineurs and their association with pain severity and treatment response. METHODS: This was a double-blind, placebo-controlled trial evaluating peripheral blood specimens from episodic migraineurs at acute pain onset and 30 to 120 minutes after treatment with sumatriptan/naproxen sodium vs placebo. Total adiponectin (T-ADP), ADP multimers (high molecular weight [HMW], middle molecular weight, and low molecular weight [LMW]), leptin, and resistin levels were evaluated by immunoassays. RESULTS: Thirty-four participants (17 responders, 17 nonresponders) were included. In all participants, pretreatment pain severity increased with every quartile increase in both the HMW:T-ADP ratio (coefficient of variation [CV] 0.51; 95% confidence interval [CI]: 0.08, 0.93; p = 0.019) and resistin levels (CV 0.58; 95% CI: 0.21, 0.96; p = 0.002), but was not associated with quartile changes in leptin levels. In responders, T-ADP (CV -0.98; 95% CI: -1.88, -0.08; p = 0.031) and resistin (CV -0.95; 95% CI: -1.83, -0.07; p = 0.034) levels decreased 120 minutes after treatment as compared with pretreatment. In addition, in responders, the HMW:T-ADP ratio (CV -0.04; 95% CI: -0.07, -0.01; p = 0.041) decreased and the LMW:T-ADP ratio (CV 0.04; 95% CI: 0.01, 0.07; p = 0.043) increased at 120 minutes after treatment. In nonresponders, the LMW:T-ADP ratio (CV -0.04; 95% CI: -0.07, -0.01; p = 0.018) decreased 120 minutes after treatment. Leptin was not associated with treatment response. CONCLUSIONS: Both pretreatment migraine pain severity and treatment response are associated with changes in adipokine levels. Adipokines represent potential novel migraine biomarkers and drug targets.

14 Article Midlife migraine and late-life parkinsonism: AGES-Reykjavik study. 2014

Scher, Ann I / Ross, G Webster / Sigurdsson, Sigurdur / Garcia, Melissa / Gudmundsson, Larus S / Sveinbjörnsdóttir, Sigurlaug / Wagner, Amy K / Gudnason, Vilmundur / Launer, Lenore J. ·From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda · National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD · Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu · Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI · Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur · School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik · Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK · and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA. ·Neurology · Pubmed #25230997.

ABSTRACT: OBJECTIVE: In the present study, we tested the hypothesis that having migraine in middle age is related to late-life parkinsonism and a related disorder, restless legs syndrome (RLS), also known as Willis-Ekbom disease (WED). METHODS: The AGES-Reykjavik cohort (born 1907-1935) has been followed since 1967. Headaches were classified based on symptoms assessed in middle age. From 2002 to 2006, 5,764 participants were reexamined to assess symptoms of parkinsonism, diagnosis of Parkinson disease (PD), family history of PD, and RLS/WED. RESULTS: Subjects with midlife migraine, particularly migraine with aura (MA), were in later life more likely than others to report parkinsonian symptoms (odds ratio [OR]MA = 3.6 [95% CI 2.7-4.8]) and diagnosed PD (ORMA = 2.5 [95% CI 1.2-5.2]). Women with MA were more likely than others to have a parent (ORMA = 2.26 [95% CI 1.3-4.0]) or sibling (ORMA = 1.78 [95% CI 1.1-2.9]) with PD. Late-life RLS/WED was increased for headache generally. Associations were independent of cardiovascular disease and MRI-evident presumed ischemic lesions. CONCLUSIONS: These findings suggest there may be a common vulnerability to, or consequences of, migraine and multiple indicators of parkinsonism. Additional genetic and longitudinal observational studies are needed to identify candidate pathways that may account for the comorbid constellation of symptoms.

15 Article Headache linked with incidence of metabolic syndrome: comment on migraine, headache and development of metabolic syndrome: an 11-year follow-up in the HUNT study. 2013

Voss, Jameson D / Scher, Ann I. ·Department of Preventive Medicine and Biometrics, Uniformed Services University, Bethesda, MD, USA. ·Pain · Pubmed #23707292.

ABSTRACT: -- No abstract --

16 Article Migraine, depression, and brain volume: the AGES-Reykjavik Study. 2013

Gudmundsson, Larus S / Scher, Ann I / Sigurdsson, Sigurdur / Geerlings, Mirjam I / Vidal, Jean-Sebastien / Eiriksdottir, Gudny / Garcia, Melissa I / Harris, Tamara B / Kjartansson, Olafur / Aspelund, Thor / van Buchem, Mark A / Gudnason, Vilmundur / Launer, Lenore J. ·Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, National Institute on Aging, Bethesda, MD, USA. larus.gudmundsson@usuhs.edu ·Neurology · Pubmed #23700334.

