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Davidsson OB, Rostgaard K, Chalmer MA, Kogelman LJA, Aagaard B, Brodersen T, Bruun MT, Mikkelsen C, Mikkelsen S, Nyegaard M, Pedersen OB, Ullum H, Sørensen E, Ostrowski SR, Erikstrup C, Hansen TF, Hjalgrim H. Blood donation and migraine relief: A national population cohort study in Denmark. Transfusion 2024; 64:647-655. [PMID: 38400775 DOI: 10.1111/trf.17770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/09/2024] [Accepted: 02/09/2024] [Indexed: 02/26/2024]
Abstract
INTRODUCTION Migraine is a prevalent neurological headache disorder. Due to challenges associated with finding effective treatment, many individuals with migraine feel compelled to explore alternative treatment strategies, such as blood donation, hypothesized to provide migraine relief. METHODS Through logistic, Poisson, and Cox regression methods, we examined the links between migraine and blood donation activities in two population cohorts: Danish blood donors in the Scandinavian Donations and Transfusions Database (SCANDAT-DK, N >1 million) and the Danish Blood Donor Study (N ~ 100,000). RESULTS SCANDAT-DK analyses showed no link between migraine and the propensity to become a blood donor among males (odds ratio [OR]Males = 0.95 [95% Confidence Interval: 0.86-1.04], and a reduced propensity among females ORFemales = 0.88 [0.83-0.93]). The incidence of migraine was not reduced upon blood donation (standardized incidence ratio [SIR]Males = 0.94 [0.83-1.06]; SIRFemales = 1.04 [0.99-1.10]). Donors with migraine demonstrated longer intervals between donations (hazard ratio [HR]Males = 0.87 [0.85-0.91], HRFemales = 0.80 [0.78-0.82]), and an increased risk of donor lapse (ORMales = 1.23 [1.14-1.32]; ORFemales = 1.28 [1.22-1.33]). Results were corroborated in DBDS using self-reported migraine. Genetic predisposition to migraine associated with longer intervals in females (HRFemales = 0.98 [0.97-0.99]), but not in males. DISCUSSION Our findings do not support the hypothesis that blood donation serves as a viable treatment strategy among migraine patients. Future prospective investigations may help to elucidate the underlying biological mechanisms by which blood donation may influence migraine pathology.
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Affiliation(s)
- Olafur B Davidsson
- Statens Serum Institut, Copenhagen, Denmark
- Haematology, Danish Cancer Institute, Copenhagen, Denmark
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Klaus Rostgaard
- Statens Serum Institut, Copenhagen, Denmark
- Haematology, Danish Cancer Institute, Copenhagen, Denmark
| | - Mona A Chalmer
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Lisette J A Kogelman
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, University Hospital of Copenhagen, Copenhagen, Denmark
- Department of Health Science and Technology, Genomic Medicine Group, Aalborg University, Aalborg, Denmark
| | - Bitten Aagaard
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Thorsten Brodersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - Mie Topholm Bruun
- Clinical Immunology Research Unit, Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Christina Mikkelsen
- Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Science, Copenhagen University, Copenhagen, Denmark
| | - Susan Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Mette Nyegaard
- Statens Serum Institut, Copenhagen, Denmark
- Department of Health Science and Technology, Genomic Medicine Group, Aalborg University, Aalborg, Denmark
| | - Ole Birger Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Erik Sørensen
- Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Sisse Rye Ostrowski
- Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Thomas Folkmann Hansen
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, University Hospital of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Hjalgrim
- Statens Serum Institut, Copenhagen, Denmark
- Haematology, Danish Cancer Institute, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Haematology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
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2
