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Migraine and Depression Linked to Smaller Brain Size

Migraineurs have twice the risk of developing depression as those without migraine, and researchers have learned that the disorders may be connected in a striking way: The combination of the two has been linked to smaller brain size in older adults.

In a recent study, the brains of patients with migraine and depression had about 2% less volume than the brains of people who experienced neither or only one of the disorders. The information is not alarming, researchers said, but more study is warranted to fully understand the connection and its implications, including if the smaller volume is accompanied by a decline in cognitive abilities.

For this study, roughly 4,300 people with an average age of 51 were evaluated for migraine between 1967 to 1991. When the participants reached an average age of 76, they were assessed for depression.

Participants also underwent an MRI to determine their brain volume. The vast majority of participants (2,753) had neither condition, and just 37 had experienced both migraine and depression.

On average, those individuals with both disorders measured 19.2 milliliters less brain tissue than their study counterparts, but the cause of the reduced volume is not clear.

“It is important to note that participants in this study were imaged using MRI once, so we cannot say that migraine and depression resulted in brain atrophy. In future studies, we need to examine at what age participants develop both migraine and depression and measure their brain volume changes over time in order to determine what comes first,” said lead author Larus Gudmundsson, PhD, of the National Institute on Aging in Bethesda, MD.

The authors suggested a variety of possibilities for their findings, however.

It may be that pain, brain inflammation, genetics and differences in a combination of social and economic factors play a role in brain volume. Alternatively, smaller brain volume may stem from genetic or socioeconomic factors that increase the risk of migraine and depression. Furthermore, people with both disorders may belong to a different group than those with only one of the disorders and may require treatment tailored accordingly.

Regardless, Dr. Gudmundsson said, a reduction in brain size is not desired and has been associated with both aging and pain.

“Our results should … give more incentive to treat both migraine and depression better,” he said.

Arthur Elkind, MD, the President of the Board of the National Headache Foundation, expressed caution about the study and called for additional studies with larger populations to better understand the two disorders and their relationship with brain size.

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