Finnish researchers have always played a major role in the study of migraine genetics. This is of course helped by the fact that Finns are very research-friendly. I would like to highlight a study led by Professor Aarno Palotie. The study is called Common Variant Burden Contributes to the Familial Aggregation of Migraine in 1,589 Families (reference below). A quick glance at the study in question immediately reveals that genetic research is a statistical analysis of large numbers.
The article investigates the genetic background of migraine heritability by analyzing 1,589 Finnish families and comparing their genetic profile to controls and random cases from a matched population.
Polygenic risk scores and family concentration
Familial migraine is significantly explained by a polygenic risk score (PRS), which reflects the combined effect of many common genetic variants, with each individual variant contributing slightly to the risk. The PRS burden in familial migraine was significantly higher (1.76) than in population-based cases (1.32). The study indicates that polygenic burden is a significant cause of inherited morbidity in families.
Genetic load of migraine subtypes
Elevated polygenic burden was observed in all subtypes of familial migraine, including migraine without aura, migraine with typical aura, and hemiplegic migraine. Migraine with paralytic symptoms had the highest burden (1.96). Significant differences in PRS levels were observed between migraine subtypes: typical aura and hemiplegic migraine were higher than migraine without aura. Typical aura (= moving sawtooth in the visual field) without headache showed a very low polygenic burden that did not differ from the level of controls.
Rare and common gene mutations
Only a small proportion, approximately 10%, of familial cases of paralytic migraine were associated with previously known single-gene diseases, particularly common in Central Europe. The majority of Finns had a high polygenic risk level, which emphasizes the importance of numerous genetic changes rather than rare, strong genetic defects.
Age of onset and severity of symptoms
The genetic load is higher when migraines start early and to a lesser extent with more severe clinical symptoms. Migraine patients who used triptan medication, i.e. needed more effective medication, had a higher PRS than usual.
The risk of inheriting migraine
According to the study, more migraine-related gene mutations were passed from parents to symptomatic children than statistically expected, confirming the importance of variation due to multiple genes.
Conclusions
Both common and rare forms of migraine, including migraine with paralytic symptoms, appear to be influenced by a multi-gene load. The genetic background of familial migraine is not mainly caused by changes in individual genes, but rather a polygenic risk load plays a very important role in the occurrence of migraine in families.
Reference: Cell – Common Variant Burden Contributes to the Familial Aggregation of Migraine in 1,589 Families
Markku Nissilä, neurology specialist
Frequently asked questions about the inheritance of migraines
Can migraine be inherited?
Yes. According to research, the genetic risk of migraine is passed from parents to children through several gene changes.
Is there a “migraine gene”?
Not just one. Migraines are caused by the combined effect of many small genetic changes.
Can a genetic test tell you your migraine risk?
Currently, a single genetic test cannot reliably predict risk because it is a multigenic phenomenon.
If parents have migraines, will the child definitely get it?
Not necessarily. Genes increase susceptibility, but environment and lifestyle also play a big role.
How does knowledge about heredity help?
When we understand the genetic background, we can identify risk factors earlier and seek appropriate treatment in a timely manner.
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