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Bjornsdottir G, Chalmer MA, Stefansdottir L, Skuladottir AT, Einarsson G, Andresdottir M, Beyter D, Ferkingstad E, Gretarsdottir S, Halldorsson BV, Halldorsson GH, Helgadottir A, Helgason H, Hjorleifsson Eldjarn G, Jonasdottir A, Jonasdottir A, Jonsdottir I, Knowlton KU, Nadauld LD, Lund SH, Magnusson OT, Melsted P, Moore KHS, Oddsson A, Olason PI, Sigurdsson A, Stefansson OA, Saemundsdottir J, Sveinbjornsson G, Tragante V, Unnsteinsdottir U, Walters GB, Zink F, Rødevand L, Andreassen OA, Igland J, Lie RT, Haavik J, Banasik K, Brunak S, Didriksen M, T Bruun M, Erikstrup C, Kogelman LJA, Nielsen KR, Sørensen E, Pedersen OB, Ullum H, Masson G, Thorsteinsdottir U, Olesen J, Ludvigsson P, Thorarensen O, Bjornsdottir A, Sigurdardottir GR, Sveinsson OA, Ostrowski SR, Holm H, Gudbjartsson DF, Thorleifsson G, Sulem P, Stefansson H, Thorgeirsson TE, Hansen TF, Stefansson K. Rare variants with large effects provide functional insights into the pathology of migraine subtypes, with and without aura. Nat Genet 2023; 55:1843-1853. [PMID: 37884687 PMCID: PMC10632135 DOI: 10.1038/s41588-023-01538-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 09/18/2023] [Indexed: 10/28/2023]
Abstract
Migraine is a complex neurovascular disease with a range of severity and symptoms, yet mostly studied as one phenotype in genome-wide association studies (GWAS). Here we combine large GWAS datasets from six European populations to study the main migraine subtypes, migraine with aura (MA) and migraine without aura (MO). We identified four new MA-associated variants (in PRRT2, PALMD, ABO and LRRK2) and classified 13 MO-associated variants. Rare variants with large effects highlight three genes. A rare frameshift variant in brain-expressed PRRT2 confers large risk of MA and epilepsy, but not MO. A burden test of rare loss-of-function variants in SCN11A, encoding a neuron-expressed sodium channel with a key role in pain sensation, shows strong protection against migraine. Finally, a rare variant with cis-regulatory effects on KCNK5 confers large protection against migraine and brain aneurysms. Our findings offer new insights with therapeutic potential into the complex biology of migraine and its subtypes.
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Affiliation(s)
| | - Mona A Chalmer
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet-Glostrup, Copenhagen, Denmark
| | | | | | | | | | | | | | | | - Bjarni V Halldorsson
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- Reykjavik University, School of Technology, Reykjavik, Iceland
| | - Gisli H Halldorsson
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | - Hannes Helgason
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | | | | | - Ingileif Jonsdottir
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | | | | | - Sigrun H Lund
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- Faculty of Physical Sciences, School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | - Pall Melsted
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | | | | | | | | | | | | | | | | | | | | | - Linn Rødevand
- NORMENT, Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Health and Social Science, Centre for Evidence-Based Practice, Western Norway University of Applied Science, Bergen, Norway
| | - Rolv T Lie
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Karina Banasik
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maria Didriksen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Mie T Bruun
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine Health, Aarhus University, Aarhus, Denmark
| | - Lisette J A Kogelman
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet-Glostrup, Copenhagen, Denmark
| | - Kaspar R Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Ole B Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Unnur Thorsteinsdottir
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Jes Olesen
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet-Glostrup, Copenhagen, Denmark
| | - Petur Ludvigsson
- Department of Pediatrics, Landspitali University Hostpital, Reykjavik, Iceland
| | - Olafur Thorarensen
- Department of Pediatrics, Landspitali University Hostpital, Reykjavik, Iceland
| | | | | | - Olafur A Sveinsson
- Laeknasetrid Clinic, Reykjavik, Iceland
- Department of Neurology, Landspitali University Hospital, Reykjavik, Iceland
| | - Sisse R Ostrowski
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hilma Holm
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
| | - Daniel F Gudbjartsson
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | | | | | | | - Thomas F Hansen
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet-Glostrup, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kari Stefansson
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland.