ABSTRACT: OBJECTIVE: To examine the joint association of migraine headache and major depressive disorder on brain volume in older persons without dementia. METHODS: Participants (n = 4,296, 58% women) from the population-based Age, Gene/Environment Susceptibility-Reykjavik Study were assessed for migraine headache in 1967-1991 (age 51 years [range 33-65]) according to modified International Classification of Headache Disorders-II criteria. In 2002-2006 (age 76 years [range 66-96]), lifetime history of major depressive disorder (depression) was diagnosed according to DSM-IV criteria, and full-brain MRI was acquired, which was computer postprocessed into total brain volume (TBV) (gray matter [GM], white matter [WM], white matter hyperintensities) and CSF volume for each study subject. We compared brain tissue volumes by headache categories with or without depression using linear regression, adjusting for intracranial volume and other factors. RESULTS: Compared with the reference group (no headache, no depression) TBV and WM and GM volumes were smaller in those with both migraine and depression (TBV -19.2 mL, 95% confidence interval [CI] -35.3, -3.1, p = 0.02; WM -12.8 mL, CI -21.3, -4.3, p = 0.003; GM -13.0 mL, CI -26.0, 0.1, p = 0.05) but not for those with migraine alone (TBV 0.4 mL, WM 0.2 mL, GM 0.6 mL) or depression alone (TBV -3.9 mL, WM -0.9 mL, GM -2.9 mL). CONCLUSIONS: Reporting both migraine and major depressive disorder was associated with smaller brain tissue volumes than having one or neither of these conditions. Migraineurs with depression may represent a distinct clinical phenotype with different long-term sequelae. Nonetheless, the number of subjects in the current study is relatively small and these findings need to be confirmed in future studies.

17 Article Haplotype analysis of the folate-related genes MTHFR, MTRR, and MTR and migraine with aura. 2013

Roecklein, Kathryn A / Scher, Ann I / Smith, Albert / Harris, Tamara / Eiriksdottir, Gudny / Garcia, Melissa / Gudnason, Villi / Launer, Lenore J. ·Department of Psychology, Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA 15260, USA. kroecklein@gmail.com ·Cephalalgia · Pubmed #23430981.

ABSTRACT: AIMS: The C677T variant in the methylenetetrahydrofolate reductase ( MTHFR ; EC enzyme, a key player in the folate metabolic pathway, has been associated with increased risk of migraine with aura. Other genes encoding molecular components of this pathway include methionine synthase ( MTR ; EC and methionine synthase reductase ( MTRR ; EC among others. We performed a haplotype analysis of migraine risk and MTHFR , MTR , and MTRR . METHODS: Study participants are from a random sub-sample participating in the population-based AGES-Reykjavik Study, including subjects with non-migraine headache ( N = 367), migraine without aura ( N = 85), migraine with aura ( N = 167), and no headache ( N = 1347). Haplotypes spanning each gene were constructed using Haploview. Association testing was performed on single SNP and haplotypes using logistic regression, controlling for demographic and cardiovascular risk factors and correcting for multiple testing. RESULTS: Haplotype analysis suggested an association between MTRR haplotypes and reduced risk of migraine with aura. All other associations were not significant after correcting for multiple testing. CONCLUSIONS: These results suggest that MTRR variants may protect against migraine with aura in an older population.

18 Article Lack of association between the MTHFR C677T variant and migraine with aura in an older population: could selective survival play a role? 2013

Scher, Ann I / Eiriksdottir, Gudny / Garcia, Melissa / Feit, Preethy / Smith, Albert V / Harris, Tamara B / Roecklein, Kathryn A / Gudmundsson, Larus S / Gudnason, Vilmundur / Launer, Lenore J. ·Department of Preventive Medicine and Biometrics, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD 20814, USA. ann.scher@usuhs.edu ·Cephalalgia · Pubmed #23230240.

ABSTRACT: BACKGROUND: Several studies, but not all, of primarily middle-aged or younger adults have suggested that the common MTHFR C677T variant is a genetic risk factor for migraine with aura (MA). Here, we consider whether this variant is associated with MA risk in an older non-clinical population (AGES-Reykjavik cohort). METHODS: Participants are a sub-sample ( N  = 1976) of subjects from the Reykjavik Study (RS; mean age 50) and its continuation, AGES-RS (mean age 76). We estimated the relative odds of MA in TT versus CC carriers using multinomial logistic regression. As both MA and the TT genotype may be linked with modestly reduced longevity, we performed a simple simulation to illustrate the effect that selective survival may have had on our observed gene-disease association. RESULTS: TT versus CC carriers were at marginally reduced odds of MA (ORTT 0.55 (0.3-1.0), P  = 0.07), significantly for women (ORTT 0.45 (0.2-0.9), P  = 0.03). Assuming the 'true' (e.g. mid-life) effect of the TT genotype is ORTT 1.26, from a recent meta-analysis, our simulation suggested that if 25-year mortality had been (hypothetically) 13% higher in MA subjects with the TT versus CC genotype, the measured effect of the TT genotype on MA would have been attenuated to non-significance (e.g. ORTT 1.00). Our observed protective effect was consistent with the most extreme selective mortality scenario, in which essentially all of the previously reported increased mortality in MA subjects was (hypothetically) found in CT or TT carriers. CONCLUSION: The MTHFR 677TT genotype was associated with marginally reduced risk of MA in our older population. Our simulation illustrated how even modest selective survival might obscure the apparent effect of a genetic or other risk factor in older populations. We speculate that some of the heterogeneity previously observed for this particular genetic variant may be due to age range differences in the studied populations.

