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Sex Differences in Migraine: A Twin Study.

Morgan C Fitzgerald1, Ursula G Saelzler1, Matthew S Panizzon1,2

  • 1Department of Psychiatry, University of California, San Diego, San Diego, CA, United States.

Frontiers in Pain Research (Lausanne, Switzerland)
|March 17, 2022
PubMed
Summary
This summary is machine-generated.

Migraine affects women more than men. This study found that while genetics play a role, the prenatal environment, specifically exposure to male hormones, may increase migraine risk in females.

Keywords:
heritabilityhormonesmigrainesex-differencestwins

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Area of Science:

  • Neurology
  • Genetics
  • Endocrinology

Background:

  • Migraine disproportionately affects women, with two-thirds of sufferers being female.
  • The underlying mechanisms for this prominent sex difference in migraine remain largely unknown.
  • Understanding these factors is crucial for developing targeted prevention and treatment strategies.

Purpose of the Study:

  • To investigate the contributions of genetic and environmental factors to sex differences in migraine.
  • To determine if migraine heritability differs between sexes (quantitative genetic differences).
  • To explore if different genes influence migraine in men and women (qualitative genetic differences).
  • To assess the role of the prenatal hormone environment in migraine risk.

Main Methods:

  • Analysis of data from 51,872 participants in the Swedish Twin Registry.
  • Application of a sex-limitation model to assess genetic influences on migraine.
  • Utilized multilevel logistic regression comparing twin pairs to evaluate prenatal environmental effects.

Main Results:

  • Women exhibited a significantly higher prevalence of migraine without aura (17.6%) compared to men (5.5%).
  • Migraine showed equal heritability in both sexes (0.45), with subtle evidence for sex-specific genetic influences.
  • Females with a male co-twin had a 1.51 times higher risk of migraine compared to females with a female co-twin.

Conclusions:

  • Genetic factors alone do not fully explain the sex difference in migraine prevalence.
  • Masculinization of the prenatal environment may elevate migraine risk in females.
  • Prenatal neuroendocrine factors are implicated as potential contributors to migraine development.