Three Dozen Migraine Susceptibility Loci Uncovered in Large Meta-Analysis

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Three Dozen Migraine Susceptibility Loci Uncovered in Large Meta-Analysis

Nice writeup of this meta analysis in Nature. If you don’t want to do the free registration to read the genomeweb piece, they 38 loci (loci = spot in the genome) associated with migraine, including 28 that had never been found before.

A couple interesting things about this study:

  • 13 loci have previously been associated with migraine and this study replicated 10 of them. False positives are a big problem in this kind of study (GWAS: Genome Wide Association Analysis), so that gives us a bit more confidence that those 10 have something to do with migraine.
  • Most of the loci were in protein coding genes – genes that make things that could maybe be made wrong and give us horrible headaches, etc. They could have been loci that don’t really do much important, which wouldn’t have told us as much about how migraine might work.
  • Most of those protein coding genes are for things that have to do with the vascular system and its regulation and some are even genes that cause other vascular diseases. That means we might want to start looking more closely at the vascular system for treatment and cures. This also hints at why blood pressure drugs seem to work for many people’s migraines – even when they don’t have high blood pressure.
  • The involvement with the vascular system lines up with other stuff we know about migraine

Finding such a link to vascular tissue is consistent with migraine
comorbidities and previously reported shared polygenic risk among
migraine, stroke, and cardiovascular disease, the researchers noted.

  • And on my favorite topic lately, migraine and BROKEN GUTS – many of the genes get expressed in the guts!

 Palotie and his colleagues also searched for tissues that are enriched
for the expression of these 38-migraine associated genes. Based on this
analysis, they found that the most strongly associated tissues were part
of the cardiovascular system, though tissues in the digestive system
also showed enrichment.

  • Ok, last fact, I promise. It’s really cool though. They found the first ever migraine associated gene on the X chromosome. You know the one ladies and two of and dudes have one of? Could this point to why migraine fucks with so many more women than men?

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Migraine Art #082

Migraine Art #082 by Migraine Art

Via Flickr:

From new book Migraine Art by Klaus Podoll and Derek Robinson

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[I]n 1973, Seymour Diamond and Donald Dalessio, then codirectors of the famous Diamond Headache Clinic in Chicago, wrote that the inability of people with migraine to adapt represents the repressed hostility of the migraine patient.

Joanna Kempner in Not Tonight

I am actually pretty angry about having a painful and debilitating disease that most people like to treat as an attitude problem so they can tell me to go to therapy and do yoga and meditate and otherwise remove myself from the world where I inconveniently highlight the failures of medicine, our bodies, and our economy.

June migraine log

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migraine logA graph of my migraines over the last few years. July 2016 data thru day 12.

Severity continues to decline, but frequency doesn’t seem to be budging much. The number of days with migraine looked like it was starting to go down before June – which was when I started my gradual ramp-up of work. That does not make me feel good.

[Work goals update

  • Week 1: 2 hrs SUCCESS
  • Week 2: 4 hrs FAILURE
  • Week 3: 6 hrs SUCCESS
  • Week 4: 8 hrs FAILURE]

Given the pattern of my success and failures combined with the overall monthly migraine data, I’m absolutely terrified that working is making me sick.

Botox for migraines – time for improvement

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When I first got Botox it didn’t do a goddamn thing – except paralyze my forehead. But after I’d gotten multiple rounds of injections over the course of 6-9 months, I saw real improvement in the intensity of my attacks. Now, there’s evidence showing that you could still expect big improvements from Botox even after your 3rd set of injections. Not only are those improvements then maintained if you keep up with injections, but there may even be additional improvements.

I tried Botox for the first time more than 15 years ago, then 4 years ago, but each time I only got one set of injections and then stopped after I saw no improvement in the first 3 months. Now I’ve been getting injections every 3 months for more than a year. I haven’t had my worst category of migraine in more than 6 months and I’m well enough to get out of bed and even eat during most migraines. 😀

So, if you’ve tried Botox and it didn’t work for you, try it again in 3 month increments for at least 6 months and then decide. Given it’s minimal side effects compared to other migraine preventative “treatments,” it’s probably worth a shot!

From Cephalalgia. 2016 Jun 10. pii: 0333102416652092.

The internal milieu of the un-curable patient

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The embrace of biochemical approaches meant the corresponding rejection of psychogenic theories. … That the efficacy of a medication should erode a psychosomatic theory is not surprising. This is a fairly common phenomenon. Several disorders understood to be psychosomatic (depression or stomach ulcers, for example) were reframed as somatic with the discovery of effective medication. Yet in the case of migraine, ergota­mine derivatives had been used successfully to treat the disorder for thirty-five years, yet had given a boost to theories of migraine as psychosomatic. Why did ergotamine promote psychosomatic theories, while methysergide eroded them? The answer is that methysergide worked as a preventative, eliminating migraines without changing the temperament of the patient. Raskin suggests this was an unexpected outcome when he says, “within a week they were headache free. No change in their internal milieu.”

– Joanna Kempner in Not Tonight

What does this say about a migraine patient today who cannot be cured, who doesn’t get better on preventative medications?

I think this idea of migraine patients causing their migraines does linger.