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
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3
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Winsvold BS, Harder AVE, Ran C, Chalmer MA, Dalmasso MC, Ferkingstad E, Tripathi KP, Bacchelli E, Børte S, Fourier C, Petersen AS, Vijfhuizen LS, Magnusson SH, O'Connor E, Bjornsdottir G, Häppölä P, Wang Y, Callesen I, Kelderman T, Gallardo VJ, de Boer I, Olofsgård FJ, Heinze K, Lund N, Thomas LF, Hsu C, Pirinen M, Hautakangas H, Ribasés M, Guerzoni S, Sivakumar P, Yip J, Heinze A, Küçükali F, Ostrowski SR, Pedersen OB, Kristoffersen ES, Martinsen AE, Artigas MS, Lagrata S, Cainazzo MM, Adebimpe J, Quinn O, Göbel C, Cirkel A, Volk AE, Heilmann‐Heimbach S, Skogholt AH, Gabrielsen ME, Wilbrink LA, Danno D, Mehta D, Guðbjartsson DF, Rosendaal FR, Willems van Dijk K, Fronczek R, Wagner M, Scherer M, Göbel H, Sleegers K, Sveinsson OA, Pani L, Zoli M, Ramos‐Quiroga JA, Dardiotis E, Steinberg A, Riedel‐Heller S, Sjöstrand C, Thorgeirsson TE, Stefansson H, Southgate L, Trembath RC, Vandrovcova J, Noordam R, Paemeleire K, Stefansson K, Fann CS, Waldenlind E, Tronvik E, Jensen RH, Chen S, Houlden H, Terwindt GM, Kubisch C, Maestrini E, Vikelis M, Pozo‐Rosich P, Belin AC, Matharu M, van den Maagdenberg AM, Hansen TF, Ramirez A, Zwart J. Cluster Headache Genomewide Association Study and Meta-Analysis Identifies Eight Loci and Implicates Smoking as Causal Risk Factor. Ann Neurol 2023; 94:713-726. [PMID: 37486023 PMCID: PMC10952302 DOI: 10.1002/ana.26743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/22/2023] [Accepted: 07/07/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE The objective of this study was to aggregate data for the first genomewide association study meta-analysis of cluster headache, to identify genetic risk variants, and gain biological insights. METHODS A total of 4,777 cases (3,348 men and 1,429 women) with clinically diagnosed cluster headache were recruited from 10 European and 1 East Asian cohorts. We first performed an inverse-variance genomewide association meta-analysis of 4,043 cases and 21,729 controls of European ancestry. In a secondary trans-ancestry meta-analysis, we included 734 cases and 9,846 controls of East Asian ancestry. Candidate causal genes were prioritized by 5 complementary methods: expression quantitative trait loci, transcriptome-wide association, fine-mapping of causal gene sets, genetically driven DNA methylation, and effects on protein structure. Gene set and tissue enrichment analyses, genetic correlation, genetic risk score analysis, and Mendelian randomization were part of the downstream analyses. RESULTS The estimated single nucleotide polymorphism (SNP)-based heritability of cluster headache was 14.5%. We identified 9 independent signals in 7 genomewide significant loci in the primary meta-analysis, and one additional locus in the trans-ethnic meta-analysis. Five of the loci were previously known. The 20 genes prioritized as potentially causal for cluster headache showed enrichment to artery and brain tissue. Cluster headache was genetically correlated with cigarette smoking, risk-taking behavior, attention deficit hyperactivity disorder (ADHD), depression, and musculoskeletal pain. Mendelian randomization analysis indicated a causal effect of cigarette smoking intensity on cluster headache. Three of the identified loci were shared with migraine. INTERPRETATION This first genomewide association study meta-analysis gives clues to the biological basis of cluster headache and indicates that smoking is a causal risk factor. ANN NEUROL 2023;94:713-726.
