Migraine is a neurological condition that affects nearly 40 million people in the United States.
Migraine attacks often occur on one side of the head. They may sometimes be preceded or accompanied by visual or sensory disturbances known as an aura.
Other symptoms, like nausea, vomiting, and light sensitivity, can also be present during a migraine attack.
While the exact cause of migraine is unknown, it’s believed that both environmental and genetic factors play a role in the condition. Below, we’ll take a closer look at the connection between migraine and genetics.
Your DNA, which contains your genes, is packaged into 23 pairs of chromosomes. You inherit one set of chromosomes from your mother and the other from your father.
A gene is a portion of DNA that provides information on how to make various proteins in your body.
Sometimes genes can undergo changes, and these changes may cause or predispose a person to a certain health condition. These gene changes can potentially be passed down from parent to child.
Genetic changes or variations have been linked to migraine. In fact, it’s estimated that more than half of people who have migraine have at least one other family member who also has the condition.
Let’s take a deeper dive into what researchers are learning about genetics and migraine.
Gene mutations associated with migraine
You may have heard about some research in the news regarding different gene mutations being linked with migraine. Some examples include:
- KCNK18. This gene encodes a protein called TRESK, which is associated with pain pathways and is found in migraine-relevant nerve areas. A specific mutation in KCNK18 has been
foundto be associated with migraine with aura.
- CKIdelta. This gene encodes an enzyme that has many functions within the body, one of which is associated with your sleep-wake cycle. According to a 2013 study, specific mutations in CKIdelta were associated with migraine.
Gene variations associated with migraine
It’s important to point out that most migraine attacks are believed to be polygenic. This means that multiple genes contribute to the condition. This appears to be due to small genetic variations called single-nucleotide polymorphisms (SNPs).
Genetic studies have identified more than 40 genetic locations with variations that are associated with common forms of migraine. These locations are often linked with things like cellular and nerve signaling or vascular (blood vessel) function.
Alone, these variations may have a minimal effect. However, when many of them accumulate, it can contribute to migraine development.
A 2018 study of 1,589 families with migraine found an increased “load” of these genetic variations compared to the general population.
Various genetic factors also appear to determine specific migraine features. Having a strong family history of migraine may increase your risk for having:
Some types of migraine have a well-known genetic association. An example of this is familial hemiplegic migraine (FHM). Because of this known association, FHM has been extensively studied in relation to the genetics of migraine.
FHM is a type of migraine with aura that typically has an earlier age of onset than other migraine types. Along with other common aura symptoms, people with FHM also have numbness or weakness on one side of the body.
There are three different genes that are known to be associated with FHM. They are:
A mutation in one of these genes can affect nerve cell signaling, which can trigger a migraine attack.
FHM is inherited in an autosomal dominant manner. This means you only need one copy of the mutated gene to have the condition.
It may sound counterintuitive, but having a genetic link to migraine can actually be beneficial. That’s because you can receive valuable information and support from your family members who understand the condition.
Information from your family members that may be helpful for your own migraine experience include:
- what their migraine triggers are
- the specific symptoms they experience
- treatments or medications that help to effectively manage their migraine symptoms
- whether their migraine attacks have changed in frequency, intensity, or in other ways throughout their life
- the age at which they first experienced a migraine
If you have symptoms that are consistent with migraine, make an appointment with your doctor. Migraine attack symptoms include:
- a pulsing or throbbing pain, often on one side of your head
- nausea and vomiting
- light sensitivity
- sound sensitivity
- aura symptoms, which can precede a migraine attack and may include:
- seeing bright flashes of light
- difficulty speaking
- feelings of weakness or numbness on one side of your face or in a limb
Sometimes head pain can be a sign of a medical emergency. Get immediate medical attention for a headache that:
Migraine is often treated with medications. There are two types of migraine medications:
- those that ease acute migraine symptoms
- those that help prevent a migraine attack from occurring
There are also some integrative methods that may be effective. We’ll explore each type of treatment in more detail below.
Medications for acute migraine symptoms
You typically take these medications as soon as you begin to feel symptoms of an aura or migraine attack. Examples include:
- Over-the-counter pain medications. These include NSAIDs like ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin. Acetaminophen (Tylenol) may also be used.
- Triptans. There are many types of triptans. These drugs help block inflammation and constrict blood vessels, relieving pain. Some examples include sumatriptan (Imitrex), eletriptan (Relpax), and rizatriptan (Maxalt).
- Ergot alkaloids. These drugs work in a similar way to triptans. They may be given if treatment with triptans is ineffective. One example is dihydroergotamine (Migranal).
- Gepants. This new wave of migraine medication blocks a peptide that mediates inflammation.
- Ditans. A novel family of rescue medications, ditans are similar to triptans but can be used in people with a history of heart attack and stroke, as triptans may increase the risk of heart issues.
Medications that prevent migraine attacks
Your doctor may prescribe one of these medications if you have frequent or severe migraine attacks. Some examples are:
- Anticonvulsants. These medications were originally developed to help treat seizures. Examples include topiramate (Topamax) and valproate.
- Blood pressure medications. These can include either beta-blockers or calcium channel blockers.
- Antidepressant medications. Amitriptyline, a tricyclic antidepressant, may be used.
- CGRP inhibitors. These are a newer type of medication given by injection. They’re antibodies that bind to a receptor in the brain that promotes vasodilation (widening of blood vessels).
- Botox injections. Receiving a Botox injection every 12 weeks may help prevent migraine attacks in some adults.
There are also various integrative treatments that may be effective for migraine, such as:
- Relaxation techniques. Stress is a common migraine trigger. Relaxation methods may help you keep your stress levels in check. Examples include yoga, meditation, breathing exercises, and muscle relaxation.
- Acupuncture. Acupuncture involves inserting thin needles into pressure points on the skin. This is thought to help restore the flow of energy in the body. It may be helpful with relieving migraine pain.
- Herbs, vitamins, and minerals. Some herbs and supplements may help with migraine symptoms. A few examples include butterbur, magnesium, and vitamin B-2.
Although researchers have identified possible causes of migraine, there’s still much that’s unknown.
However, from the research that has been done, it seems a complex combination of environmental and genetic factors causes this condition.
Mutations in specific genes are associated with some types of migraine, as in the case of familial hemiplegic migraine. However, most types of migraine are likely polygenic, meaning variations in several genes causes it.
Having a family history of migraine can be beneficial in that you can get valuable information from family members who experience the same condition. You may even respond to similar treatments.
If you have migraine symptoms that make it difficult to get through the day, see your doctor to discuss your treatment options.