Association Between Migraine Comorbidity and Psychiatric Symptoms Among People With Newly Diagnosed Focal Epilepsy
Publication: The Journal of Neuropsychiatry and Clinical Neurosciences
Abstract
Objective:
Little is known about psychiatric symptoms among patients with migraine and newly diagnosed focal epilepsy. The investigators compared symptoms of depression, anxiety, and suicidality among people with newly diagnosed focal epilepsy with migraine versus without migraine.
Methods:
The Human Epilepsy Project is a prospective multicenter study of patients with newly diagnosed focal epilepsy. Depression (measured with the Center for Epidemiologic Studies Depression Scale), anxiety (measured with the 7-item Generalized Anxiety Disorder scale), and suicidality scores (measured with the Columbia-Suicide Severity Rating Scale [C-SSRS]) were compared between participants with versus without migraine. Data analysis was performed with the Kolmogorov-Smirnov test for normality assessment, the Mann-Whitney U test, chi-square test, and linear regression.
Results:
Of 349 patients with new-onset focal epilepsy, 74 (21.2%) had migraine. There were no differences between the patients without migraine versus those with migraine in terms of age, race, and level of education. There were more women in the group with migraine than in the group without migraine (75.7% vs. 55.6%, p=0.0018). The patients with epilepsy and comorbid migraine had more depressive symptoms than the patients with epilepsy without migraine (35.2% vs. 22.7%, p=0.031). Patients with epilepsy with comorbid migraine had more anxiety symptoms than patients with epilepsy without migraine, but this relation was mediated by age in logistic regression, with younger age being associated with anxiety. Comorbid migraine was not associated with C-SSRS ideation or behavior.
Conclusions:
Among a sample of patients with newly diagnosed focal epilepsy, 21.2% had migraine. Migraine comorbidity was associated with higher incidence of depressive symptoms. Future studies should be performed to better assess these relationships and possible treatment implications.
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Received: 9 July 2021
Accepted: 16 August 2021
Published online: 28 December 2021
Published in print: Spring 2022
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Dr. Kanner has received honoraria from GW Laboratories for a lecture given to their staff. Dr. Sperling has received research contracts between Thomas Jefferson University and Cavion, Cerevel, Eisai, Engage Therapeutics, Medtronic, Neurelis, SK Life Sciences, Takeda, UCB Pharma, and Xenon and receives consulting with fees to Thomas Jefferson University from Medtronic and speaking fees from Eisai, Medscape, NeurologyLive, and Projects in Knowledge. Dr. French receives New York University (NYU) salary support from the Epilepsy Foundation and for consulting work or attending Scientific Advisory Boards on behalf of the Epilepsy Study Consortium for Aeonian/Aeovian, Anavex, Arvelle Therapeutics, Athenen Therapeutics/Carnot Pharma, Axovant, Biogen, BioXcel Therapeutics, Blackfynn, Cerebral Therapeutics, Cerevel, Crossject, CuroNZ, Eisai, Encoded Therapeutics, Engage Therapeutics, Epiminder, Epitel, Fortress Biotech, Greenwich Biosciences, GW Pharma, Ionis, Janssen Pharmaceutica, Knopp Biosciences, Lundbeck, Marinus, Merck, NeuCyte, Neurocrine, Otsuka Pharmaceutical Development, Ovid Therapeutics, Passage Bio, Pfizer, Praxis, Redpin, Sage, SK Life Sciences, Stoke, Sunovion, Supernus, Takeda, UCB, Xenon, Xeris, and Zogenix; she has also received research grants from Biogen, Cavion, Eisai, Engage, GW Pharma, Lundbeck, Neurelis, Ovid, Pfizer, SK Life Sciences, Sunovion, UCB, Xenon, and Zogenix, as well as grants from the Epilepsy Research Foundation, Epilepsy Study Consortium, and National Institute of Neurological Disorders and Stroke; she serves on the editorial board of Lancet Neurology and Neurology Today; she is Chief Medical/Innovation Officer for the Epilepsy Foundation, for which NYU receives salary support; and she has received travel reimbursement related to research, advisory meetings, or presentation of results at scientific meetings from Arvelle Therapeutics, Biogen, Cerevel, Engage, Epilepsy Foundation, Epilepsy Study Consortium, Lundbeck, NeuCyte, Inc., Otsuka, Sage, UCB, Xenon, and Zogenix. Dr. O’Brien has received research support funding from Biogen, Eisai, Praxis Precision Medicine, UCB, and Zynerba. The other authors report no financial relationships with commercial interests.
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