NEUROLOGY
02.11.2016
Migraines Linked to
Parkinson's Risk
Longitudinal Taiwanese
cohort study finds link between migraines and Parkinson's disease
by Sydney
Lupkin
Reporter,
VICE News/MedPage Today
People
who have migraines may be more likely to develop Parkinson's disease, according
to a Taiwanese study.
In a longitudinal follow-up cohort study,
having two migraine diagnoses in 1 year was associated with a greater risk of
developing Parkinson's disease over about 3 years (HR 1.64, P=0.0004),
Shin-Liang
Pan, MD, PhD, of the National Taiwan University Hospital, and
colleagues reported
online in the journal Cephalalgia.Action
Points
The
researchers included Taiwanese subjects between the ages of 40 and 90 who were
diagnosed with migraines in at least two ambulatory care visits in 2001 but had
not been diagnosed with Parkinson's disease or secondary Parkinsonism the year
before. They were then score-matched to patients without migraine diagnoses in
2001 based on sex, age, comorbidity, and socioeconomic data using a two-stage
propensity score. Once patients were matched, there were 41,019 people in each
group.
During
the median 32-month follow-up, 148 patients in the migraine group and 101 patients
in the nonmigraine group were diagnosed with Parkinson's disease, suggesting a
statistically significant increase in Parkinson's risk for those with migraine.
"These
findings may highlight the importance of early risk assessment for Parkinson's
disease in migraineurs," Pan told MedPage Today,
adding that the study still had its limitations. "Future longitudinal
studies with neuroimaging and neurologic examinations are needed in order to
elucidate the relationship and the underlying pathophysiological mechanism
between migraine and Parkinson's disease."
Although
the reason for the increased risk of Parkinson's disease among patients in the
migraine group is unclear, the authors listed several suggestions. One could be
that both migraines and Parkinson's disease are the result of serotonergic and
dopaminergic system dysfunction. They also suggest both ailments could arise
from dysfunctional iron metabolism in the brain.
Since the median follow-up
time was only 32 months,the authors
couldn't determine the long-term effects of migraines on the risk of Parkinson's
disease, they wrote in the study.
And
because most older migraine patients don't present for care, it's possible the
study missed migraine patients in the migraine group and unintentionally
included them in the nonmigraine group, said Mia Minen, MD,
director of headache services at NYU Langone Medical Center, who was not
involved in the study. She added that she wasn't familiar with health insurance
data in Taiwan, but in the Pan and colleagues noted that the study
was also limited by the fact that it relied on codes in the Taiwanese National
Health Insurance claims database for diagnostic data, although these data are
audited to ensure validity.
These data also lacked lifestyle
information, such as smoking, alcohol intake, and obesity, which could have
influenced findings, they wrote.
"Since this study is an observational
study, it is subject to confounding effects arising from imbalance in clinical
characteristics between patients with and without migraine," Pan said,
explaining that the study's design attempted to make up for this weakness.
"This matching procedure required a lot of sampling and computation in the
large scale database."
The authors added that their work was also
limited by possible ascertainment bias because both migraine and Parkinson's
disease are neurological.
Still,
Minen said the study's biggest strength is its size, adding that it's
"interesting" and can pave the way for future studies.
Pan
said a good follow-up study would be to examine how having migraines effects
the risk of developing Alzheimer's disease.
The
study authors declared no conflicts of interest. The study was funded by the
Department of Health, Executive Yuan, Republic of China.
Reviewed F. Perry
Wilson, MD, MSCE Assistant Professor,
Section of Nephrology, Yale School of Medicine
Primary
Source
Cephalalgia
Source Reference: Pan S, et al
"Migraine is related to an increased risk of Parinson's disease: A
population-based propensity score-matched, longitudinal follow-up study"
Cephalalgia 2016; DOI: 10.1177/0333102416630577.
http://www.medpagetoday.com/Neurology/Migraines/56133?
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