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Migraine is a common struggle of over a billion people annually[1], often associated with a plethora of adjoined health issues. It is a frequent and well-researched yet extremely complex issue that constantly yields new findings. Aside from health complications that arise from this chronic condition, migraine impacts the mental well-being, as well as the professional and social life of those affected, significantly impacting quality of life.
The list of risk factors for migraines is extensive, yet it includes several vital aspects predominant in migraine development. One of these is the hereditary factor, as migraines have a strong, undeniable genetic component. In this guide, we will explore the inheritance of migraines while defining the different types, symptoms, and causes of this condition.
By definition, migraine is a cyclic disorder manifested as an episodic headache accompanied by sensitivity to movement, sound, and light. It is often defined as a “recurring syndrome of headache”[1], mostly occurring in four phases:
Understanding and knowing how to identify the stages of your migraine adequately can help in successfully mitigating its symptoms and creating a defense mechanism that works for you.
In addition to recognizing the phases of a migraine attack, it is essential to understand and define the type. While there are some common causes and symptoms of migraines in general, these may differ depending on the type—as well as management and treatment options.
Common migraine, as the name suggests, is the most commonly encountered form, characterized by throbbing or pulsing pain focused on one side of the head. The aura precedes the migraine and “announces” it with symptoms that mostly include visual disturbance. In this case, the migraine attack comes unannounced and can last anywhere from four hours to three days.[5]
Common migraine symptoms include:
In the case of a migraine with aura, the attack will be preceded by visual disturbances such as flashes, spots, and zigzags. While auras commonly affect vision, in severe cases, they may also alter speech and orientation.[6]
Symptoms of migraine preceded by aura include:
The subtypes of this migraine form include[6]:
Unlike common migraine that excludes the aura, silent migraine excludes the headache. In this case, a person experiences the migraine aura in full effect but not the headache that usually follows.[7] Even though the term “silent” and the fact that there’s no headache may imply that this type of migraine is less aggressive, that isn’t always the case.
Silent migraine symptoms include:
Triggered by hormonal changes and fluctuations, menstrual migraines accompany menstruation and are tied to this moment of a person’s cycle. What is recognized as the main cause of menstrual migraine is a decrease in estrogen levels and a boost in prostaglandin, which is also linked to painful periods.[8] The headaches usually occur before the period, but if a person struggles with migraines in general, they may experience them both during and after their period.
Migraines are recognized as brain disorders that develop due to interactions between genetic and environmental conditions. Multiple studies have confirmed the hereditary factor in migraine development.
The overall heritability rate of this condition varies from 35% to 60%, but more recent studies place it at about 42%. What’s more, patients with these genetic predispositions are more likely to develop migraine with aura than silent migraine (without aura).[9]
Migraines are essentially polygenic, meaning that multiple genetic variants are involved. While these variants are small, when accumulated, they jointly lead to the development of migraines.
Polygenic risk scores, which compare an individual’s genetic constitution to other structures, are vital in the investigation of a person’s migraine patterns, as well as the tailoring of the treatment process. These genetic findings could also be used to assess the potential of certain treatment options, such as monoclonal antibodies.[10]
Monogenic migraines are much more rare than polygenic cases. In these migraines, a single gene (CACNA1A, ATP1A2, or SCN1A) is affected by a pathogenic mutation, yet it is strong enough to trigger the disease.Often, the monogenic migraine develops as a result of another hereditary condition, such as a neurological or neurovascular disease.[11]
The most common form of monogenic migraine is familial hemiplegic migraine (FHM), a subcategory of hemiplegic migraine (HM) that affects only 0.01% of the general population. In cases of FHM, there must be a family history of disease, where at least one first- or second-degree relative is diagnosed with this condition.
The early symptoms of the disease are experienced in youth, including motor weakness, as well as speech or visual impairment. Moreover, the aura duration in HM cases is prolonged and can last several days to weeks. The overall symptoms of headache attacks in HM are similar to common migraine symptoms. In rare, more severe cases, these attacks can have serious consequences, including mild head trauma, hemiparalysis, and seizures.[11]
The genetic factor in the development of FHM is extremely strong since 70-90% of patients with this genetic mutation develop the disease.[11] What’s more, the genes involved in this mutation have also been linked to other disorders, such as epilepsy.[12]
Numerous studies have shown that, in addition to environmental factors, such as lack of sleep and stress, gender plays a crucial role in migraine development. While this could be attributed to hormonal fluctuations, the genetic factor cannot be excluded.[12]
The genes on the X chromosome, such as synapsin I (SYN1), could be tied to migraine risk. Certain gender-specific effects were not observed in men, suggesting that genetic factors may act differently depending on gender. Migraines are, in fact, three to four times more prevalent in women than in men.[13]
While these findings offer promising insights, more research is needed to understand the genetic mechanisms behind this gender disparity and identify the exact genes responsible.[12]
Migraines represent a complex and multifaceted condition that can be influenced by both genetic and environmental factors. Identifying the genetic components of migraines, whether polygenic or monogenic, is crucial for more accurate diagnoses, personalized treatment plans, and a deeper understanding of susceptibility to this condition. As research advances, genetic testing provides a valuable tool for identifying risk factors and tailoring preventive measures in individual treatment.
Genetic factors are at the core of numerous health conditions, including migraines. Exploring family history and genetic susceptibility to certain conditions can give you the upper hand you need to optimize your health and wellness fully.
Unlock the power of your DNA and get personalized reports and tailored recommendations based on your individual genetic makeup.
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