偏头痛与女性帕金森病风险：一项队列研究。
Migraine and Risk of Parkinson Disease in Women: A Cohort Study.
机构信息
From the Charité - Universitätsmedizin Berlin (R.S.S., T.G., T.K.), corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Public Health, Germany; and Division of Preventive Medicine (J.E.B., P.M.R., T.K.), Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
出版信息
Neurology. 2024 Sep 24;103(6):e209747. doi: 10.1212/WNL.0000000000209747. Epub 2024 Aug 21.
BACKGROUND AND OBJECTIVES
Migraine and Parkinson disease (PD) are common neurologic disorders, which are hypothesized to share some pathophysiologic mechanisms. However, data on the association between migraine and risk of developing PD are sparse. We estimate the effect of migraine, migraine subtypes, and migraine episode frequency on the risk of developing PD in middle-aged and older women.
METHODS
We used data from the Women's Health Study, a United States-based cohort of women in health professions aged 45 years and older at baseline (1992-1995). Only women with complete self-reported information on migraine and headache and no history of PD were included. Participants were followed up for self-reported physician-diagnosed PD through December 31, 2021. We used multivariable Cox proportional hazards models to estimate hazard ratios (HRs) and corresponding 95% CIs of the association between migraine, migraine subtypes, and migraine episode frequency and the risk of developing PD.
RESULTS
A total of 39,312 women were included in the analyses. Among those, 7,321 women (18.6%) reported any migraine at baseline, of whom 2,153 (5.5%) reported a history of migraine, 2,057 (5.2%) reported migraine with aura, and 3,111 (7.9%) reported migraine without aura. During a mean follow-up of 22.0 years, 685 PD cases were reported. Of those, 128 (18.7%) were reported by women who also reported any migraine and 557 (81.3%) by women without any migraine. After adjusting for confounding, the HR for the association of any migraine on the risk of PD was 1.07 (0.88-1.29). Compared with women without migraine, the HRs (95% CI) for PD were 0.87 (0.59-1.27) for migraine with aura, 1.21 (0.93-1.58) for migraine without aura, and 1.05 (0.76-1.45) for history of migraine. Compared with those with a migraine frequency of less than monthly, the HRs were 1.09 (0.64-1.87) for a monthly frequency and 1.10 (0.44-2.75) for a weekly or greater frequency.
DISCUSSION
In this large cohort of women, the risk of developing PD was not elevated among those experiencing migraine, irrespective of migraine subtypes or the frequency of migraine. The generalizability of our findings to other populations, such as men, should be further investigated.
TRIAL REGISTRATION INFORMATION
ClinicalTrials.gov Identifier: NCT00000479.
背景与目的
偏头痛和帕金森病（PD）是常见的神经系统疾病，据推测它们具有一些共同的病理生理机制。然而，偏头痛与 PD 发病风险之间的关联数据有限。本研究旨在评估偏头痛、偏头痛亚型和偏头痛发作频率对中年及以上女性发生 PD 的影响。
方法
我们使用了美国妇女健康研究的数据，该研究是一项基于队列的研究，参与者为基线时（1992-1995 年）年龄在 45 岁及以上的卫生专业女性。仅纳入有完整的偏头痛和头痛自我报告信息且无 PD 病史的女性。通过截至 2021 年 12 月 31 日的自我报告的医生诊断 PD 对参与者进行随访。我们使用多变量 Cox 比例风险模型来估计偏头痛、偏头痛亚型和偏头痛发作频率与发生 PD 风险之间的关联的风险比（HR）和相应的 95%置信区间（CI）。
结果
共有 39312 名女性纳入分析。其中，7321 名女性（18.6%）在基线时报告有任何偏头痛，其中 2153 名（5.5%）报告有偏头痛病史，2057 名（5.2%）报告有偏头痛伴先兆，3111 名（7.9%）报告有偏头痛无先兆。在平均 22.0 年的随访期间，报告了 685 例 PD 病例。其中，128 例（18.7%）由报告有任何偏头痛的女性报告，557 例（81.3%）由无偏头痛的女性报告。调整混杂因素后，任何偏头痛与 PD 风险的关联的 HR 为 1.07（0.88-1.29）。与无偏头痛的女性相比，偏头痛伴先兆的 HR（95%CI）为 0.87（0.59-1.27），偏头痛无先兆的 HR 为 1.21（0.93-1.58），偏头痛病史的 HR 为 1.05（0.76-1.45）。与每月偏头痛发作频率小于每月的女性相比，每月偏头痛发作频率的 HR 为 1.09（0.64-1.87），每周或更高频率的 HR 为 1.10（0.44-2.75）。
讨论
在这项大型女性队列研究中，经历偏头痛的女性发生 PD 的风险并未升高，无论偏头痛亚型或偏头痛发作频率如何。我们的研究结果在其他人群（如男性）中的适用性有待进一步研究。
试验注册信息
ClinicalTrials.gov 标识符：NCT00000479。
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