Terhart Maria, Overeem Lucas Hendrik, Hong Ja Bin, Reuter Uwe, Raffaelli Bianca
Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Doctoral Program, International Graduate Program Medical Neurosciences, Humboldt Graduate School, Berlin, Germany.
Eur J Neurol. 2025 Mar;32(3):e16590. doi: 10.1111/ene.16590.
Migraine is a debilitating neurological disease with a multifaceted pathophysiology. Pre-existing comorbidities may influence the risk of developing migraine. This review and meta-analysis aim to present a comprehensive overview of the known comorbidities predisposing individuals to new migraine onset, thereby improving our understanding of the respective diseases' interactions.
A systematic search of PubMed and EMBASE identified studies on pre-existing comorbidities as risk factors for new migraine onset. We performed three-level meta-analyses employing restricted maximum likelihood estimation to calculate pooled risk ratios (pRR). Subgroup and sensitivity analyses were conducted to assess the robustness of the data. Risk of bias (RoB) was assessed with the Quality in Prognostic Studies Tool. This review was pre-registered on Prospero (CRD42024501140).
From a total of 17,330 records, we identified 38 studies, encompassing 124 effect sizes from 58 exposures. Most studies (n = 28, 74%) had a low RoB. Heterogeneity was high (>90%), primarily due to within-study differences (>50%), and was not significantly impacted by moderator tests or the exclusion of outliers. We found significantly increased risks for migraine onset associated with prior atopic conditions [pRR = 1.53 (1.15, 2.03)], psychiatric or psychological disorders [pRR = 2.63 (1.79, 3.85)], sleep disorders [pRR = 1.89 (1.26, 2.85)], and cardiovascular conditions [pRR = 1.72 (1.07, 2.76)].
Pre-existing atopic, psychiatric, sleep, and cardiovascular conditions are significantly associated with new migraine onset, likely due to shared genetic predisposition and mediating factors like stress and inflammation. Future research should focus on these associations to advance targeted prevention and treatment strategies.
偏头痛是一种使人衰弱的神经系统疾病，其病理生理学具有多方面特点。先前存在的合并症可能会影响患偏头痛的风险。本综述和荟萃分析旨在全面概述已知的使个体易患新发偏头痛的合并症，从而增进我们对各疾病间相互作用的理解。
对PubMed和EMBASE进行系统检索，以确定关于先前存在的合并症作为新发偏头痛风险因素的研究。我们采用限制最大似然估计进行三级荟萃分析，以计算合并风险比（pRR）。进行亚组分析和敏感性分析以评估数据的稳健性。使用预后研究质量工具评估偏倚风险（RoB）。本综述已在国际前瞻性系统评价注册库（Prospero）上预先注册（CRD42024501140）。
在总共17330条记录中，我们确定了38项研究，涵盖58种暴露因素的124个效应量。大多数研究（n = 28，74%）的偏倚风险较低。异质性较高（>90%），主要是由于研究内部差异（>50%），并且未受到调节因素检验或排除异常值的显著影响。我们发现，与先前的特应性疾病相关的偏头痛发病风险显著增加[pRR = 1.53（1.15，2.03）]，精神或心理障碍[pRR = 2.63（1.79，3.85）]，睡眠障碍[pRR = 1.89（1.26，2.85）]和心血管疾病[pRR = 1.72（1.07，2.76）]。
先前存在的特应性、精神、睡眠和心血管疾病与新发偏头痛显著相关，这可能是由于共同的遗传易感性以及压力和炎症等中介因素所致。未来的研究应关注这些关联，以推进有针对性的预防和治疗策略。
