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- Title
Adverse Childhood Experiences Are Associated With Migraine and Vascular Biomarkers.
- Authors
Tietjen, Gretchen E.; Khubchandani, Jagdish; Herial, Nabeel A.; Shah, Kavit
- Abstract
Objectives.- Migraine is a risk factor for stroke in young women. Biomarker studies implicate endothelial activation as a possible mechanism. Emerging relationships of childhood adversity with migraine, and with inflammation, a component of endothelial activation, suggest that it may play a role in the migraine-stroke association. Our objective is to evaluate the relationship between adverse childhood experiences (ACEs), migraine, and vascular biomarker levels in premenopausal women. Methods.- Vascular and metabolic biomarkers from women 18-50 years, including 125 with migraine (interictal) and 50 without migraine, were evaluated. An ACE questionnaire was later collected by mail (response rate 80.6%, 100 migraineurs, 41 controls). Results.- Migraineurs and controls were demographically similar. Migraineurs reported adversity more commonly than controls (71% vs 46%, odds ratio [OR] = 1.53, 95% confidence interval 1.07-2.17). Average ACE scores were elevated in migraineurs as compared with controls (2.4 vs 0.76, P < .001). ACE scores correlated with headache frequency (0.37, P = .001) and younger age of headache onset (−0.22, P = .04). It also correlated with body mass index (r = 0.43, P = .0001), von Willebrand factor activity (r = 0.21, P = .009), tissue plasminogen activator antigen (r = 0.28, P = .004), prothrombin activation fragment (r = 0.36, P = .001), high-sensitivity C-reactive protein (r = 0.98, P = .0001), transforming growth factor-beta1 (r = 0.28, P = .003), tissue necrosis factor-alpha (r = 0.20, P = .03), interleukin-6 (r = 0.22, P = .03), adiponectin (r = −0.29, P = .003), and nitrate/nitrite concentration (r = −314, P = .001). Logistic regression analyses (adjusted for vascular risk factors and migraine) demonstrated an association of childhood adversity with inflammatory factors (high-sensitivity C-reactive protein, interleukin-6, and tissue necrosis factor-alpha). Conclusions.- In young women, adverse childhood events are associated with migraine, particularly chronic and transformed migraine, and with vascular biomarkers, especially inflammatory biomarkers. These findings implicate early life stress as a link between migraine and endothelial activation.
- Subjects
BIOMARKERS; CHI-squared test; CHILD abuse; CONFIDENCE intervals; STATISTICAL correlation; EPIDEMIOLOGY; DOMESTIC violence; MIGRAINE; PROBABILITY theory; QUESTIONNAIRES; SELF-evaluation; STATISTICS; T-test (Statistics); PERIMENOPAUSE; LOGISTIC regression analysis; DATA analysis; DATA analysis software; DESCRIPTIVE statistics
- Publication
Headache: The Journal of Head & Face Pain, 2012, Vol 52, Issue 6, p920
- ISSN
0017-8748
- Publication type
Article
- DOI
10.1111/j.1526-4610.2012.02165.x