Patent foramen ovale and migraine: A cross-sectional study from the Northern Manhattan Study (NOMAS)

Tatjana Rundek, Mitchell S V Elkind, Marco R. Di Tullio, Emmanuel Carrera, Zhezhen Jin, Ralph L Sacco, Shunichi Homma

Research output: Contribution to journalArticle

99 Citations (Scopus)

Abstract

Background - A causal relationship between patent foramen ovale (PFO) and migraine has been hypothesized, and improvement of migraine frequency and severity after percutaneous PFO closure has been reported. Population-based data on the relationship between PFO and migraine are sparse, however. The objective of this study was to examine the association between PFO and migraine among stroke-free individuals in an urban, population-based, multiethnic cohort. Methods and Results - As a part of the ongoing Northern Manhattan Study (NOMAS), 1101 stroke-free subjects were assessed for self-reported history of migraine. The presence of PFO was assessed by transthoracic echocardiography. The mean age of the group was 69±10 years; 58% were women. Forty-eight percent were Caribbean Hispanic, 24% were white, 26% were black, and 2% were another race/ethnicity. The prevalence of self-reported migraine was 16% (13% migraine with aura). The prevalence of PFO was 15%. Migraine was significantly more frequent among younger subjects, women, and Hispanics. The prevalence of PFO was not significantly different between subjects who had migraine (26/178, or 14.6%) and those who did not (138/923, or 15.0%; P=0.9). In an adjusted multivariate logistic regression model, the presence of PFO was not associated with increased prevalence of migraine (odds ratio 1.01, 95% confidence interval 0.63 to 1.61). Increasing age was associated with lower prevalence of migraine in both subjects with a PFO (odds ratio 0.94, 95% confidence interval 0.90 to 0.99 per year) and those without PFO (odds ratio 0.97, 95% confidence interval 0.95 to 0.99 per year). The observed lack of association between PFO and migraine (with or without aura) was not modified by diabetes mellitus, hypertension, cigarette smoking, or dyslipidemia. Conclusions - In this multiethnic, elderly, population-based cohort, PFO detected with transthoracic echocardiography and agitated saline was not associated with self-reported migraine. The causal relationship between PFO and migraine remains uncertain, and the role of PFO closure among unselected patients with migraine remains questionable.

Original languageEnglish
Pages (from-to)1419-1424
Number of pages6
JournalCirculation
Volume118
Issue number14
DOIs
StatePublished - Sep 30 2008

Fingerprint

Patent Foramen Ovale
Migraine Disorders
Cross-Sectional Studies
Migraine with Aura
Odds Ratio
Confidence Intervals
Hispanic Americans
Echocardiography
Logistic Models
Stroke
Migraine without Aura
Urban Population
Dyslipidemias
Population

Keywords

  • Echocardiography
  • Epidemiology
  • Foramen ovale, patent
  • Migraine disorders
  • Risk factors

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Cite this

Patent foramen ovale and migraine : A cross-sectional study from the Northern Manhattan Study (NOMAS). / Rundek, Tatjana; Elkind, Mitchell S V; Di Tullio, Marco R.; Carrera, Emmanuel; Jin, Zhezhen; Sacco, Ralph L; Homma, Shunichi.

In: Circulation, Vol. 118, No. 14, 30.09.2008, p. 1419-1424.

Research output: Contribution to journalArticle

Rundek, Tatjana ; Elkind, Mitchell S V ; Di Tullio, Marco R. ; Carrera, Emmanuel ; Jin, Zhezhen ; Sacco, Ralph L ; Homma, Shunichi. / Patent foramen ovale and migraine : A cross-sectional study from the Northern Manhattan Study (NOMAS). In: Circulation. 2008 ; Vol. 118, No. 14. pp. 1419-1424.
@article{847d6284c77c4adfbec3af07af700e91,
title = "Patent foramen ovale and migraine: A cross-sectional study from the Northern Manhattan Study (NOMAS)",
abstract = "Background - A causal relationship between patent foramen ovale (PFO) and migraine has been hypothesized, and improvement of migraine frequency and severity after percutaneous PFO closure has been reported. Population-based data on the relationship between PFO and migraine are sparse, however. The objective of this study was to examine the association between PFO and migraine among stroke-free individuals in an urban, population-based, multiethnic cohort. Methods and Results - As a part of the ongoing Northern Manhattan Study (NOMAS), 1101 stroke-free subjects were assessed for self-reported history of migraine. The presence of PFO was assessed by transthoracic echocardiography. The mean age of the group was 69±10 years; 58{\%} were women. Forty-eight percent were Caribbean Hispanic, 24{\%} were white, 26{\%} were black, and 2{\%} were another race/ethnicity. The prevalence of self-reported migraine was 16{\%} (13{\%} migraine with aura). The prevalence of PFO was 15{\%}. Migraine was significantly more frequent among younger subjects, women, and Hispanics. The prevalence of PFO was not significantly different between subjects who had migraine (26/178, or 14.6{\%}) and those who did not (138/923, or 15.0{\%}; P=0.9). In an adjusted multivariate logistic regression model, the presence of PFO was not associated with increased prevalence of migraine (odds ratio 1.01, 95{\%} confidence interval 0.63 to 1.61). Increasing age was associated with lower prevalence of migraine in both subjects with a PFO (odds ratio 0.94, 95{\%} confidence interval 0.90 to 0.99 per year) and those without PFO (odds ratio 0.97, 95{\%} confidence interval 0.95 to 0.99 per year). The observed lack of association between PFO and migraine (with or without aura) was not modified by diabetes mellitus, hypertension, cigarette smoking, or dyslipidemia. Conclusions - In this multiethnic, elderly, population-based cohort, PFO detected with transthoracic echocardiography and agitated saline was not associated with self-reported migraine. The causal relationship between PFO and migraine remains uncertain, and the role of PFO closure among unselected patients with migraine remains questionable.",
keywords = "Echocardiography, Epidemiology, Foramen ovale, patent, Migraine disorders, Risk factors",
author = "Tatjana Rundek and Elkind, {Mitchell S V} and {Di Tullio}, {Marco R.} and Emmanuel Carrera and Zhezhen Jin and Sacco, {Ralph L} and Shunichi Homma",
year = "2008",
month = "9",
day = "30",
doi = "10.1161/CIRCULATIONAHA.108.771303",
language = "English",
volume = "118",
pages = "1419--1424",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "14",