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Affiliation(s)
- Bendik S. Winsvold
- Department of Research and Innovation, Division of Clinical NeuroscienceOslo University HospitalOsloNorway
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Department of NeurologyOslo University HospitalOsloNorway
- Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement ScienceNorwegian University of Science and Technology (NTNU)TrondheimNorway
| | - Aster V. E. Harder
- Department of Human GeneticsLeiden University Medical CenterLeidenThe Netherlands
- Department of NeurologyLeiden University Medical CenterLeidenThe Netherlands
| | - Caroline Ran
- Centre for Cluster Headache, Department of NeuroscienceKarolinska InstitutetStockholmSweden
| | - Mona A. Chalmer
- Department of Neurology, Danish Headache Center, Rigshospitalet‐GlostrupUniversity of Copenhagen University HospitalGlostrupDenmark
| | - Maria Carolina Dalmasso
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital CologneUniversity of CologneCologneGermany
- Neurosciences and Complex Systems Unit (EnyS), CONICET, Hospital El Cruce 'N. Kirchner'National University A. Jauretche (UNAJ)Florencio VarelaArgentina
| | | | - Kumar Parijat Tripathi
- Division of Neurogenetics and Molecular Psychiatry, Department of PsychiatryUniklinik KölnCologneGermany
| | - Elena Bacchelli
- Department of Pharmacy and BiotechnologyUniversity of BolognaBolognaItaly
| | - Sigrid Børte
- Department of Research and Innovation, Division of Clinical NeuroscienceOslo University HospitalOsloNorway
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement ScienceNorwegian University of Science and Technology (NTNU)TrondheimNorway
| | - Carmen Fourier
- Centre for Cluster Headache, Department of NeuroscienceKarolinska InstitutetStockholmSweden
| | - Anja S. Petersen
- Department of Neurology, Danish Headache Center, Rigshospitalet‐GlostrupUniversity of Copenhagen University HospitalGlostrupDenmark
| | | | | | - Emer O'Connor
- Department of Neuromuscular Diseases, Institute of NeurologyUniversity College LondonLondonUK
| | | | - Paavo Häppölä
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of HelsinkiHelsinkiFinland
| | - Yen‐Feng Wang
- Department of NeurologyTaipei Veterans General HospitalTaipeiTaiwan
- Brain Research CenterNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
| | - Ida Callesen
- Department of Neurology, Danish Headache Center, Rigshospitalet‐GlostrupUniversity of Copenhagen University HospitalGlostrupDenmark
| | - Tim Kelderman
- Department of NeurologyGhent University HospitalGhentBelgium
| | - Victor J Gallardo
- Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Departament de MedicinaUniversitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR)BarcelonaSpain
| | - Irene de Boer
- Department of NeurologyLeiden University Medical CenterLeidenThe Netherlands
| | | | | | - Nunu Lund
- Department of Neurology, Danish Headache Center, Rigshospitalet‐GlostrupUniversity of Copenhagen University HospitalGlostrupDenmark
| | - Laurent F. Thomas
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Department of Clinical and Molecular MedicineNorwegian University of Science and Technology (NTNU)TrondheimNorway
- BioCore–Bioinformatics Core FacilityNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Clinic of Laboratory MedicineSt. Olavs Hospital, Trondheim University HospitalTrondheimNorway
| | - Chia‐Lin Hsu
- Institute of Biomedical Sciences, Academia SinicaTaipeiTaiwan
| | - Matti Pirinen
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of HelsinkiHelsinkiFinland
- Department of Public HealthUniversity of HelsinkiHelsinkiFinland
- Department of Mathematics and StatisticsUniversity of HelsinkiHelsinkiFinland
| | - Heidi Hautakangas
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of HelsinkiHelsinkiFinland
| | - Marta Ribasés
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and AddictionUniversitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR)BarcelonaSpain
- Department of PsychiatryVall d'Hebron University HospitalBarcelonaSpain
- Biomedical Network Research Centre on Mental Health (CIBERSAM)Instituto de Salud Carlos IIIMadridSpain
- Department of Genetics, Microbiology, and Statistics, Faculty of BiologyUniversitat de BarcelonaBarcelonaSpain
| | | | - Prasanth Sivakumar
- Department of Neuromuscular Diseases, Institute of NeurologyUniversity College LondonLondonUK
| | - Janice Yip
- Department of Neuromuscular Diseases, Institute of NeurologyUniversity College LondonLondonUK
| | - Axel Heinze
- Kiel Migraine and Headache CentreKielGermany
| | - Fahri Küçükali
- Complex Genetics of Alzheimer's Disease Group, Center for Molecular Neurology, VIBAntwerpBelgium
- Department of Biomedical SciencesUniversity of AntwerpAntwerpBelgium
| | - Sisse R. Ostrowski
- Department of Clinical Immunology, Centre of Diagnostic InvestigationRigshospitaletCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Ole B. Pedersen
- Department of Clinical ImmunologyZealand University HospitalKøgeDenmark
| | - Espen S. Kristoffersen
- Department of Research and Innovation, Division of Clinical NeuroscienceOslo University HospitalOsloNorway
- Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement ScienceNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Department of General PracticeUniversity of OsloOsloNorway
