Researching the Mystery of Migraine: A Doctor Breaks Down A Recent Meta-Analysis

October 8, 2016

shutterstock_121028026For all that we know regarding migraine – their triggers, phases, percentages of the population afflicted, etc. – the causes of migraine remain a bit of a research mystery. A good amount of medical researchers has suspected that migraine is strongly associated with genetics. Yet after a recent meta-analysis published in Nature Genetics, medical professionals can feel even more confident in this hypothesis.

The website Medical-Net recently asked one of them – Nick Furlotte, PhD, Senior Scientist, Statistical Geneticist, and Health R&D for 23andMe to help us understand this major studies’ findings.  Below is a synopsis of what Dr. Furlotte had to say.

The Study
Dr. Furlotte outlines both the debate regarding migraine cause, the study, and describes what a meta-analysis is, and its importance to medical research, “there’s a big debate right now in the migraine community around the underlying cause of the disease. The question is whether it is vascular, and has something to do with our vessels, or whether it has to do with our neurons not functioning correctly or misfiring….There’s not a lot of genetic evidence to support either hypothesis….This study was aimed at trying to, firstly, find genetic determinants of migraine and then, to use those discoveries to understand more about the underlying mechanisms of migraine.”

Dr. Furlotte goes on to state the intention was, “to do a meta-analysis. A meta-analysis is when you simply take a bunch of studies, in this case twenty-two, and combine the results.”  Meta-analyses are crucial to a researcher’s work, since the sample pool is much greater. Rather than taking a single case study, say, of 300 participants, this analysis took 22 case studies and compared each’s findings. The size, scope, and checks-and-balances in meta-analyses, then, make for a much more powerful study, and ultimately, hypothesis. Or, as Dr. Furlotte refers to it, it has, “statistical power.”

The meta-analysis included a large sample set of participants of over approximately 100,000 individuals. Each participant was required for their explicit consent to “data share” their information for the study. Some discoveries included:

  1. 45 “association signals” encompass 38 different regions of the genome
  2. 28 of these signals were unique, or not previously known from previous studies
  3. Many of the regions identified home genes related to maintaining…blood vessels and their structure. This, in turn, lends credence to the hypothesis that migraine is vascular in nature

But is it Genetic?
In terms of the DNA sequence and whether migraine is “genetic,” Dr. Furlotte explains traits like migraine to be “complex.” In other words, factors could be caused genetically, through lifestyle, or environment. Researchers quantify the “genetic” nature a trait is through a system called “heritability.” Height is a good way to think of heritability, or the “canonical complex genetic trait.”

Influence of Study
When asked what Dr. Furlotte thought the impact the study’s finding would have on migraine treatment, he simply explains, “these kinds of studies can lead to a deeper understanding of how migraine or other diseases are caused. Once we understand that, we can also start to understand sub-types of the disease” which then lead to better understandings to smaller and smaller components of migraine’s make-up. This, of course, most likely leads to new development of more effective treatments for different people.

Migraine Treatment Today
Now, migraine treatment is often “self-experiment” or basically trial-and-error. This is still the case, for example, with the current methods psychiatrists use to see how one anti-depressant on an individual, and if there is an optimal one.

Based on the interview, this important study was quite an experience for Dr. Furlotte, “I came straight here from grad school and it was just unbelievable to me the kind of signal you could get out of really large sample sizes. We realize internally the value of that data, and that it can provide us with results that lead to a better understanding of how genetics influences diseases.”

The Future
The future for Dr. Furlotte seems quite bright. He is optimistic about the study, claiming, “I think genetics is obviously going to be really important for discovering how things work and what the molecular mechanisms behind diseases are, but also for treatment of diseases, development of new therapies, and prevention.”

However, it was Dr. Furlotte’s mission and goal of being part of the study seems the most important component of this exciting, groundbreaking study, “All of it is aimed at ultimately helping people, whether that’s finding a drug or creating something new that could help influence someone’s wellness, that’s what we’re interested in.”

We at Migraine Treatment Centers of America certainly hope he’s correct.

References

  1. Cashin-Garbutt, MA, April. ‘Are Migraines Genetic? An Interview with Nick Furlotte’. Medical News (News-Medical), September 26, 2016. http://www.news-medical.net/news/20160926/Are-migraines-genetic-An-interview-with-Nick-Furlotte.aspx?utm_medium=twitter&utm_source=twitterfeed.
  2. ‘Migraine Headaches’. June 23, 2015. Accessed October 10, 2016. http://youngmenshealthsite.org/guides/migraine/.
  3. Gormley, P. and 71 Additional Contributors. ‘Meta-Analysis of 375,000 Individuals Identifies 38 Susceptibility Loci for Migraine’. Nat Genet 48, no. 8 (June 20, 2016): 856–66. Accessed October 10, 2016. https://www.ncbi.nlm.nih.gov/pubmed/27322543.
  4. Sequin, Molly. ‘Researchers Think They Finally Know Why We Get Migraines’. July 5, 2016. Accessed October 10, 2016. http://www.businessinsider.com/researchers-think-that-they-finally-know-why-we-get-migraines-2016-6.
  5. ‘International Headache Genetics Consortium’. October 2015. Accessed October 10, 2016. http://www.headachegenetics.org/content/scientific-publications.

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