The association between multiple sclerosis and migraine: A meta-analysis

Mohammad Mohammadi; Samuel Berchi Kankam; Sadaf Salehi; Mobin Mohamadi; Aynaz Mohammadi; Seyed Reza Dehghani Firoozabadi; Vahid Shaygannejad; Omid Mirmosayyeb

doi:10.1016/j.msard.2023.104954

The association between multiple sclerosis and migraine: A meta-analysis

Mult Scler Relat Disord. 2023 Nov:79:104954. doi: 10.1016/j.msard.2023.104954. Epub 2023 Aug 30.

Authors

Mohammad Mohammadi¹, Samuel Berchi Kankam², Sadaf Salehi³, Mobin Mohamadi¹, Aynaz Mohammadi¹, Seyed Reza Dehghani Firoozabadi¹, Vahid Shaygannejad⁴, Omid Mirmosayyeb⁵

Affiliations

¹ School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
² School of Medicine, Tehran university of medical sciences, Tehran, Iran.
³ Iran University of Medical Sciences, Tehran, Iran.
⁴ Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
⁵ Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: omid.mirmosayyeb@gmail.com.

PMID: 37714098
DOI: 10.1016/j.msard.2023.104954

Abstract

Background: Multiple sclerosis (MS) is a chronic progressive condition marked by the deterioration of myelin and impairment of neurological function. The global prevalence of MS is approximately 2.2 million. Migraines are common in MS patients, with inconclusive data on their relationship. Our systematic review aimed to assess the prevalence and odds of migraine in pwMS and investigate the potential factors that may influence these associations.

Method: Through an extensive search and meticulous study selection, we identified pertinent literature investigating the occurrence and odds of migraines among pwMS. Additionally, we explored the comparative risk of migraines in MS patients compared to healthy controls. Data were extracted, including publication details, diagnostic criteria, and migraine prevalence in MS patients.

Results: A total of 35 studies were included, involving 279,620 pwMS and 279,603 healthy controls. The overall prevalence of migraine in pwMS was 0.24 (95% CI: 0.21-0.28). Subgroup analyses and meta-regression were conducted to investigate the potential impact of various factors on the relationship between migraine and MS. These factors included age, duration of MS, study design, and the Expanded Disability Status Scale (EDSS), migraine diagnosis method, study design, publication year of the study, country and continent of the study population. The results of these analyses revealed no significant influence of these factors on the relationship between migraine and MS. The meta-analysis indicated that pwMS had significantly increased odds of having migraine compared to healthy controls (OR = 1.96, 95% CI: 1.20-3.20). Sensitivity analyses supported the robustness of the findings.

Conclusions: Our study highlights that approximately 24% of pwMS experience migraine. The method of diagnosis significantly affects the reported prevalence, with questionnaires yielding higher rates. Furthermore, pwMS have a 1.96-fold increased odds of having migraine compared to healthy individuals. These findings emphasize the importance of further research and interventions to address the significant burden of migraine in the MS population.

Keywords: Headache; Meta-analysis; Migraine; Multiple sclerosis.

Publication types

Systematic Review
Meta-Analysis
Review

MeSH terms

Humans
Migraine Disorders* / epidemiology
Multiple Sclerosis*
Prevalence
Research Design