Migraine Linked to Increased Risk of Parkinson Disease in the Middle-aged and Older Population

Article

A study presented at the MDS Congress 2022 found an association between migraine and the incidence of Parkinson disease in the middle-aged and older population.

There have been inconsistent findings from previous studies on the association between Parkinson’s disease and migraine, but new data from a study presented at the 2022 International Parkinson and Movement Disorders Society Congress, held September 15-18, in Madrid, Spain, suggest that among middle-aged and older adults, there is an association between migraine and the incidence of Parkinson disease (PD).1

Min Seok Baek, MD, assistant professor in the department of neurology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, and colleagues used a large dataset that encompassed the medical records of the nationwide population of the Republic of Korea for investigating the effects of migraine on incident PD. They aimed to explore the incidence and risks of PD in patients with migraine. 

There were a total of 214,193 individuals with migraine while 5,879,711 individuals without migraine included in the study. A follow-up of 9.1 years was conducted (55,435,626 person-years), 1973 individuals among 214,193 individuals (0.92%) with migraine were newly diagnosed with PD, while 30,664 individuals among 5,879,711 (0.52%) individuals without migraine were newly diagnosed with PD. After adjustment for covariates, the risk of PD was 1.35-fold higher in the individuals with migraine than those without migraine.1

Several Genetic Loci Show Increased Risk of Mortality, Cognitive Impairment in Parkinson Disease

One of the identified loci related to clinical progression in Parkinson disease expresses ADORA2A in the cerebellum, which encodes the adenosine A2A receptor, a promising target for therapeutics in PD.

Another finding from the research was that the incidence of PD was higher in the individuals with the chronic migraine than in those with episodic migraine (HR, 2.36; 95% CI, 2.20-2.54).1 In comparison, men who had underlying dyslipidemia had a further increased risk of PD among the individuals with migraine (P = .012). Meanwhile for women, younger age increased the risk of PD in the individuals with migraine (P = .038).

The incidence of PD in individuals with or without migraine were analyzed retrospectively using the Korean National Health Insurance Service database. Individuals aged 40 years or older (n= 6,093,904) were enrolled among those who were registered in the national health screening program in 2009. The individuals without migraine were defined as having no records of migraine diagnosis from 2002 to 2008, and the patients with migraine were defined using the International Classification of Diseases, 10th Revision(ICD-10) code G43 in2009.1 Individuals were selected using the ICD-10 code G20 and registration code V124 in the program for rare intractable diseases for those that were identified as newly diagnosed with PD.

This study is supported by previous findings from Wang et al in 2016, where the purpose of the conducted research was to investigate whether people with migraine are at a higher risk of developing PD.2 In that study, individuals (n= 41,019) aged between 40 and 90 years were enrolled in the migraine group while the nonmigraine group consisted of randomly sampled subjects (n= 41,019) without migraine. For the follow-up, 148 subjects in the migraine group and 101 in the nonmigraine group developed PD. In comparison with the nonmigraine group, the hazard ratio of PD for the migraine group was 1.64(95% CI, 1.25-2.14; P = .0004). The PD-free survival rate for the migraine group was also significantly lower than that for the nonmigraine group(P =.0041), with both studies ultimately providing evidence in their findings that there is an increased risk of developing PD in patients with migraine.

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REFERENCES
1. Baek M, Ha W, Hong J, Han K. Migraine Increases the Risk of Parkinson’s Disease in the Middle-aged and Older Population: A Nationwide Cohort Study. Presented at: MDS Annual Congress; September 15-18, 2022; Madrid, Spain. Abstract.
2. Wang HI, Ho YC, Huang YP, Pan SL. Migraine is related to an increased risk of Parkinson's disease: A population-based, propensity score-matched, longitudinal follow-up study. Cephalalgia. 2016;36(14):1316-1323. doi:10.1177/0333102416630577
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