- Department of NeurologyAkershus University HospitalLørenskogNorway
| | - Amy E. Martinsen
- Department of Research and Innovation, Division of Clinical NeuroscienceOslo University HospitalOsloNorway
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement ScienceNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway
| | - María S. Artigas
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and AddictionUniversitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR)BarcelonaSpain
- Department of PsychiatryVall d'Hebron University HospitalBarcelonaSpain
- Biomedical Network Research Centre on Mental Health (CIBERSAM)Instituto de Salud Carlos IIIMadridSpain
- Department of Genetics, Microbiology, and Statistics, Faculty of BiologyUniversitat de BarcelonaBarcelonaSpain
| | - Susie Lagrata
- Headache and Facial Pain GroupUniversity College London Queen Square Institute of Neurology and National Hospital for Neurology and NeurosurgeryLondonUK
| | | | - Joycee Adebimpe
- Department of Neuromuscular Diseases, Institute of NeurologyUniversity College LondonLondonUK
| | - Olivia Quinn
- Department of Neuromuscular Diseases, Institute of NeurologyUniversity College LondonLondonUK
| | - Carl Göbel
- Kiel Migraine and Headache CentreKielGermany
- Department of NeurologyUniversity Hospital Schleswig‐HolsteinLübeckGermany
| | - Anna Cirkel
- Kiel Migraine and Headache CentreKielGermany
- Department of NeurologyUniversity Hospital Schleswig‐HolsteinLübeckGermany
| | - Alexander E. Volk
- Institute of Human GeneticsUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Stefanie Heilmann‐Heimbach
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital BonnBonnGermany
| | - Anne Heidi Skogholt
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway
| | - Maiken E. Gabrielsen
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway
| | | | - Daisuke Danno
- Headache and Facial Pain GroupUniversity College London Queen Square Institute of Neurology and National Hospital for Neurology and NeurosurgeryLondonUK
| | - Dwij Mehta
- Headache and Facial Pain GroupUniversity College London Queen Square Institute of Neurology and National Hospital for Neurology and NeurosurgeryLondonUK
| | | | | | - Frits R. Rosendaal
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Ko Willems van Dijk
- Department of Human GeneticsLeiden University Medical CenterLeidenThe Netherlands
- Einthoven Laboratory for Experimental Vascular MedicineLeiden University Medical CenterLeidenThe Netherlands
- Department of Internal Medicine, Division of EndocrinologyLeiden University Medical CenterLeidenThe Netherlands
| | - Rolf Fronczek
- Department of NeurologyLeiden University Medical CenterLeidenThe Netherlands
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric PsychiatryUniversity Hospital BonnBonnGermany
- German Center for Neurodegenerative Diseases (DZNE Bonn)BonnGermany
| | - Martin Scherer
- Department of Primary Medical CareUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | | | - Kristel Sleegers
- Complex Genetics of Alzheimer's Disease Group, Center for Molecular Neurology, VIBAntwerpBelgium
- Department of Biomedical SciencesUniversity of AntwerpAntwerpBelgium
| | - Olafur A. Sveinsson
- Faculty of Medicine, School of Health SciencesUniversity of IcelandReykjavikIceland
| | - Luca Pani
- Department of Biomedical, Metabolic and Neural SciencesUniversity of Modena and Reggio EmiliaModenaItaly
- Department of Psychiatry and Behavioral SciencesUniversity of MiamiMiamiFL
| | - Michele Zoli
- Department of Biomedical, Metabolic and Neural SciencesUniversity of Modena and Reggio EmiliaModenaItaly
| | - Josep A. Ramos‐Quiroga
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and AddictionUniversitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR)BarcelonaSpain
- Department of PsychiatryVall d'Hebron University HospitalBarcelonaSpain
- Biomedical Network Research Centre on Mental Health (CIBERSAM)Instituto de Salud Carlos IIIMadridSpain
- Department of Psychiatry and Forensic MedicineUniversitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR)BarcelonaSpain
| | - Efthimios Dardiotis
- Department of Neurology, Faculty of MedicineUniversity of ThessalyVolosGreece
| | - Anna Steinberg
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
- Department of NeurologyKarolinska University HospitalStockholmSweden
| | - Steffi Riedel‐Heller
- Institute of Social Medicine, Occupational Health and Public HealthUniversity of LeipzigLeipzigGermany
| | - Christina Sjöstrand
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
- Department of NeurologyDanderyd HospitalStockholmSweden
| | | | | | - Laura Southgate
- Molecular and Clinical Sciences Research InstituteSt. George's, University of LondonLondonUK
- Department of Medical & Molecular Genetics, Faculty of Life Sciences & MedicineKing's College LondonLondonUK
| | - Richard C. Trembath
- Department of Medical & Molecular Genetics, Faculty of Life Sciences & MedicineKing's College LondonLondonUK
| | - Jana Vandrovcova
- Department of Neuromuscular Diseases, Institute of NeurologyUniversity College LondonLondonUK
| | - Raymond Noordam
- Department of Internal Medicine, Section of Gerontology and GeriatricsLeiden University Medical CenterLeidenThe Netherlands
| | - Koen Paemeleire
- Department of NeurologyGhent University HospitalGhentBelgium
