Migraine with Aura: the Gene that increases Stroke Risk?

There’s been a lot of conversation about last month’s report on a genotype known as methyleneterahydrofolate reductase, or MTHFR 677TT.  If you’ve read any of the reports, you may be as confused as I was at first, but let’s take a closer look.

There has been a lot of research into the connection between stroke and migraine.  People with migraine, particularly specific types of migraine, do have an increased risk of stroke, according to modern research.

Now, this study involved 4577 Caucasian women who had a history of migraine (the study as a whole actually involved over 25,000 women).  Over a quarter of those presently were dealing with migraine with aura.

The study followed the women for 12 years, specifically watching for cardiovascular disease.

The interesting thing about this gene is that it actually seems to decrease the risk of migraine with aura.  However, if a woman has the genetic variation, and still develops migraine with aura, the risk of stroke takes a dramatic jump.

Women with the gene and migraine with aura had over three times the risk of developing cardiovascular disease.  They had four times the risk of stroke, compared to women without the gene and without migraine with aura.

It’s too early to see this as a finished picture – it’s really only another small piece in the puzzle.  It doesn’t look like the gene variant itself increases stroke risk – instead, there seems to be a connection between the gene and at least one type of migraine.  How this all fits together is turning out to be very complex.

So what does a woman with migraine do with this information?  Should she look into genetic testing?  Dr. Tobias Kurth from the Harvard Medical School and one of the authors of the study says no.  "At the moment, we’re not suggesting genotyping for women with migraines with aura. The consequences [of having this gene] are completely unclear right now."

Dr. Keith Siller, director of the Comprehensive Stroke Care Center at New York University’s Langone Medical Center explains that this may not even be the "right" gene – there is a connection, but it may be another gene causing the problem.

As we try to understand the link between stroke and migraine, there are a couple of things to keep in mind.  First, the increased risk from migraine alone is not a reason to panic.  Second, it is a reminder that we need to pay special attention to decreasing our risk in other ways – such as paying attention to our lifestyle and what we put in our bodies.

Dr. Kurth recommends:  "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."

And we wait until the puzzle is more complete…

For more, read Gene May Put Women With Migraine At Increased Risk Of Heart Disease And Stroke, Gene Linked To Migraine and Increased Stroke Risk, and Interrelationships among the MTHFR 677C>T polymorphism, migraine, and cardiovascular disease