Gervil M, Ulrich V, Kaprio J, Olesen J, Russell M B
Department of Neurology, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark.
Neurology. 1999 Sep 22;53(5):995-9. doi: 10.1212/wnl.53.5.995.
To clarify the relative role of genetic and environmental factors in the etiology of migraine without aura (MO).
The study population consisted of 5,360 twins, 1,013 monozygotic (MZ) and 1,667 same-gender dizygotic (DZ) twin pairs, from the population-based Danish Twin Registry. A total of 87% completed a simple validated questionnaire screening for migraine. All twin pairs, in whom at least one twin had self-reported migraine or severe headache with accompanying symptoms, were interviewed via telephone by a physician. Ninety percent of the eligible twins were interviewed. Probandwise concordance rates and correlations in liability were calculated, and structural equation model-fitting analyses were applied to quantitate the relative role of genetic and environmental factors in the etiology of MO.
The probandwise concordance rate was higher in MZ than DZ twin pairs (0.43 versus 0.31; 95% CI, 0.36 to 0.49 versus 0.26 to 0.36). The correlation in liability was higher in MZ than in DZ twin pairs (0.62 versus 0.41; 95% CI, 0.50 to 0.74 versus 0.29 to 0.53). Structural equation model fitting indicated a highly significant genetic component, because a model with both genetic and environmental components fitted significantly better than a model with only environmental components. The best fitting model implied that the liability to MO resulted from additive genetic effects (61%; 95% CI, 49 to 71%)) and individual-specific environmental effects (39%; 95% CI, 29 to 51%).
This study indicates that genetic factors play a role in the etiology of migraine without aura. The genetic variability is additive, with a negligible contribution of nonadditive genetic effects. The genetic contributions were similar in men and women despite a higher prevalence in women. Environmental factors are equally important and these factors are individual to the migraineurs.
阐明遗传因素和环境因素在无先兆偏头痛（MO）病因学中的相对作用。
研究人群包括来自基于人群的丹麦双胞胎登记处的5360对双胞胎，其中1013对同卵双胞胎（MZ）和1667对同性异卵双胞胎（DZ）。共有87%的人完成了一份用于筛查偏头痛的简单有效问卷。所有双胞胎对中，至少有一个双胞胎自我报告有偏头痛或伴有相关症状的严重头痛，由一名医生通过电话进行访谈。90%符合条件的双胞胎接受了访谈。计算先证者一致率和易感性相关性，并应用结构方程模型拟合分析来量化遗传因素和环境因素在MO病因学中的相对作用。
MZ双胞胎对的先证者一致率高于DZ双胞胎对（0.43对0.31；95%可信区间，0.36至0.49对0.26至0.36）。MZ双胞胎对的易感性相关性高于DZ双胞胎对（0.62对0.41；95%可信区间，0.50至0.74对0.29至0.53）。结构方程模型拟合表明存在高度显著的遗传成分，因为同时包含遗传和环境成分的模型比仅包含环境成分的模型拟合得明显更好。最佳拟合模型表明，MO的易感性由加性遗传效应（61%；95%可信区间，49至71%）和个体特异性环境效应（39%；95%可信区间，29至51%）导致。
本研究表明遗传因素在无先兆偏头痛的病因学中起作用。遗传变异性是加性的，非加性遗传效应的贡献可忽略不计。尽管女性患病率较高，但遗传贡献在男性和女性中相似。环境因素同样重要，且这些因素因偏头痛患者个体而异。