| | - Kari Stefansson
- deCODE genetics/Amgen Inc.ReykjavikIceland
- Faculty of Medicine, School of Health SciencesUniversity of IcelandReykjavikIceland
| | | | - Elisabet Waldenlind
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
- Department of NeurologyKarolinska University HospitalStockholmSweden
| | - Erling Tronvik
- Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement ScienceNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Department of Neurology and Clinical NeurophysiologySt. Olavs Hospital, Trondheim University HospitalTrondheimNorway
| | - Rigmor H. Jensen
- Department of Neurology, Danish Headache Center, Rigshospitalet‐GlostrupUniversity of Copenhagen University HospitalGlostrupDenmark
| | - Shih‐Pin Chen
- Brain Research CenterNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
- Department of Medical Research, Division of Translational ResearchTaipei Veterans General HospitalTaipeiTaiwan
| | - Henry Houlden
- Department of Neuromuscular Diseases, Institute of NeurologyUniversity College LondonLondonUK
| | - Gisela M. Terwindt
- Department of NeurologyLeiden University Medical CenterLeidenThe Netherlands
| | - Christian Kubisch
- Institute of Human GeneticsUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Elena Maestrini
- Department of Pharmacy and BiotechnologyUniversity of BolognaBolognaItaly
| | | | - Patricia Pozo‐Rosich
- Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Departament de MedicinaUniversitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR)BarcelonaSpain
- Headache Unit, Neurology DepartmentVall d'Hebron University HospitalBarcelonaSpain
| | - Andrea C. Belin
- Centre for Cluster Headache, Department of NeuroscienceKarolinska InstitutetStockholmSweden
| | - Manjit Matharu
- Headache and Facial Pain GroupUniversity College London Queen Square Institute of Neurology and National Hospital for Neurology and NeurosurgeryLondonUK
| | - Arn M.J.M. van den Maagdenberg
- Department of Human GeneticsLeiden University Medical CenterLeidenThe Netherlands
- Department of NeurologyLeiden University Medical CenterLeidenThe Netherlands
| | - Thomas F. Hansen
- Department of Neurology, Danish Headache Center, Rigshospitalet‐GlostrupUniversity of Copenhagen University HospitalGlostrupDenmark
- Novo Nordic Foundation Center for Protein ResearchUniversity of CopenhagenCopenhagenDenmark
| | - Alfredo Ramirez
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital CologneUniversity of CologneCologneGermany
- Department of Neurodegenerative Diseases and Geriatric PsychiatryUniversity Hospital BonnBonnGermany
- German Center for Neurodegenerative Diseases (DZNE Bonn)BonnGermany
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative DiseasesUniversity of Texas Health Sciences CenterSan AntonioTX
- Cluster of Excellence Cellular Stress Responses in Aging‐associated Diseases (CECAD)University of CologneCologneGermany
| | - John‐Anker Zwart
- Department of Research and Innovation, Division of Clinical NeuroscienceOslo University HospitalOsloNorway
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement ScienceNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway
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4
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Banasik K, Møller PL, Techlo TR, Holm PC, Walters GB, Ingason A, Rosengren A, Rohde PD, Kogelman LJA, Westergaard D, Siggaard T, Chmura PJ, Chalmer MA, Magnússon ÓÞ, Þórisson GÁ, Stefánsson H, Guðbjartsson DF, Stefánsson K, Olesen J, Winther S, Bøttcher M, Brunak S, Werge T, Nyegaard M, Hansen TF. DanMAC5: a browser of aggregated sequence variants from 8,671 whole genome sequenced Danish individuals. BMC Genom Data 2023; 24:30. [PMID: 37244984 DOI: 10.1186/s12863-023-01132-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 05/18/2023] [Indexed: 05/29/2023] Open
Abstract
OBJECTIVES Allele counts of sequence variants obtained by whole genome sequencing (WGS) often play a central role in interpreting the results of genetic and genomic research. However, such variant counts are not readily available for individuals in the Danish population. Here, we present a dataset with allele counts for sequence variants (single nucleotide variants (SNVs) and indels) identified from WGS of 8,671 (5,418 females) individuals from the Danish population. The data resource is based on WGS data from three independent research projects aimed at assessing genetic risk factors for cardiovascular, psychiatric, and headache disorders. To enable the sharing of information on sequence variation in Danish individuals, we created summarized statistics on allele counts from anonymized data and made them available through the European Genome-phenome Archive (EGA, https://identifiers.org/ega. DATASET EGAD00001009756 ) and in a dedicated browser, DanMAC5 (available at www.danmac5.dk ). The summary level data and the DanMAC5 browser provide insight into the allelic spectrum of sequence variants segregating in the Danish population, which is important in variant interpretation. DATA DESCRIPTION Three WGS datasets with an average coverage of 30x were processed independently using the same quality control pipeline. Subsequently, we summarized, filtered, and merged allele counts to create a high-quality summary level dataset of sequence variants.
