Are Migraines Hereditary?

Migraine disorder has genetic roots, but additional factors are involved.

Suffering from a migraine headache.
Suffering from a migraine headache. JGI/Jamie Grill/Getty Images

Migraines tend to run in families. Because of that, researchers believe the condition has genetic roots and that migraines are hereditary, but they've only just begun to pin down exactly which genes are responsible and how those genes interact with your environment to produce the actual headaches.

There are several different types of migraine, and these have been grouped into two overall classifications: migraine with aura and migraine without aura.

Both appear to have genetic links, making them hereditary.

Studies of identical and fraternal twins show that up to one-half of migraine susceptibility is due to genetic factors, with more genetic risk for migraine with aura when compared to migraine without aura.

That means your genes may control a significant amount of your risk for having migraine disease — up to half, as I said — but other factors also contribute. Teasing out these genetic and non-genetic factors can lead to prospects for more effective treatments.

Severe Migraine with Aura: Genetic Links Clear

When looking for particular genes linked to migraine disease, researchers first studied a particular type of severe migraine with aura called familial hemiplegic migraine.

In this type of migraine with aura, people also suffer from temporary numbness and weakness, usually only on one side of their body, as the aura takes hold ("hemiplegic" simply indicates this occurs on just one side of the body).

Sufferers also may experience slurred or difficult speech, confusion and drowsiness.

Familial hemiplegic migraine can cause incredibly severe migraine episodes with fever, seizures and even coma. Death from these migraines has occurred in a few instances, and around 20% of sufferers develop permanent problems with balance, coordination and eye movements.

The genetic links in this type of migraine are clear and involve at least four genes, each of which seems to have a role in controlling neurotransmitters that tell our brains what to do. This initial research into familial hemiplegic migraine laid the groundwork for a closer look at migraine genetics in general.

Additional Migraine Genes Identified

To date, several studies have identified at least 13 genes that can cause a person to be more susceptible to migraine disease. Three of these affect a specific neurotransmitter, glutamate, while others affect the ability of the neurons themselves to behave in a normal fashion.

Scientists speculate that this genetic combination may lead the brain to be more "excitable" — meaning they cause increased activity in certain parts of the brain that seems to be related to the pain and other neurological symptoms of migraine. However, there's no clear proof of this theory yet.

It's also not clear if some of these features are unique to migraine, since one mechanism that seems to lead to the pain of a migraine also occurs in other conditions, including irritable bowel syndrome, fibromyalgia and even low back pain.

Genetics Important to Future Treatments

Whether you call it "migraine," "migraine disease," or "migraine disorder," migraine is a recurrent, episodic, hereditary neurological disease. That means migraineurs have a neurological disease all the time, not just when they actually have a migraine.

It might help to draw a comparison to epilepsy, another recurrent neurological disorder. People with epilepsy have the disorder all the time, even when they're not actively having episodes, and the goal for their medical care is to keep the disorder controlled to avoid episodes.

Scientists hope that by identifying the various genes that may contribute to migraine risk, they can devise drugs and other treatments that target the problems caused by those genes. Since migraines can be extremely disabling, with major effects on your work, your family and your overall health, any breakthroughs in migraine therapy based on your individual genes would be most welcome.

Sources:

Burstein R et al. Migraine: Multiple Processes, Complex Pathophysiology. The Journal of Neuroscience. 2015 Apr 29; 35(17): 6619–6629.

Honkasalo ML et al. Migraine and concomitant symptoms among 8167 adult twin pairs. Headache. 1995 Feb;35(2):70-8.

National Institutes of Health Genetic Home Reference. Familial Hemiplegic Migraine fact sheet. Accessed Nov. 20, 2015.

Piane M et al. Genetics of migraine and pharmacogenomics: some considerations. Journal of Headache Pain. 2007 Dec; 8(6): 334–339.

Smitherman TA et al. The prevalence, impact, and treatment of migraine and severe headaches in the United States: a review of statistics from national surveillance studies. Headache. 2013 Mar;53(3):427-36.

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