Migraine is not just a headache, but a multifaceted disease, often associated with other symptoms and diseases. A recent Finnish study of Terveystalo patient data (Korolainen et al. 2019) reveals that the morbidity of migraine patients is significantly higher than that of controls – and that migraine forms extensive disease networks.
Methods and materials
The study used Terveystalo's electronic patient data from 2012–2017. It included 17,623 migraine patients and a control group of the same size, matched for age and gender.
Disease networks were formed using an automatic algorithm that grouped diagnoses based on their close connections.
Score
Diagnoses of migraine patients
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Migraine patients had on average 1.7 times more diagnoses than controls.
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Median number: 12 diagnoses in migraine patients vs. 6 in controls.
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Only 1% of migraine patients had a single diagnosis, compared to 13% of controls.
Wider disease networks
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Migraine patients had 9 disease groups, controls had 6.
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The largest group included fatigue, respiratory and digestive symptoms, infections, and psychological symptoms such as anxiety and depression.
Typical comorbidities
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Mood disorders and anxiety disorders
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Non-organic sleep disorders
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Respiratory infections and asthma
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Food and intestinal symptoms
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Musculoskeletal diseases
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Skin diseases and infections
Conclusions
Migraine patients have a broader and more diverse range of morbidity than controls.
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This is not explained by individual comorbidities, but by the overall effect of migraine on the body.
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Symptom clusters are often manifestations of migraine, not separate diseases.
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For example, irritable bowel syndrome and sleep disorders are very common in migraine sufferers.
Migraine is therefore a broad entity, the treatment of which should take into account all related symptoms and diseases - not just the headache.
Summary
Migraine is associated with a multifaceted morbidity that affects mood, sleep, respiratory and digestive systems, highlighting the need to understand migraine holistically and provide holistic treatments.
Markku Nissilä, neurology specialist
Frequently asked questions
1. What is meant by a disease network?
A disease network describes the connections between different diseases and symptoms. In migraine patients, these networks are larger and more complex than in controls.
2. What diseases are most commonly associated with migraine?
Depression, anxiety, sleep disorders, digestive symptoms, respiratory infections and musculoskeletal disorders.
3. Why does migraine affect so widely?
Migraine is associated with complex interactions between the nervous, vascular, and immune systems, which can affect many different organ systems.
4. How should migraine treatment be organized?
Treatment requires a holistic approach that also takes into account associated diseases – not just the headache.