Migraine With Comorbid Depression: Pathogenesis, Clinical Implications, and Treatment

Abstract

Migraine is a neurological disorder that strongly relates to psychiatric conditions like depression. Lately, the increased prevalence of depression in migraineurs has come to attention. This article compiled various literature to explore the association between migraine and depression. Genetic overlap of various gene segments was studied, and heritability patterns were explored. Shared mechanisms such as serotonergic dysfunction, methylenetetrahydrofolate reductase (MTHFR) polymorphisms, and hormonal effects were investigated, and commonalities like comorbidities, stress, and environmental factors were analyzed. Migraine with comorbid depression (MID) affects various aspects of life and its clinical impact on migraine disability, quality of life (QOL), progression, and medication overuse was investigated. We further inspected several types of research in order to provide options on various treatment modalities. Pharmacotherapy such as antidepressants and anti-Calcitonin Gene-Related Peptide (CGRP) monoclonal antibodies like fremanezumab were studied. Alternative treatment options such as onabotulinumtoxinA (OBTA) injections, cognitive behavioral therapy (CBT), and vagal nerve stimulations (VNS) were also appraised and the efficacies of each were compared.

The relationship between major depression and migraine: A bidirectional two-sample Mendelian randomization study

“…Many studies have found a link between migraine and depression (39, 40). Migraine is a risk factor for depression, and the incidence and severity of migraine attacks rise during the depression and vice versa (41). Similarly, Jat et al (42) discovered that 6.6% of patients with depression had MA, and 26.1% had MO in crosssectional research.…”

Study of Risk Factors and Correlates of Migraine and Depression Comorbidity

“…Moreover, the results suggest that the right paracentral lobule, left calcarine sulcus, and dorsolateral superior frontal gyrus (SFGdor.L) may be the core region for the development of depression in migraine patients. The study found that (Asif N, Patel A, Vedantam D, et al, 2022) the changes of right paraventral lobule and right fusiform gyrus are the specific manifestations of migraine combined with depression, and the left thalamus, medial orbit of superior frontal gyrus and triangular part of inferior frontal gyrus are all changed in migraine patients. Emotional symptoms of migraine are associated with functional changes in the right paracentral lobule, left talus, and left dorsolateral superior frontal gyrus.…”

Cefaleia Relacionada Ao Esporte

“…Além disso, atua também de forma agonista na melhora de condições associadas que podem influenciar o tratamento e as recidivas da cefaleia, como doenças metabólicas, mecânicas e mentais (ASIF et al, 2022).…”