}

TY - JOUR

T1 - Patent foramen ovale and migraine

T2 - A cross-sectional study from the Northern Manhattan Study (NOMAS)

AU - Rundek, Tatjana

AU - Elkind, Mitchell S V

AU - Di Tullio, Marco R.

AU - Carrera, Emmanuel

AU - Jin, Zhezhen

AU - Sacco, Ralph L

AU - Homma, Shunichi

PY - 2008/9/30

Y1 - 2008/9/30

N2 - Background - A causal relationship between patent foramen ovale (PFO) and migraine has been hypothesized, and improvement of migraine frequency and severity after percutaneous PFO closure has been reported. Population-based data on the relationship between PFO and migraine are sparse, however. The objective of this study was to examine the association between PFO and migraine among stroke-free individuals in an urban, population-based, multiethnic cohort. Methods and Results - As a part of the ongoing Northern Manhattan Study (NOMAS), 1101 stroke-free subjects were assessed for self-reported history of migraine. The presence of PFO was assessed by transthoracic echocardiography. The mean age of the group was 69±10 years; 58% were women. Forty-eight percent were Caribbean Hispanic, 24% were white, 26% were black, and 2% were another race/ethnicity. The prevalence of self-reported migraine was 16% (13% migraine with aura). The prevalence of PFO was 15%. Migraine was significantly more frequent among younger subjects, women, and Hispanics. The prevalence of PFO was not significantly different between subjects who had migraine (26/178, or 14.6%) and those who did not (138/923, or 15.0%; P=0.9). In an adjusted multivariate logistic regression model, the presence of PFO was not associated with increased prevalence of migraine (odds ratio 1.01, 95% confidence interval 0.63 to 1.61). Increasing age was associated with lower prevalence of migraine in both subjects with a PFO (odds ratio 0.94, 95% confidence interval 0.90 to 0.99 per year) and those without PFO (odds ratio 0.97, 95% confidence interval 0.95 to 0.99 per year). The observed lack of association between PFO and migraine (with or without aura) was not modified by diabetes mellitus, hypertension, cigarette smoking, or dyslipidemia. Conclusions - In this multiethnic, elderly, population-based cohort, PFO detected with transthoracic echocardiography and agitated saline was not associated with self-reported migraine. The causal relationship between PFO and migraine remains uncertain, and the role of PFO closure among unselected patients with migraine remains questionable.

AB - Background - A causal relationship between patent foramen ovale (PFO) and migraine has been hypothesized, and improvement of migraine frequency and severity after percutaneous PFO closure has been reported. Population-based data on the relationship between PFO and migraine are sparse, however. The objective of this study was to examine the association between PFO and migraine among stroke-free individuals in an urban, population-based, multiethnic cohort. Methods and Results - As a part of the ongoing Northern Manhattan Study (NOMAS), 1101 stroke-free subjects were assessed for self-reported history of migraine. The presence of PFO was assessed by transthoracic echocardiography. The mean age of the group was 69±10 years; 58% were women. Forty-eight percent were Caribbean Hispanic, 24% were white, 26% were black, and 2% were another race/ethnicity. The prevalence of self-reported migraine was 16% (13% migraine with aura). The prevalence of PFO was 15%. Migraine was significantly more frequent among younger subjects, women, and Hispanics. The prevalence of PFO was not significantly different between subjects who had migraine (26/178, or 14.6%) and those who did not (138/923, or 15.0%; P=0.9). In an adjusted multivariate logistic regression model, the presence of PFO was not associated with increased prevalence of migraine (odds ratio 1.01, 95% confidence interval 0.63 to 1.61). Increasing age was associated with lower prevalence of migraine in both subjects with a PFO (odds ratio 0.94, 95% confidence interval 0.90 to 0.99 per year) and those without PFO (odds ratio 0.97, 95% confidence interval 0.95 to 0.99 per year). The observed lack of association between PFO and migraine (with or without aura) was not modified by diabetes mellitus, hypertension, cigarette smoking, or dyslipidemia. Conclusions - In this multiethnic, elderly, population-based cohort, PFO detected with transthoracic echocardiography and agitated saline was not associated with self-reported migraine. The causal relationship between PFO and migraine remains uncertain, and the role of PFO closure among unselected patients with migraine remains questionable.

KW - Echocardiography

KW - Epidemiology

KW - Foramen ovale, patent

KW - Migraine disorders

KW - Risk factors

UR - http://www.scopus.com/inward/record.url?scp=54049120091&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=54049120091&partnerID=8YFLogxK

U2 - 10.1161/CIRCULATIONAHA.108.771303

DO - 10.1161/CIRCULATIONAHA.108.771303

M3 - Article

C2 - 18794393

AN - SCOPUS:54049120091

VL - 118

SP - 1419

EP - 1424

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 14

ER -