Election 2022: Migraine and the comorbidity problem

One of the biggest reasons every single politician should be jumping up and down about wanting to do more for migraine is the comorbidity problem.

Migraine is a gateway condition: having migraine puts you at a significantly higher risk of a long list of other conditions from heart disease, to cancer, to recurrent miscarriage. In many cases, we don’t know why, because there is limited substantive research on migraine globally.

To put it simply: migraine always has friends. The kind of friends you could do without. Because migraine makes you sick enough, you really don’t need more chronic conditions, but there they are, hanging out on your couch, eating your food, and not taking the hint to go home.

Of highest priority and concern is the growing evidence that migraine and COVID-19 are a poor combination. COVID-19 exacerbates migraine symptoms, in particular bringing on aura or more severe presentations of migraine that persist long after the infection has passed. People with migraine are also at a significantly greater risk of Long COVID or Post COVID Neurological Syndrome. To effectively deal with COVID-19 and long covid, we must effectively deal with migraine.

We know that people with migraine, and particularly migraine with aura subtypes, have a higher risk of stroke. Migrainous infarction is a type of ischaemic stroke that happens as a result of a migraine attack. Migraine with Aura has long been recognised as causing a risk of stroke 1.8 times higher than otherwise healthy people. To effectively deal with stroke we must effectively deal with migraine.

Mental health issues are proven to be linked with migraine disorders. It is estimated by the American Migraine Foundation that people with migraine are five times more likely to live with anxiety, affecting up to 60% of people with migraine, while 25% of people living with migraine also have depression. My own research has found similar figures here. The disease itself feeds mental ill-health: we worry about when the next attack will come, what will trigger it, and feel helpless and frustrated about the unpredictability of migraine and how it is affecting our lives. And, when we don’t know when the next attack is coming, it can cause a great deal of migraine related anxiety. Then, when migraine has completely taken over your life, it is natural that people become depressed. To effectively deal with anxiety and depression, we must effectively deal with migraine.  

There has been debate for a long time about the links between migraine and dementia, with a similar symptom – white matter hyperintensities particularly in the frontal lobe – visible on MRI scans in both dementia and migraine patients, and a lack of clarity about whether later life migraine diagnoses were early symptoms of dementia. This debate was largely resolved in 2020 with the publication of a very large national register study in Denmark of 1,657,890 people. This study found that people with migraine are 1.5 times more likely to develop dementia, and people with migraine with aura subtypes are more than twice as likely to develop dementia. To effectively deal with dementia, we must effectively deal with migraine.  

The list goes on and on. People with migraine are more likely to have allergies, asthma, eczema, endometriosis, fibromyalgia, insomnia, irritable bowel disease and other gut disorders, and tinnitus. We are also significantly more likely to be obese, so add all the other health risks associated with obesity to the list.

Migraine is a gateway disorder. If you want to fix anything else in our health system, you have to deal with migraine. And it affects 1 in 3 women, 1 in 10 men. So why isn’t it front and centre in our health system? Why isn’t it an issue in this election?

Ask your candidates what they’re going to do to bring migraine #OutOfTheDark. Because if they don’t, then they aren’t serious about any other disease they are talking about.