A recent analysis of genetic and environmental data from the world’s biggest twin database suggests that prenatal hormone levels may be connected to adult migraine risk.

The study is also the first to indicate that migraine risk genetic factors varied between men and women.

The current study published in Frontiers in Pain Research links factors in the womb to adult migraine risk. It also discovered evidence that migraine risk varies between men and women.

“We are the first to show that females with a male co-twin have a higher risk of migraine compared to females with a female co-twin, suggesting that prenatal factors, possibly relating to in utero hormone levels, may contribute to migraine risk,” says lead author Morgan Fitzgerald.

“We are also the first to present evidence that genetic factors related to migraine risk may be different between females and males.”

A debilitating illness

Migraine is a severe and devastating neurological condition that affects about 12% of the global population. Migraine is about seven times more common in women than in men, and it is a primary cause of disability in young women.

“Despite its prevalence, the factors that contribute to migraine are poorly understood,” adds Dr Matthew Panizzon, principal investigator of the study.

“With the data from the Swedish Twin Registry, the largest twin registry in the world, there was a unique opportunity to probe factors contributing to female-male differences in migraine.”

The researchers looked at data from 51,872 people who had previously taken part in Swedish Twin Registry investigations. Based on the International Headache Society Classification of Headache Disorders, they identified people who had migraine without aura.

Fitzgerald explains: “Since the data were collected from twins, we were able to use analytic methods that allowed us to test whether migraine risk was driven by different genes in females and males, and whether the presence of an opposite-sex twin in utero, which is believed to impact prenatal hormone levels, had an influence.”

“We found that the prenatal environment may contribute to migraine risk, and that some of the genetic factors that contribute to migraine risk may be different between females and males.”

New treatments

“The findings of our study are important because the more we understand the factors that contribute to migraine, and especially the differences between males and females, the more opportunity there is to improve clinical care, diagnostic abilities, and therapeutic interventions for both men and women,” adds Panizzon.

There are still some unanswered questions, such as what factors influence the existence or absence of aura in migraine sufferers, and at what age and stage of life does migraine begin.

“Unfortunately, age at onset was not available in the Swedish Twin Registry data. In fact, most studies do not ask individuals when their migraine attacks first start,” says Fitzgerald.

“In the future, we hope to examine how age at migraine onset coincides with the timing of critical hormonal events like puberty.”

Source: 10.3389/fpain.2021.766718/

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