19 Article Migraine with aura and risk of cardiovascular and all cause mortality in men and women: prospective cohort study. 2010

Gudmundsson, Larus S / Scher, Ann I / Aspelund, Thor / Eliasson, Jon H / Johannsson, Magnus / Thorgeirsson, Gudmundur / Launer, Lenore / Gudnason, Vilmundur. ·Department of Pharmacology and Toxicology, University of Iceland, Hagi Hofsvallagata 53, IS-107 Reykjavik, Iceland. lsg@hi.is ·BMJ · Pubmed #20736269.

ABSTRACT: OBJECTIVE: To estimate whether migraine in mid-life is associated with mortality from cardiovascular disease, other causes, and all causes. DESIGN: Population based cohort study. SETTING: Reykjavik, Iceland. PARTICIPANTS: 18,725 men and women, born 1907-35 and living in Reykjavik and adjacent communities. MAIN OUTCOME MEASURES: Mortality from cardiovascular disease, non-cardiovascular disease, and all causes. Questionnaires and clinical measures were obtained in mid-life (mean age 53, range 33-81) in the Reykjavik Study (1967-91). Headache was classified as migraine without aura, migraine with aura, or non-migraine headache. Median follow-up was 25.9 years (0.1-40.2 years), with 470,990 person years and 10,358 deaths: 4323 from cardiovascular disease and 6035 from other causes. We used Cox regression to estimate risk of death in those with migraine compared with others, after adjusting for baseline risk factors. RESULTS: People with migraine with aura were at increased risk of all cause mortality (adjusted (for sex and multivariables) hazard ratio 1.21, 95% confidence interval 1.12 to 1.30) and mortality from cardiovascular disease (1.27, 1.13 to 1.43) compared with people with no headache, while those with migraine without aura and non-migraine headache were not. Further examination of mortality from cardiovascular disease shows that people with migraine with aura were at increased risk of mortality from coronary heart disease (1.28, 1.11 to 1.49) and stroke (1.40, 1.10 to 1.78). Women with migraine with aura were also at increased risk of mortality from non-cardiovascular disease (1.19, 1.06 to 1.35). CONCLUSIONS: Migraine with aura is an independent risk factor for cardiovascular and all cause mortality in men and women. The risk of mortality from coronary heart disease and stroke mortality is modestly increased in people with migraine, particularly those with aura.

20 Article Obesity and migraine: the effect of age, gender and adipose tissue distribution. 2010

Peterlin, B Lee / Rosso, Andrea L / Rapoport, Alan M / Scher, Ann I. ·Drexel University College of Medicine - Neurology, Philadelphia, PA, USA. ·Headache · Pubmed #19496830.

ABSTRACT: OBJECTIVE: To evaluate the prevalence of migraine/severe headaches in those with and without general obesity and abdominal obesity (Abd-O) and the effect of gender and age on this relationship. BACKGROUND: General, or total body obesity (TBO), as estimated by body mass index, is a risk factor for migraine chronification. However, there are conflicting data as to whether TBO is associated with migraine prevalence. Abd-O has been shown to be a better predictor of various disease states than TBO, but has not been evaluated in general population studies in association with migraine. METHODS: Data from a general population survey, the National Health and Nutrition Examination Survey, were used to obtain demographics, self-report of migraine/severe headaches and measured body mass indices, including height, weight, and waist circumference. All analyses were stratified by age and gender and multivariate analyses were determined through use of logistic regression models. RESULTS: A total of 21,783 participants were included in the analysis. Between 20-55 years of age, the prevalence of migraine was increased in both men and women with TBO as compared with those without, (P The relationship between migraine and obesity varies by age, gender, and adipose tissue distribution (eg, TBO vs Abd-O). In men and women

21 Article Migraine headache in middle age and late-life brain infarcts. 2009

Scher, Ann I / Gudmundsson, Larus S / Sigurdsson, Sigurdur / Ghambaryan, Anna / Aspelund, Thor / Eiriksdottir, Gudny / van Buchem, Mark A / Gudnason, Vilmundur / Launer, Lenore J. ·Uniformed Services University, Bethesda, Maryland, USA. ·JAMA · Pubmed #19549973.