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Affiliation(s)
- Karina Banasik
- Translational Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark.
| | - Peter L Møller
- Department of Biomedicine, Aarhus University, Høegh-Guldbergsgade 10, DK-8000, Aarhus C, Denmark
| | - Tanya R Techlo
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Valdemar Hansensvej 1-13, DK-2600, Glostrup, Denmark
| | - Peter C Holm
- Translational Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | | | - Andrés Ingason
- Institute for Biological Psychiatry, Mental Health Center Sct Hans, Copenhagen University Hospital, Boeserup vej 2, DK-4000, Roskilde, Denmark
| | - Anders Rosengren
- Institute for Biological Psychiatry, Mental Health Center Sct Hans, Copenhagen University Hospital, Boeserup vej 2, DK-4000, Roskilde, Denmark
| | - Palle D Rohde
- Department of Health Science and Technology, Genomic Medicine Group, Aalborg University, Selma Lagerløfs Vej 249, DK-9260, Gistrup, Denmark
| | - Lisette J A Kogelman
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Valdemar Hansensvej 1-13, DK-2600, Glostrup, Denmark
| | - David Westergaard
- Translational Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Troels Siggaard
- Translational Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Piotr J Chmura
- Translational Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Mona A Chalmer
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Valdemar Hansensvej 1-13, DK-2600, Glostrup, Denmark
| | | | | | | | | | | | - Jes Olesen
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Valdemar Hansensvej 1-13, DK-2600, Glostrup, Denmark
| | - Simon Winther
- Department of Cardiology, University Clinic for Cardiovascular Research, Gødstrup Hospital, Hospitalsvej 15, DK-7400, Herning, Denmark
| | - Morten Bøttcher
- Department of Cardiology, University Clinic for Cardiovascular Research, Gødstrup Hospital, Hospitalsvej 15, DK-7400, Herning, Denmark
| | - Søren Brunak
- Translational Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Thomas Werge
- Institute for Biological Psychiatry, Mental Health Center Sct Hans, Copenhagen University Hospital, Boeserup vej 2, DK-4000, Roskilde, Denmark
| | - Mette Nyegaard
- Department of Biomedicine, Aarhus University, Høegh-Guldbergsgade 10, DK-8000, Aarhus C, Denmark
- Department of Health Science and Technology, Genomic Medicine Group, Aalborg University, Selma Lagerløfs Vej 249, DK-9260, Gistrup, Denmark
| | - Thomas F Hansen
- Translational Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Valdemar Hansensvej 1-13, DK-2600, Glostrup, Denmark
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5
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Davidsson OB, Rostgaard K, Hjalgrim LL, Chalmer MA, Olofsson IA, Søegaard SH, Winther JF, Kenborg L, Hansen TF, Hjalgrim H. Childhood cancer confers increased risk of migraine - A Danish nationwide register study. Cancer Epidemiol 2022; 81:102278. [PMID: 36244298 DOI: 10.1016/j.canep.2022.102278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/05/2022] [Accepted: 10/07/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Investigations of migraine among childhood cancer survivors have predominantly relied on self-reported information and hospital discharge diagnoses. Alone, both approaches are liable to bias. We used Danish nationwide registers to obtain data on both prescriptions of acute migraine medications (antimigraines) and hospital discharge diagnoses of migraine to assess the relative risk of migraine across a wider spectrum of migraine presentations than previously studied. METHODS We followed a Danish population-based cohort of 7771 individuals with childhood cancer diagnosed in the period from Jan 1st, 1978 to Dec 31st, 2017, for risk of prescription antimigraine initiation and for risk of hospitalization due to migraine. Rates of hospitalization were assessed for the entire follow-up period whereas rates of antimigraine initiations were assessed in the period from Jan 1st, 1997, to Dec 31st, 2017. Relative to the general population without childhood cancer, standardized incidence ratios (SIRs) were calculated for each outcome. RESULTS Individuals exposed to childhood cancer were at increased risk of antimigraine initiation (SIR of 1.24, 95% CI: 1.11-1.38) and of migraine hospitalization (SIR of 2.44, 95% CI: 1.87-3.12) from the day of their cancer diagnosis and up to 40 years after. CONCLUSIONS Individuals diagnosed with childhood cancer have a higher risk of migraine of varying presentations, in addition to migraine resulting in hospitalization as previously reported. This potentially preventable problem warrants clinical attention.
