Abstract
Objective: This study aims to measure the rate of occurrence of migraine in patients diagnosed with multiple sclerosis (MS) and to assess the associated clinical and radiological factors among MS patients with and without migraine.
Background: Several reports indicated that prevalence of migraine in patients with MS ranges between 20% and 45% in the literature. A deregulation of the serotoninergic system caused by demyelinating lesions has been linked to the headache exacerbation Periaqueductal gray matter (PAG), located in the midbrain, is thought to be a key area in the pathogenesis of migraine.
Design/Methods: This is a cross-sectional study to assess the rate of occurrence of migraine in MS patients and to compare the demographic, clinical and radiological characteristics of MS patients with and without migraine who were attending a specialized MS clinic. MS diagnosis was based on the revised 2010 McDonald criteria while migraine diagnosis based on International Classification of Headache Disorders, 3rd edition (ICHD-III-beta) criteria.
Results: Among 137 MS patients screen at the MS clinic between 1st June 2016 up to 31st August 2016, the occurrence rate of migraine was 35%. Although statistically insignificant, women and patients with younger age at MS onset were more likely to have migraine compared to MS patients without migraine. MS patients with migraine had significant involvement of the periaqueductal gray matter (PAG) ( 77% vs. 16%; p <0.0001). There was no significant association between the number of relapse or expanded disability status scale (EDSS) scores and migraine.
Conclusions: Migraine is a common comorbidity in MS patients especially in women and MS patients with young age at onset. Periaqueductal lesions on MRI brain were more prevalent in MS patients with migraine. Future studies are warranted to further assess the correlation of demyelination lesions and migraine in large cohorts.
Disclosure: Dr. Ahmed has nothing to disclose. Dr. Al Hashel has nothing to disclose. Dr. Abdelall has nothing to disclose. Dr. Al-Kilani has nothing to disclose. Dr. Rady has nothing to disclose. Dr. Alroughani has received personal compensation from Biogen, Bayer, Novartis, Sanofi Genzyme, Roche, and Merck as an advisor and/or speaker. Dr. Alroughani has received personal compensation in an editorial capacity for Current Treatment Options in Neurology. Dr. Alroughani has received research support from Biogen and Novartis.
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