Can predisposing factors be targeted to reduce new migraine incidence?

A systematic literature review and meta-analysis revealed that comorbidities such as atopic disorders, cardiovascular disorders, sleep disorders, and psychiatric disorders are significant risk factors for the appearance of new migraine.

Although the scientific body of literature contains data on predictive risk factors for migraine onset, there is no comprehensive report that can inform on the various predisposing factors for migraine and perhaps further elucidate the pathophysiology of migraine. Ms Maria Terhart (Charité University Medicine Berlin, Germany) and colleagues performed a systematic literature review and meta-analysis focused on risk factors for new migraine onset using records included in PubMed and EMBASE [1].

The systematic literature search revealed 17,730 records, of which 52 were included in the final analysis. The 3-level meta-analysis revealed a total of 142 exposures. Risk factors for migraine identified included social and familial stress events (5 studies; RR 1.23; 95% CI 1.00–1.51), atopic disorders (8 studies; RR 1.53; 95% CI 1.15–2.03), behavioural factors (2 studies; RR 1.63; 95% CI 1.09–2.42), cardiovascular disorders (7 studies; RR 1.72; 95% CI 1.07–2.76), sleep disorders (6 studies, RR 1.89; 95% CI 1.26–2.85), and psychiatric/psychological disorders (20 studies; RR 2.63; 95% CI 1.79–3.85). Other identified factors which were associated with an increased risk of migraine included prenatal factors such as maternal alcohol and tobacco use.

“There are various comorbidities and some environmental factors associated with late-onset migraine in our study,” said Ms Terhart. “Part of the explanation is, with high likelihood, a shared genetic predisposition, but there are also overarching themes of stress and inflammation in our analysis that, in my opinion, warrant particular attention and further research.”

1. Terhart M, et al. Risk factors for migraine onset – a systematic review and three-level meta-analysis. 18^th European Headache Congress, 4–7 December 2024, Rotterdam, the Netherlands.

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Posted on 6 January 20256 January 2025