Genes and Your Migraine Headaches

Migraine disorder has genetic roots, but additional factors are involved

Migraines often run in families, and it has long been believed that there may be a genetic component to migraine predisposition. Research into the association between genes and migraines has yielded some links, but there is still a long way to go in terms of understanding the significance and the exact role heredity plays when it comes to these painful and often debilitating headaches.

Migraine Heredity

While it is possible to develop migraines without a family history of the condition, if one of your parents has migraines, you have about a 50 percent chance of developing them yourself. When both of your parents have migraines, that chance increases even more. While twins and siblings may have an increased risk of sharing migraine tendencies, the link isn't as strong as it is with parents, suggesting that there may be environmental factors at play as well.

A family history of migraines means you are likely to experience more severe migraine types, including migraines with aura, which involve neurological symptoms such as visual changes and motor weakness.

Between 7 percent and 18 percent of the population experience recurrent migraines, making it one of the most common chronic ailments.

In addition to hereditary factors, there are others that predispose one to migraines. For example, women are more likely to have migraines than men, and episodes generally decline in frequency and severity after menopause.

Genes Associated With Migraines

While several different genes have been identified as possibly being associated with migraines, it is not completely clear how they are inherited or whether you need to inherit more than one to develop this genetic predisposition.

Some suspected migraine-associated genes are linked to blood vessel function; neurotransmitters in the brain; hormones, especially estrogen; inflammation; or ion channels, which control the electrical activity of the brain. For example, TARBP2 and NPFF genes, both located on chromosome 12, have been associated with inflammation, migraines with aura, and migraines without aura.

Another gene, the TRPV1 (transient related potential vanilloid type 1), modulates pain receptors, and alterations of this gene have been associated with scalp hypersensitivity, chronic headaches, and migraines.

Inconsistent Data

Other genes, including the methylenetetrahydrofolate reductase gene (MTHFR), had been believed to be associated with migraines, but follow-up research showed that mutations in this gene are not likely to be responsible for these headaches. Overall, this result suggests that identifying the specific genes that cause migraines and how they are inherited in families is more complicated than previously thought.

Familial Hemiplegic Migraine

The genetics of familial hemiplegic migraine, a rare migraine type, is more established and well understood than the genetics of more common migraine types.

Familial hemiplegic migraine is associated with mutations in CACNA1A, ATP1A2, and SCN1A, genes that direct production of the brain's ion channels. This type of migraine inheritance is autosomal dominant, meaning that you only need to inherit the gene from one parent to develop the condition.

Familial hemiplegic migraine is characterized by severe headaches accompanied by weakness of one side of the body. Sometimes, the episodes may come with numbness on one side of the body, slurred speech, language impairment, confusion, and/or drowsiness. In rare instances, familial hemiplegic migraine can cause migraine episodes with fever, seizures, and even coma.

Imaging studies suggest that there may be vascular changes and decreased blood flow to certain areas of the brain during these episodes. Electroencephalogram (EEG) studies also show an alteration of electrical activity in the brain— described as spreading depression— during a hemiplegic migraine. This EEG pattern is consistent with the mutations that are associated with this condition, as they involve genes that modulate electrical activity in the brain.

A Word From Verywell

While there have been genes linked with migraines, it is not customary to diagnose migraines through genetic testing. This is because an evaluation of your symptoms, particularly if your migraines are new or associated with neurological defects, is of greater urgency when it comes to your treatment—and ruling out other conditions such as stroke, transient ischemic attack (TIA), or meningitis often requires rapid results, given their serious nature.

Nevertheless, research into the link between genes and migraines may eventually help doctors identify whether an individual's chronic migraines are caused by alterations in vascular, inflammatory, hormonal, or neurotransmitter activity, ultimately helping tailor the most effective migraine treatments.

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