Adolescent Migraine Linked to Biology, Low Income

BY DIANA MAHONEY
Elsevier Global Medical News

BOSTON (EGMN) - The prevalence of migraine in adolescents is linked to biologic predisposition in those with a strong family history of migraine and to household income among those who are not biologically predisposed to the condition, according to the results of a study reported on Wed., May 2, at the annual meeting of the American Academy of Neurology.

The findings suggest that the inverse relationship between migraine and income that has been consistently observed in adult populations might be a function of the social causation hypothesis, whereby poor socioeconomic conditions predispose people to migraine vs. the social selection hypothesis, by which migraine and its consequences leads people to poor socioeconomic circumstances, Dr. Richard B. Lipton said in a poster presentation.

Because adolescents contribute little to the family income, Dr. Lipton and lead author Dr. Marcelo Bigal, both of Albert Einstein College of Medicine in New York, and colleagues considered them to be an ideal age for testing whether social causation or selection might explain the inverse relationship between migraine and household income. Toward this end, the investigators mailed a validated headache questionnaire to 120,000 households representative of the U.S. population, from which they identified migraineurs according to the International Classification of Headache Disorders and calculated sex-specific prevalence migraine estimates by demographics and parental migraine status.

From 32,015 adolescents identified and contacted, 18,714 completed the surveys. "The 1-year migraine prevalence was 6.3%, and it was inversely related to household income among adolescents without a parent with migraine but not among those who had a parent with migraine," according to Dr. Lipton. Among the adolescents with no parental migraine history, the adjusted migraine prevalence rate in those from families with an annual income less than $22,500 was 4.4%, compared with 2.9% among those from families with an annual income of at least $90,000, he said.

In the presence of parental migraine history, the migraine prevalence was 8.6% among adolescents in the lower-income group, compared with 8.4% among adolescents from the higher-income families, Dr. Lipton noted.

"The inverse relationship between migraine prevalence and household income in the absence of family migraine history supports the social causation vs. social selection hypothesis," said Dr. Lipton. "This finding warrants further research to explore the environmental risk factors related to low income and migraine, as well as how interventions might minimize the incidence of migraine in at-risk adolescents."

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