Research Article: Spinal Cord Injury and Migraine Headache: A Population-Based Study

Date Published: August 26, 2015

Publisher: Public Library of Science

Author(s): Freda M. Warner, Jacquelyn J. Cragg, Marc G. Weisskopf, John K. Kramer, Juei-Tang Cheng.

http://doi.org/10.1371/journal.pone.0135550

Abstract

Migraine headaches are a common neurological condition, negatively impacting health and quality of life. Among potential risk factors for migraine headache, risk of migraine headaches was elevated in individuals with spinal cord injury (SCI). The association between migraines and SCI is intriguing to consider from the perspective that migraine headaches may be acquired in response to damage in the spinal cord. The primary objective of this study was to further examine the association between SCI and migraine headache, controlling for potential confounding variables. A secondary objective was to determine the impact of migraine headaches on self-perceived health. Data from a sample of 61,047 participants were obtained from the cross-sectional Canadian Community Health Survey. Multivariable logistic regression was used to explore the association between SCI and migraine headache using probability weights and adjusting for confounders. The multivariable age- and sex-adjusted model revealed a strong association between SCI and migraine headache, with an adjusted odds ratio for migraine of 4.82 (95% confidence interval [3.02, 7.67]) among those with SCI compared to those without SCI. Further, individuals who experienced both SCI and migraine tended to report poorer perceived general health compared with the other groups (i.e., SCI and no migraine). In conclusion, this study established a strong association between SCI and migraine headache. Further research is needed to explore the possible mechanisms underlying this relationship. Improvements in clinical practice to minimize this issue could result in significant improvements in quality of life.

Partial Text

With an estimated lifetime prevalence of 11% in the general worldwide population, migraines are characterized by nausea, sensitivity to light and noise, and visual auras, in addition to intensely painful headaches [1]-[3] Migraine headaches are a particularly debilitating disease, negatively impacting overall health and quality of life [1], [4], [5]. Well-established risk factors for migraine headaches include family history, sex, and age [1], [2]. Specifically, migraine headaches are most prevalent in women of reproductive age [1], [2]. Somewhat more controversial, social and psychological (e.g., anxiety and mood disorders) variables have also been implicated as potential risk factors [1], [2], [4], [5]. An incidental finding of a recent population based study in Canada, increased prevalence of migraine headaches was reported among individuals with spinal cord injury (SCI) [6]. In principle, the association between migraines and SCI is intriguing to consider from the perspective that migraine headaches may be acquired in response to damage in the spinal cord, or as a function of other common SCI complications (e.g., chronic pain) [7].

The present study used data from a nationally representative Canadian survey to examine the relationship between SCI and migraine headache. Similar to a number of previous investigations, the odds of migraine headaches were increased in females, individuals between the ages of 30 to 50 years, individuals reporting a stroke, and smokers [1], [2]. Also in agreement with a previous report [14], migraines were associated with a 4-fold increased odds in individuals with SCI. In the present study, after adjusting for major confounding variables (e.g., age and sex), this association increased to nearly 5-fold. Interestingly, the association between migraines and SCI is drastically higher than the risk of other secondary conditions more commonly linked with SCI, including Type 2 diabetes, chronic respiratory conditions, heart disease, and stroke [15–17]. Highlighting functional significance, individuals who experienced SCI and migraines reported significantly poorer self-perceived health compared to those with SCI and no migraine.

In summary, we report a strong relationship between migraine headache and SCI after controlling for major confounding variables, and show that migraine headaches and SCI may compound self-perceptions of health when occurring together. To shed new light on this association and potential mechanisms, further studies are warranted.

 

Source:

http://doi.org/10.1371/journal.pone.0135550