Revisiting the bipolar disorder with migraine phenotype: Clinical features and comorbidity

Francisco Romo-Nava, Thomas Blom, Alfredo B. Cuellar-Barboza, Oluwole O. Awosika, Brian E. Martens, Nicole N. Mori, Colin L. Colby, Miguel L. Prieto, Marin Veldic, Balwinder Singh, Manuel Gardea-Resendez, Nicolas A. Nunez, Aysegul Ozerdem, Joanna M. Biernacka, Mark A. Frye, Susan L. McElroy

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: To evaluate the prevalence and clinical correlates of lifetime migraine among patients with bipolar disorder (BD). Methods: In a cross-sectional study, we evaluated 721 adults with BD from the Mayo Clinic Bipolar Disorder Biobank and compared clinical correlates of those with and without a lifetime history of migraine. A structured clinical interview (DSM-IV) and a clinician-assessed questionnaire were utilized to establish a BD diagnosis, lifetime history of migraine, and clinical correlates. Results: Two hundred and seven (29%) BD patients had a lifetime history of migraine. BD patients with migraine were younger and more likely to be female as compared to those without migraine (p values <0.01). In a multivariate logistic regression model, younger age (OR=0.98, p<0.01), female sex (OR=2.02, p<0.01), higher shape/weight concern (OR=1.04, p=0.02), greater anxiety disorder comorbidities (OR=1.24, p<0.01), and evening chronotype (OR=1.65, p=0.03) were associated with migraine. In separate regression models for each general medical comorbidity (controlled for age, sex, and site), migraines were significantly associated with fibromyalgia (OR=3.17, p<0.01), psoriasis (OR=2.65, p=0.03), and asthma (OR=2.0, p<0.01). Participants with migraine were receiving ADHD medication (OR=1.53, p=0.05) or compounds associated with weight loss (OR=1.53, p=0.02) at higher rates compared to those without migraine. Limitations: Study design precludes determination of causality. Migraine subtypes and features were not assessed. Conclusions: Migraine prevalence is high in BD and is associated with a more severe clinical burden that includes increased comorbidity with pain and inflammatory conditions. Further study of the BD-migraine phenotype may provide insight into common underlying neurobiological mechanisms.

Original languageEnglish
Pages (from-to)156-162
Number of pages7
JournalJournal of Affective Disorders
Volume295
DOIs
StatePublished - 1 Dec 2021

Bibliographical note

Funding Information:
Francisco Romo-Nava receives grant support from the National Institute of Mental Health K23 Award (K23MH120503) and from a 2017 NARSAD Young Investigator Award from the Brain and Behavior Research Foundation; is the inventor on a U.S. Patent and Trademark Office patent # 10,857,356; and has received non-financial research support from Soterix Medical. Susan L. McElroy: is or has been a consultant to or member of the scientific advisory boards of F. Hoffmann-La Roche Ltd. Idorsia, Myriad, Novo Nordisk, Otsuka, Sipnose, Sunovion and Takeda. She is or has been a principal or co-investigator on studies sponsored by Brainsway, Idorsia, Janssen, Marriott Foundation, Myriad, National Institute of Mental Health, Novo Nordisk, Otsuka, and Sunovion. She is also an inventor on United States Patent No. 6,323,236 B2, Use of Sulfamate Derivatives for Treating Impulse Control Disorders, and along with the patent's assignee, University of Cincinnati, Cincinnati, Ohio, has received payments from Johnson & Johnson, which has exclusive rights under the patent. Balwinder Singh reports research time support from Medibio (unrelated to the current study); grant support from Clinical and Translational Science (CCaTS) Small Grants Award, and Mayo Clinic. Miguel L. Prieto receives grant support from ANID/CONICYT FONDECYT 1181365 and FONDEF ID19I10116.This study was supported by the Marriott Foundation. The Marriott Foundation had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Partial information and results of this study were presented as an abstract and poster at the International Society of Bipolar Disorder meeting in May, 2021.

Funding Information:
Francisco Romo-Nava receives grant support from the National Institute of Mental Health K23 Award ( K23MH120503 ) and from a 2017 NARSAD Young Investigator Award from the Brain and Behavior Research Foundation ; is the inventor on a U.S. Patent and Trademark Office patent # 10,857,356; and has received non-financial research support from Soterix Medical. Susan L. McElroy: is or has been a consultant to or member of the scientific advisory boards of F. Hoffmann-La Roche Ltd. Idorsia, Myriad, Novo Nordisk, Otsuka, Sipnose, Sunovion and Takeda. She is or has been a principal or co-investigator on studies sponsored by Brainsway , Idorsia , Janssen , Marriott Foundation , Myriad , National Institute of Mental Health , Novo Nordisk , Otsuka , and Sunovion . She is also an inventor on United States Patent No. 6,323,236 B2, Use of Sulfamate Derivatives for Treating Impulse Control Disorders, and along with the patent's assignee, University of Cincinnati, Cincinnati, Ohio, has received payments from Johnson & Johnson , which has exclusive rights under the patent. Balwinder Singh reports research time support from Medibio (unrelated to the current study); grant support from Clinical and Translational Science (CCaTS) Small Grants Award, and Mayo Clinic . Miguel L. Prieto receives grant support from ANID / CONICYT FONDECYT 1181365 and FONDEF ID19I10116 .

Funding Information:
This study was supported by the Marriott Foundation . The Marriott Foundation had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Partial information and results of this study were presented as an abstract and poster at the International Society of Bipolar Disorder meeting in May, 2021.

Publisher Copyright:
© 2021

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