Stewart W F, Bigal M E, Kolodner K, Dowson A, Liberman J N, Lipton R B
Center for Health Research and Rural Advocacy, Geisinger Health System, Baltimore, MD, USA.
Neurology. 2006 Feb 14;66(3):344-8. doi: 10.1212/01.wnl.0000196640.71600.00.
It is well established that migraine aggregates within families. Less is known about the influence of proband characteristics (e.g., age at onset, headache severity) on familial aggregation.
To examine the association between the proband's migraine severity and age at migraine onset and familial aggregation of migraine.
The authors investigated the migraine prevalence in first-degree relatives of 532 persons with migraine and control subjects in a population study. Familial aggregation was expressed as the risk of migraine in family members of probands divided by risk in control family members.
The relative risk (RR) of migraine in first-degree relatives of migraine probands was elevated compared with family members of controls (RR = 1.88; 95% CI: 1.30 to 2.72). The RR was also significantly higher for relatives of probands reporting onset of migraine before age 16 (2.50; 95% CI: 1.65 to 3.79) compared with those with onset at age 16 or older (1.44; 95% CI: 0.93 to 2.23). Among probands with very severe average pain scores (i.e., 9 to 10 on a 0 to 10 scale), the RR of migraine in family members was 2.38 (95% CI: 1.56 to 3.62) compared with 1.52 (0.99 to 2.34) for less severe pain (p < 0.05).
Early onset of migraine in the proband as well as the severity of migraines are associated with higher levels of family aggregation.
偏头痛在家族中具有聚集性,这一点已得到充分证实。关于先证者特征(如发病年龄、头痛严重程度)对家族聚集性的影响,人们了解得较少。
研究先证者偏头痛严重程度、偏头痛发病年龄与偏头痛家族聚集性之间的关联。
作者在一项人群研究中调查了532名偏头痛患者的一级亲属和对照者的偏头痛患病率。家族聚集性用先证者家庭成员患偏头痛的风险除以对照家庭成员的风险来表示。
与对照家庭成员相比,偏头痛先证者的一级亲属患偏头痛的相对风险(RR)升高(RR = 1.88;95%可信区间:1.30至2.72)。与偏头痛发病年龄在16岁及以上的先证者的亲属相比,报告偏头痛发病年龄在16岁之前的先证者的亲属的RR也显著更高(2.50;95%可信区间:1.65至3.79)(1.44;95%可信区间:0.93至2.23)。在平均疼痛评分非常高(即0至10分的评分中为9至10分)的先证者中,家庭成员患偏头痛的RR为2.38(95%可信区间:1.56至3.62),而疼痛较轻者的RR为1.52(0.99至2.34)(p < 0.05)。
先证者偏头痛的早发以及偏头痛的严重程度与更高水平的家族聚集性相关。