Evidence of shared genetic risk factors for migraine and rolandic epilepsy
Evidence of shared genetic risk factors for migraine and rolandic epilepsy
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DOI：
10.1111/j.1528-1167.2009.02240.x
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发表时间：
2009-11-01
期刊：
影响因子：
5.6
通讯作者：
Pal, Deb K.
中科院分区：
文献类型：
--
作者：
Clarke, Tara;Baskurt, Zeynep;Pal, Deb K.
目的：偏头痛和罗兰式癫痫（RE）之间的特定联系的证据一直相互矛盾。偏头痛儿童经常有脑电图（EEG）异常，包括罗兰放电，大约50%的RE患者的兄弟姐妹表现出罗兰放电。我们评估偏头痛的风险在RE先证者和他们的siblings.Methods：我们使用队列和重建队列设计，分别评估偏头痛的相对危险度在72例RE和他们的88个兄弟姐妹使用国际头痛疾病分类（ICHD-2）标准。比较了150名年龄和地理位置匹配的非癫痫先证者及其188名同胞的发病率。我们使用了一个考克斯比例风险模型，以年龄为时间基础，调整风险比（HR）的先证者分析中的性别，性别和先证者偏头痛状态在siblinganalysis.Results：偏头痛的患病率在RE先证者是15%与7%的nonepilepsy先证者，并在兄弟姐妹的RE先证者患病率为14%与4%的nonepilepsy同胞。RE先证者偏头痛的性别校正HR为2.46 [95%置信区间（CI）1.06-5.70]。RE家族中有1个兄弟姐妹患有偏头痛的校正HR为3.35（95%CI 1.20-9.33），而RE先证者的任何一个兄弟姐妹的HR为2.86（95%CI 1.10-7.43）。这些结果表明，共同的偏头痛和RE的易感性，是不直接介导的癫痫发作。RE的易感基因变异可能被测试为偏头痛的危险因素。
Purpose: Evidence for a specific association between migraine and rolandic epilepsy (RE) has been conflicting. Children with migraine frequently have electroencephalographic (EEG) abnormalities, including rolandic discharges, and approximately 50% of siblings of patients with RE exhibit rolandic discharges. We assessed migraine risk in RE probands and their siblings.Methods: We used cohort and reconstructed cohort designs to respectively assess the relative risk of migraine in 72 children with RE and their 88 siblings using International Classification of Headache Disorders (ICHD-2) criteria. Incidences were compared in 150 age and geographically matched nonepilepsy probands and their 188 siblings. We used a Cox proportional hazards model, using age as the time base, adjusting hazard ratios (HRs) for sex in the proband analysis, and for sex and proband migraine status in the sibling analysis.Results: Prevalence of migraine in RE probands was 15% versus 7% in nonepilepsy probands, and in siblings of RE probands prevalence was 14% versus 4% in nonepilepsy siblings. The sex-adjusted HR of migraine for an RE proband was 2.46 [95% confidence interval (CI) 1.06-5.70]. The adjusted HR of having 1 sibling with migraine in an RE family was 3.35 (95% CI 1.20-9.33), whereas the HR of any one sibling of a RE proband was 2.86 (95% CI 1.10-7.43).Discussion: Migraine is strongly comorbid in RE and independently clusters in their siblings. These results suggest shared susceptibility to migraine and RE that is not directly mediated by epileptic seizures. Susceptibility gene variants for RE may be tested as risk factors for migraine.