Nemcy Jean L.

Ballares April 27, 2010

NCM 103 NMMC Medical Ward/7am-3pm

Block A Mr. Griffin Matira, RN

Gene Linked To Migraine and Increased

Stroke Risk
by Teri Robert, Lead Expert

It's a double-edged Migraine sword. Researchers have identified a gene that may lessen
the risk of Migraine with aura (MWA), but for women who have MWA and carry the MTHFR
677TT genotype, the risk of ischemic stroke is substantially increased. This news comes from
study findings reported in the July 30, 2008, online issue of Neurology®, the medical journal of
the American Academy of Neurology.

This finding is based upon further analysis of data obtained in the Women's Health
Study. In this study, 4,577 women had a history of Migraine. Of those women, 3.226 were
actively experiencing Migraine and 39% of those had Migraine with aura (MWA). The women
were also tested for a certain gene variant in the methyleneterahydrofolate reductase gene.
Study participants were followed for a period of 12 years for the occurrence of cardiovascular
disease, including heart attacks and ischemic stroke.

The study found that women who had both the gene variant and migraine with aura had
more than three times the risk of cardiovascular disease, which was driven by four times the risk
for stroke compared with women who did not have the gene variant and no history of migraine.
An estimated 11 percent of the study population carries the gene variant.

These findings would logically Bring women to wonder about genetic testing, but the
study authors say it's too early:

“This gene by itself does not appear to increase the risk for overall and for specific
cardiovascular disease, but rather this research suggests a possible connection between the
gene variant and migraine with aura. While it is too early to start testing young women with
migraine with aura for this gene variant, more focused research will help us to understand these
complex links and will help us to potentially develop preventative strategies... Doctors should try
to reduce heart disease risk factors and advise young women who experience migraine with
aura not to smoke and to consider birth control pill alternatives as these increase the risk of
ischemic vascular problems.”

study author Tobias Kurth, MD, ScD

Brigham and Women’s Hospital and Harvard Medical School, Boston

REFERENCE: http://www.healthcentral.com/migraine/related-conditions-258769-5.html
Nemcy Jean L. Ballares April 27, 2010

NCM 103 NMMC Medical Ward/7am-3pm

Block A Mr. Griffin Matira, RN

REACTION

As with other studies that have shown a correlation between Migraine and stroke, this
one gives reason for thought and caution, but not panic. If you have Migraine with aura,
speak with your doctor about how you can reduce stroke risk factors. Work with your
doctor toward the best Migraine treatment regimen for you. Develop nutrition and
exercise lifestyle habits that will benefit your overall state of health. And, keep learning.
The more we know about our health and issues such as Migraine disease, the more we
can do to reduce our risks.

The closing paragraph of the Neurology article is worth special note:

"Our results warrant replication in other large cohorts with information on migraine and
aura status according to the IHS criteria. In particular, age- and gender specific effects
need to be considered. Given the limited knowledge about the biologic pathways
involved between migraine with aura and ischemic vascular events, genetic testing of
migraineurs with aura seems premature. However, practitioners should focus on
reducing cardiovascular risk factors and particularly advise young women with migraine
with aura not to smoke and to re-evaluate oral contraceptive use."