MTHFR Gene Polymorphisms and Susceptibility to Migraine Attacks

Background and Aim:Migraine consisting of migraine with aura (MA) and migraine without aura (MO) is a painful neurovascular disorder affecting approximately 16% of the general population. A combination of genetic and environmental factors is involved in the pathogenesis of migraine. The MTHFR enzyme is involved in homocysteine (Hcy) metabolism and it has been reported that 1298 A to C and 677 C to T mutations   in the MTHFR gene are associated with an increased in plasma Hcy levels. Hcy is a highly reactive amino acid and causes endothelial injury. Because a plausible theory about vascular impairment in migraine, it is considered that mutations in MTHFR gene and folate metabolism are associated with migraine.Materials and Methods:In total, 75 patients with migraine (24 with MA and 51with MO) in accordance with the IHS criteria participated in this case-control study. Control group were 128 normal matched healthy subjecys who selected from same region without history of migraine or other neurologic disorder after interviewing and examining by a physician. Mean age at entry was 36.42±9.6 and 31.64±8.9 years old in migraine and control group respectively.  MTHFR polymorphisms were investigated by PCR-RFLP.Results:Genotypic results indicated that the prevalence of the MTHFR 677TT genotype in migraine subjects was higher than control (17.3% and 3.1% respectively, P<0.001).  Interestingly the risk of migraine was 6-fold higher in subjects possessing the MTHFR 677T homozygous variant (OR=6.5; CI95%: 2.03-20.76). No significant difference in the prevalence of MTHFR A1298C genotypes was observed in migraine group when compared to controls (P>0.001).Conclusion:It seems that MTHFR C677T is a potential genetic risk factor for migraine attacks, both in MA and MO subclasses in Iranian population. C677T and A1298C joint effect could amplify the potential influence of each SNPs.

Sleep Quality and Depression among Patients with Migraine

The aim of this study was to determine the sleep quality and level of depression among Iranian migraineurs. Among 380 cases that were selected by simple random selection from those who attended Outpatient Neurology Clinic of Imam Khomeini Hospital, 332 patients participated in this cross-sectional study. After an inclusive examination by a neurologist, the participants were asked to fill valid and reliable Persian versions of Pittsburg Sleep Questionnaire (PSQI) and Beck Depression Inventory (BDI). They also requested to score headache severity by means of a visual analogue scale graded from 1-10. According to frequency of attacks, patients were divided into three groups: with 1-4 migraine days per month, 5-7 migraine days in a month and more than 7 migraine days per month. Mean age of participants was 36.3±10.1 years and mean headache severity score was 6.0±1.9. The PSQI total score and headache severity score were highest among patients with frequent attacks. Mean BDI, PSQI and headache severity scores significantly differ between male and female participants. There was significant positive correlation between BDI and PSQI scores (r=0.5, P<0.001) also there was a positive correlation between headache severity score and PSQI score (r=0.6, P<0.001). Decreased sleep quality with other co-morbidities such as depression in migraineurs cases should be considered