Childhood Maltreatment in the Migraine Patient

Abstract

Maltreatment during childhood increases vulnerability to a host of health disorders, including migraine. Putative mechanisms linking maltreatment and migraine include stress-induced dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, as well as disruption of other stress-mediating homeostatic systems, including those involving endocannabinoids, monoamine neurotransmitters, oxytocin, and inflammation. Prolonged elevation of glucocorticoids alters the neural architecture of the limbic system, resulting in the structural as well as functional changes described in both maltreatment and in migraine. Although treatment trials for migraine have not stratified participants by abuse history, strategies, such as cognitive behavioral therapy, which alter stress responsivity, may be particularly effective in this subgroup. Some therapies involving the endocannabinoid, serotonergic, oxytonergic, and inflammatory systems are under investigation for migraine. Anti-epileptic drugs such as valproate and topiramate, which are FDA approved for migraine treatment, are also known to interfere with epigenetic changes induced by stress. Discerning the role for this mechanism in treatment of maltreated migraineurs may introduce another therapeutic avenue.

Do Personality Traits Mediate the Relationship Between Childhood Abuse and Migraine? An Exploration of the Relationships in Young Adults Using the Add Health Dataset

“…Pathophysiologically, there is much evidence that early life stress has enduring effects on neuroendocrine, immune, and autonomic nervous systems . Involvement of the limbic system, both structurally and functionally, has been found in both maltreatment and in migraine, although it remains to be proved whether this explains a causal link .…”

“…64 Pathophysiologically, there is much evidence that early life stress has enduring effects on neuroendocrine, immune, and autonomic nervous systems. 65 Involvement of the limbic system, both structurally and functionally, has been found in both maltreatment and in migraine, although it remains to be proved whether this explains a causal link. 65 Both childhood abuse and migraine have been related to dysregulation of the hypothalamuspituitary-adrenal (HPA) axis and also to increase in inflammatory biomarkers.…”

“…65 Involvement of the limbic system, both structurally and functionally, has been found in both maltreatment and in migraine, although it remains to be proved whether this explains a causal link. 65 Both childhood abuse and migraine have been related to dysregulation of the hypothalamuspituitary-adrenal (HPA) axis and also to increase in inflammatory biomarkers. 65 Similarly, researchers have found an association between neuroticism and HPA axis regulation [66][67][68][69] and also between neuroticism and inflammatory biomarkers.…”

“…65 Both childhood abuse and migraine have been related to dysregulation of the hypothalamuspituitary-adrenal (HPA) axis and also to increase in inflammatory biomarkers. 65 Similarly, researchers have found an association between neuroticism and HPA axis regulation [66][67][68][69] and also between neuroticism and inflammatory biomarkers. [70][71][72][73] The role of genetic or epigenetic changes in each of these conditions and as a possible link between them is a nascent area of research.…”

Health Behaviors and Social Determinants of Migraine in a Canadian Population‐Based Sample of Adults Aged 45‐85 Years: Findings From the CLSA

“…7 Some have identified low socioeconomic status (SES) as a risk factor for migraine headache. 13 Recently, Burch et al 14 highlighted that migraine continues to be an important public health issue that disproportionately affects historically disadvantaged groups of persons (eg, unemployed, low household income, and individuals ≥65 years receiving Medicare and Medicaid). 13 Recently, Burch et al 14 highlighted that migraine continues to be an important public health issue that disproportionately affects historically disadvantaged groups of persons (eg, unemployed, low household income, and individuals ≥65 years receiving Medicare and Medicaid).…”