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Migraine more Likely to Worsen in Asthma Sufferers

Individuals with asthma who also experience episodic or occasional migraine may be more likely to develop chronic migraine, according to a National Headache Foundation-sponsored study recently published online in the journal Headache.

“If you have asthma along with episodic or occasional migraine, then your headaches are more likely to evolve into a more disabling form known as chronic migraine,” said Vincent Martin, MD, professor of medicine at the University of Cincinnati’s (UC) Division of General Internal Medicine, co-director of the Headache and Facial Pain Program at the UC Neuroscience Institute and lead author in the study. Dr. Martin is also Vice President of the National Headache Foundation.

Asthma_inhaler_useResearchers studied 4,500 individuals who experienced episodic migraine, defined as fewer than 15 headaches per month, in 2008 and analyzed data from the American Migraine Prevalence and Prevention (AMPP) Study, which was conducted during 2008 and 2009. Study participants completed written questionnaires in both years.  Based on responses to the 2008 questionnaire, patients were divided into two groups—one with episodic migraine and coexisting asthma and another with episodic migraine and no asthma.

After one year of follow-up, researchers found that new onset chronic migraine developed in 5.4% of participants who were also suffering from asthma and in 2.5% of individuals without asthma.

“The strength of the relationship is robust,” Dr. Martin said. “Asthma was a stronger predictor of chronic migraine than depression, which other studies have found to be one of the most potent conditions associated with future development of chronic migraine.”

One of the theories behind the findings is that many asthmatic patients are likely to also have allergies, and prior studies have shown that allergies may increase the number of headaches, particularly if the individual has hay fever. Another possibility is that patients with asthma may have an overactive parasympathetic nervous system that predisposes them to attacks of both migraine and asthma. Finally, it is also possible that asthma may not directly cause chronic migraine, but that a shared environmental or genetic factor, such as air pollution, which has been known to trigger both asthma and migraine attacks, may play a role.

Dr. Martin suggested that physicians may consider prescribing preventive medications for migraine at an earlier stage in patients who suffer from asthma and occasional migraine in order to avoid chronic migraine.

“If allergies are the trigger, it begs the question, should we treat allergies more aggressively in these patients?” Martin said.



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