Eid Karine, Torkildsen Øivind, Aarseth Jan, Cortese Marianna, Holmøy Trygve, Myhr Kjell-Morten, Riise Trond, Wergeland Stig, Gilhus Nils Erik, Bjørk Marte-Helene
Neuro-SysMed, Department of Neurology, Haukeland University Hospital Jonas Lies Vei 71, 5053, Bergen, Norway.
Norwegian Centre for Headache Research, Norwegian University of Science and Technology, Trondheim, Norway.
J Headache Pain. 2024 Dec 23;25(1):225. doi: 10.1186/s10194-024-01941-w.
People with multiple sclerosis (MS) have an increased risk of migraine. However, little is known about migraine and other headaches during the prodromal phase (before MS symptom onset). Our objective was to study the risk of migraine in women with MS before MS onset.
A nationwide, prospective cohort study of women participating in the Norwegian Mother, Father, and Child cohort study 1999-2008. The women reported the occurrence of migraine and other headaches prior to or during pregnancy. We identified women who later developed MS through data linkage with national health registries in 2018. We excluded women with an established MS diagnosis (n = 125) and women who had experienced their first clinical symptom of MS, but not yet received an MS diagnosis (n = 91). The reference group comprised all other women in the cohort (n = 85,292). We used logistic regression to estimate adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs).
Two hundred and forty-six women developed MS during follow-up. Of these, 116 women had MS symptom onset after 1-5 years, 92 after 6-10 years, and 38 after 10 years. Migraine was more common among women who developed MS compared to the reference group, 18% vs 11%, aOR 1.6 (1.2-2.3), adjusted for age, smoking, socioeconomic status and overweight. The risk of other headaches was similar for women who developed MS compared to the reference group, 29% vs 27%, aOR 1.1 (0.8-1.4). Migraine was reported by 21 of 116 (18%) women with 5 years until MS symptom onset (aOR 1.7 [1.1-2.8]) and 19 of 92 (21%) women with 6-10 years until MS symptom onset (aOR 1.9 [1.1-2.8]. Only three of 38 (8%) women with > 10 years until MS symptom onset reported migraine, aOR 0.7 (0.2-2.2).
Women with MS have increased risk of migraine, but not other headaches, up to a decade before the onset of classical MS symptoms. This supports that migraine can be a symptom of the MS prodrome. Special attention in people with migraine may lead to earlier recognition of MS.
多发性硬化症（MS）患者患偏头痛的风险增加。然而，对于前驱期（MS症状出现之前）的偏头痛和其他头痛情况知之甚少。我们的目的是研究MS发病前女性患偏头痛的风险。
对1999 - 2008年参与挪威母婴队列研究的女性进行全国性前瞻性队列研究。这些女性报告了怀孕前或怀孕期间偏头痛和其他头痛的发生情况。我们通过与2018年国家健康登记处的数据链接，确定了后来患MS的女性。我们排除了已确诊MS的女性（n = 125）以及经历了MS的首个临床症状但尚未确诊的女性（n = 91）。参照组包括队列中的所有其他女性（n = 85,292）。我们使用逻辑回归来估计调整后的优势比（aORs）及95%置信区间（95% CIs）。
246名女性在随访期间患了MS。其中，116名女性在1 - 5年后出现MS症状，92名在6 - 10年后出现，38名在10年后出现。与参照组相比，患MS的女性中偏头痛更为常见，分别为18%和11%，调整年龄、吸烟、社会经济地位和超重因素后，aOR为1.6（1.2 - 2.3）。与参照组相比，患MS的女性出现其他头痛的风险相似，分别为29%和27%，aOR为1.1（0.8 - 1.4）。在出现MS症状前5年的116名女性中有21名（18%）报告有偏头痛（aOR 1.7 [1.1 - 2.8]），在出现MS症状前6 - 10年的92名女性中有19名（21%）报告有偏头痛（aOR 1.9 [1.1 - 2.8]）。在出现MS症状前超过10年的38名女性中只有3名（8%）报告有偏头痛，aOR为0.7（0.2 - 2.2）。
在典型MS症状出现前长达十年的时间里，MS女性患偏头痛的风险增加，但其他头痛风险未增加。这支持偏头痛可能是MS前驱期的一种症状。对偏头痛患者给予特别关注可能会导致MS的更早识别。
