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(Stroke. 2007;38:3117.)
© 2007 American Heart Association, Inc.

Editorials

Blood Vessels, Migraine, and Stroke

Michael A. Moskowitz, MD Tobias Kurth, MD, ScD

From the Stroke and Neurovascular Regulation Laboratory (M.A.M.), Department of Radiology Massachusetts General Hospital, Harvard Medical School, Charlestown, Mass; The Divisions of Aging and Preventive Medicine (T.K.), Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass; and the Department of Epidemiology (T.K.), Harvard School of Public Health, Boston, Mass.

Correspondence to Michael A. Moskowitz, MD, Stroke and Neurovascular Regulation Laboratory, Department of Radiology Massachusetts General Hospital, Harvard Medical School, Charlestown, Mass CNY 149-6403. E-mail moskowitz@helix.mgh.harvard.edu

Key Words: genetics • migraine • risk factors • stroke

An extract of the first 250 words of the full text is provided, because this article has no abstract.

See related article, pages 3145–3151.

The relation between migraine and stroke has been well recognized and has been the focus of several publications.^1–3 Despite many hypotheses linking the 2 disorders, the precise mechanisms are unknown, and not surprisingly very complex. In this issue of Stroke, Pezzini and colleagues⁴ add to this complexity by suggesting that migraine with aura may "mediate" the influence of specific genotypes on stroke risk. How might this interesting association come about biologically? At the present time, we don’t know. Investigators believe that migraine is a complex genetic disorder⁵ in which multiple genes confer a small migraine risk burden together with a large impact from environmental events such as stress. However, genes responsible for causing common migraine subtypes such as migraine with and without aura are unknown as of this writing; therefore, it remains obscure whether a genetic component is involved in the link between migraine and stroke, and hence the study by Pezzini and colleagues is of particular interest.

The methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism constitutes an interesting target to further evaluate the biological link between migraine and stroke. MTHFR catalyzes the conversion of 5,10 methylene tetrahydrofolate into 5-methyl-tetrahydrofolate, the predominant form of folate within blood. Folate is used in multiple biochemical pathways including replication of DNA, metabolism of homocysteine as well as other methyl transfer reactions. The MTHFR C677T gene polymorphism has been associated with migraine with aura in some^6,7 but not all studies^8,9 and is associated with an increase . . . [Full Text of this Article]

Related Article:

Migraine Mediates the Influence of C677T MTHFR Genotypes on Ischemic Stroke Risk With a Stroke-Subtype Effect

Alessandro Pezzini, Mario Grassi, Elisabetta Del Zotto, Alessia Giossi, Roberto Monastero, Giorgio Dalla Volta, Silvana Archetti, Paola Zavarise, Cecilia Camarda, Roberto Gasparotti, Mauro Magoni, Rosolino Camarda, and Alessandro Padovani
Stroke 2007 38: 3145-3151. [Abstract] [Full Text] [PDF]

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				M. E. Bigal, T. Kurth, H. Hu, N. Santanello, and R. B. Lipton Migraine and cardiovascular disease: Possible mechanisms of interaction Neurology, May 26, 2009; 72(21): 1864 - 1871. [Abstract] [Full Text] [PDF]