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The Journal of Headache and Pain logoLink to The Journal of Headache and Pain
. 2010 Jul 13;11(5):417–425. doi: 10.1007/s10194-010-0237-9

Migraine is comorbid with multiple sclerosis and associated with a more symptomatic MS course

Ilya Kister 1,✉, A B Caminero 1,2, T S Monteith 3, A Soliman 1, T E Bacon 1, J H Bacon 1,4, J T Kalina 1, M Inglese 5, J Herbert 1, R B Lipton 6
PMCID: PMC3452278  PMID: 20625916

Abstract

The objectives of this study were: (1) to assess relative frequency of migraine in multiple sclerosis (MS) patients using the validated self-administered diagnostic questionnaire, and to compare the migraine rates in MS outpatients to age- and gender-matched historical population controls; (2) to compare clinical and radiographic characteristics in MS patients with migraine and headache-free MS patients. We conducted a cross-sectional study to assess the demographic profiles, headache features and clinical characteristics of MS patients attending a MS clinic using a questionnaire based on the American Migraine Prevalence and Prevention (AMPP) study. We compared the relative frequency of migraine in MS clinic patients and AMPP cohort. We also compared clinical and radiographic features in MS patients with migraine to an MS control group without headache. Among 204 MS patients, the relative frequency of migraine was threefold higher than in population controls both for women [55.7 vs. 17.1%; prevalence ratio (PR) = 3.26, p < 0.001] and men (18.4 vs. 5.6%; PR = 3.29, p < 0.001). In a series of logistic regression models that controlled for age, gender, disease duration, β-interferon use, and depression, migraine in MS patients was significantly associated (p < 0.01) with trigeminal and occipital neuralgia, facial pain, Lhermitte’s sign, temporomandibular joint pain, non-headache pain and a past history of depression. Migraine status was not significantly associated with disability on patient-derived disability steps scale or T2 lesion burden on brain MRI. Migraine is three-times more common in MS clinic patients than in general population. MS–migraine group was more symptomatic than the MS–no headache group.

Keywords: Migraine, Multiple sclerosis, Magnetic resonance imaging, Symptomatology, Comorbidity, Cross-sectional study

Full Text

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Acknowledgments

This study was supported by a Pilot Award PP1471 from the National Multiple Sclerosis Society to Drs. Kister, Herbert, Bacon and Lipton.

Conflict of interest

Dr. Kister received funding for research activities from EMD Serono. Dr. Lipton receives research support from the NIH [PO1 AG03949 (Program Director), PO1AG027734 (Project Leader), RO1AG025119 (Investigator), K23AG030857 (Mentor), K23NS05140901A1 (Mentor), and K23NS47256 (Mentor)], the National Headache Foundation, and the Migraine Research Fund; serves on the editorial boards of Neurology and Cephalalgia and as senior advisor to Headache, holds stock options in Neuralieve Inc. and Minster Inc; serves as consultant for Advanced Bionics, Allergan, Inc., Boehringer-Ingelheim, Endo, Glaxo Smith Kline, Kowa, Minster, Merck, Neuralieve and Pfizer and received honoraria from Allergan, Inc, Glaxo Smith Kline and Merck, Inc. Dr. Herbert has consulting agreements with Biogen, TEVA, EMD Serono and Bayer. Dr. Inglese received consulting fees from TEVA Pharmaceuticals. Other authors have nothing to disclose.

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