Department of Neurology, Leiden University Medical Centre, Albinusdreef 2, PO Box 9600, 2300 RC Leiden, the Netherlands. G
Neurology. 2010 Jan 26;74(4):288-94. doi: 10.1212/WNL.0b013e3181cbcd19. Epub 2010 Jan 13.
To investigate the co-occurrence of migraine and depression and assess whether shared genetic factors may underlie both diseases.
Subjects were 2,652 participants of the Erasmus Rucphen Family genetic isolate study. Migraine was diagnosed using a validated 3-stage screening method that included a telephone interview. Symptoms of depression were assessed using the Center for Epidemiologic Studies Depression scale and the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). The contribution of shared genetic factors in migraine and depression was investigated by comparing heritability estimates for migraine with and without adjustment for symptoms of depression, and by comparing the heritability scores of depression between migraineurs and controls.
We identified 360 migraine cases: 209 had migraine without aura (MO) and 151 had migraine with aura (MA). Odds ratios for depression in patients with migraine were 1.29 (95% confidence interval [CI] 0.98-1.70) for MO and 1.70 (95% CI 1.28-2.24) for MA. Heritability estimates were significant for all migraine (0.56), MO (0.77), and MA (0.96), and decreased after adjustment for symptoms of depression or use of antidepressant medication, in particular for MA. Comparison of the heritability scores for depression between patients with migraine and controls showed a genetic correlation between HADS-D score and MA.
There is a bidirectional association between depression and migraine, in particular migraine with aura, which can be explained, at least partly, by shared genetic factors.
研究偏头痛和抑郁症的共病情况,并评估是否存在共同的遗传因素导致这两种疾病。
研究对象为 2652 名伊拉斯谟鲁琛家族遗传隔离研究的参与者。偏头痛通过一种经过验证的 3 阶段筛查方法进行诊断,该方法包括电话访谈。使用流行病学研究抑郁量表和医院焦虑和抑郁量表(HADS-D)的抑郁分量表评估抑郁症状。通过比较偏头痛患者中未经调整和调整抑郁症状后的偏头痛遗传度估计值,以及比较偏头痛患者和对照组之间的抑郁遗传度评分,来研究偏头痛和抑郁症中共同遗传因素的贡献。
我们确定了 360 例偏头痛病例:209 例为无先兆偏头痛(MO),151 例为有先兆偏头痛(MA)。偏头痛患者患抑郁症的比值比(OR)为 MO(95%置信区间[CI] 0.98-1.70)和 MA(1.28-2.24)。所有偏头痛(0.56)、MO(0.77)和 MA(0.96)的遗传度估计值均具有统计学意义,且在调整抑郁症状或使用抗抑郁药物后降低,特别是 MA。偏头痛患者和对照组之间的抑郁遗传度评分比较显示,HADS-D 评分与 MA 之间存在遗传相关性。
抑郁症与偏头痛之间存在双向关联,特别是偏头痛伴先兆,这至少部分可以通过共同的遗传因素来解释。