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Affiliation(s)
- Olafur B Davidsson
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; Haematology, Danish Cancer Society Research Center, Copenhagen, Denmark; Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, University Hospital of Copenhagen, Denmark
| | - Klaus Rostgaard
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; Haematology, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Lisa Lyngsie Hjalgrim
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Mona A Chalmer
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, University Hospital of Copenhagen, Denmark
| | - Isa A Olofsson
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, University Hospital of Copenhagen, Denmark
| | - Signe Holst Søegaard
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Jeanette F Winther
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health, Aarhus University and University Hospital, Aarhus, Denmark
| | - Line Kenborg
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Thomas F Hansen
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, University Hospital of Copenhagen, Denmark; Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; Haematology, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Haematology, Rigshospitalet, University Hospital of Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark.
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Abstract
Background It is unknown whether clinical parameters differ between migraineurs with and without first‐degree family members with migraine. Objectives The present cross‐sectional study describes differences between familial and sporadic migraine with a focus on migraine characteristics, migraine severity, comorbidities, and treatment. Method From the Danish Headache Center we recruited 358 patients with familial migraine and 1727 patients with sporadic migraine. Each participant was assessed using a validated semi‐structured interview. Results No differences in age (Mean = 44 and 44 [SD = 12.28 and 12.58] for familial and sporadic migraineurs, respectively; P = .900) or sex (295/358 (82.4%) and 1413/1727 (81.8%) women in familial and sporadic migraineurs, respectively; P = .853) were found. Familial migraineurs had more aphasic aura than sporadic migraineurs (41% vs 27%, P = .001). Sporadic migraineurs had more lifetime attacks ie, >100 attacks (45% vs 70%, P < .001) and prolonged attacks ie, lasting >72 hours (5% vs 12%, P < .001) than familial migraineurs. Further, sporadic migraineurs had a higher incidence of concussions (37% vs 41%, P = .001) compared to familial migraineurs. In agreement with a previous study, there was no difference between familial and sporadic migraine regarding triptan response (84% vs 81%, P = .440). Conclusion Headache characteristics, triptan response, and comorbidities where similar in individulas with and without inherited migraine, suggesting that migraine are to be considered a hmogenoues disease. The difference in the clinical presentation of migraine with aura symptoms among patients with familial migraine should be considered in future studies. Further, more severe migraine among patients with sporadic migraine with aura could suggest that sporadic migraineurs have been exposed to stronger or multiple environmental factors and indicate that an early intervention in migraine treatment could lessen the severity of migraine.
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Affiliation(s)
- Julie Ravn
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Rigshospitalet-Glostrup, Glostrup, Denmark
| | - Mona A Chalmer
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Rigshospitalet-Glostrup, Glostrup, Denmark
| | - Emil L Oehrstroem
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Rigshospitalet-Glostrup, Glostrup, Denmark
| | - Lisette J A Kogelman
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Rigshospitalet-Glostrup, Glostrup, Denmark
| | - Thomas F Hansen
- Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Rigshospitalet-Glostrup, Glostrup, Denmark
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