ABSTRACT: CONTEXT: Migraine is considered to be an episodic condition with no long-term consequences. However, recent studies suggest that migraine attacks may be associated with pathologic changes in the brain, particularly in the cerebellum. OBJECTIVE: To determine whether individuals not reporting headache compared with individuals reporting migraine symptoms, particularly aura, in midlife are at increased risk of late-life infarct-like lesions found on magnetic resonance imaging (MRI) without consideration of clinical symptoms. DESIGN, SETTING, AND PARTICIPANTS: A population-based study of men and women in Reykjavik, Iceland (cohort born 1907-1935; n = 4689; 57% women) were followed up since 1967, examined, and interviewed about migraine symptoms in midlife (mean age, 51 years; range, 33-65 years). Between 2002 and 2006, more than 26 years later, brain MRIs were performed. Participants reporting headaches once or more per month were asked about migraine symptoms including nausea, unilateral location, photophobia, visual disturbance, and numbness. These individuals with headache were classified as having migraine without aura, migraine with aura, or nonmigraine headache. A comprehensive cardiovascular risk assessment was performed at both examinations. MAIN OUTCOME MEASURE: Presence of infarct-like lesions (total) and specifically located in the cortical, subcortical, and cerebellar regions. RESULTS: Infarct-like lesions were present in 39.3% of men and 24.6% of women. After adjusting for age, sex, and follow-up time, compared with those not reporting headaches once or more per month (n = 3243), those with midlife migraine with aura (n = 361) had an increased risk of late-life infarct-like lesions (adjusted odds ratio [OR], 1.4; 95% confidence interval [CI], 1.1-1.8) that specifically reflected an association with cerebellar lesions in women (prevalence of infarcts 23.0% for women with migraine with aura vs 14.5% for women not reporting headaches; adjusted OR, 1.9; 95% CI, 1.4-2.6 vs a 19.3% prevalence of infarcts for men with migraine with aura vs 21.3% for men not reporting headaches; adjusted OR, 1.0; 95% CI, 0.6-1.8; P<.04 for interaction by sex). Migraine without aura and nonmigraine headache were not associated with an increased risk. CONCLUSIONS: Migraine with aura in midlife was associated with late-life prevalence of cerebellar infarct-like lesions on MRI. This association was statistically significant only for women. This is consistent with the hypothesis that migraine with aura in midlife is associated with late-life vascular disease in the cerebellum and in women.

22 Article C-reactive protein in migraine sufferers similar to that of non-migraineurs: the Reykjavik Study. 2009

Gudmundsson, L S / Aspelund, T / Scher, A I / Thorgeirsson, G / Johannsson, M / Launer, L J / Gudnason, V. ·Department of Pharmacology and Toxicology, University of Iceland, Hagi Hofsvallagata 53, IS-107 Reykjavik, Iceland. lsg@hi.is ·Cephalalgia · Pubmed #19438929.

ABSTRACT: C-reactive protein (CRP), a marker of inflammation, has been associated with cardiovascular disease. Risk of cardiovascular disease is increased in migraineurs with aura. Results from a clinical report, case-control and a cohort study suggest that CRP is elevated in migraineurs compared with non-migraineurs. We examined the proposed association in a case-control study nested within two large population-based studies. The relationship between migraine and CRP (high-sensitivity CRP) was studied in 5906 men and women aged 55.0 +/- 8.5 years in the Reykjavik Study and 1345 men and women aged 27.7 +/- 5.5 years from the Reykjavik Study for the Young. A modified version of the International Headache Society's criteria was used to categorize people into migraineurs (two or more symptoms) or non-migraineurs. Migraineurs with visual or sensory symptoms were further defined as having migraine with aura (MA) or without aura (MO). Multivariable-adjusted CRP levels were similar in migraineurs and non-migraineurs for men (0.83 vs. 0.79 mg/l, P = 0.44) and for women (0.87 vs. 0.87 mg/l, P = 0.90). When further stratified by migraine aura and age, no differences were found between non-migraineurs, MO and MA among men. In women, CRP levels were borderline higher in those with MO compared with non-migraineurs and those with MA (1.01 mg/l vs. 0.81 and 0.75 mg/l, P = 0.08 and P = 0.08) in age group 19-34 years, but significantly lower in age group 60-81 years (0.52 mg/l vs. 1.07 and 1.01 mg/l, P = 0.007 and P = 0.03). CRP levels were not increased among migraine sufferers compared with non-migraineurs. Older women migraineurs without aura had lower CRP values than non-migraineurs and migraineurs with aura.

23 Minor Migraine: migraine with aura increases the risk of stroke. 2010

Scher, Ann I / Launer, Lenore J. · ·Nat Rev Neurol · Pubmed #20212428.

ABSTRACT: -- No abstract --