I have to tell you I'm a bit put off by a recent study on Migraines and systemic lupus erythematosus (SLE) for a number of reasons. This small study, released in August, 2011 concludes that Migraines are not a symptom of lupus. Fine. Furthermore, the study stated Migraines don't seem to be a neurologic factor in SLE and any previous incidence of such may have been due to methodological weakness of the previous studies.
In an earlier study, Mitsikostas et. al, found no meaningful links between Migraine and SLE. For their recent study, the participants included SLE patients, healthy controls and multiple sclerosis (MS) patients who kept Migraine diaries for a year. The researchers used MS patients in the study because SLE and MS are both diseases where the body uses its own immune systems to attack itself. The control group was matched by age and gender, while the SLE patients formed controlled 72 pairs. The diaries were checked at three, six, nine and 12 months for analysis.
In the year leading up to this study, the three groups had comparable headache frequency, but the SLE group had a larger number of tension-type headaches. During the study, the SLE group and MS group had a high rate of chronic tension-type headache, but there was no data on chronic tension-type headache for the control group. In both SLE and MS groups, any type of headache or Migraine could not be related to any disease activity with laboratory or clinical findings.
Study findings showed the SLE group had more anxiety, depression and a lower quality of life compared to the control group. It was speculated this may be the case in the MS group too due to disease burden. The SLE group Migraine attacks seemed to be shorter in length and less severe, but both SLE and MS groups did suffer from frequent and chronic tension-type headaches.
Senior author Dr. Dimos Mitsikostas states:
"In SLE, headache may be associated with poor quality of life and bad mood. If an SLE patient reports headaches, please see if he or she is happy and if there is any other reason to cause secondary headaches and treat them not as an SLE feature, but like a separate disorder."
Some of my thought on this study are below:
- Migraine needs to be removed as a symptom from the study. Period. It is a primary headache disorder, a neurobiological genetic brain disease and as such needs to be treated as its own disease, NOT a symptom of anything else.
- Why did the authors only scan the brains in the MS group? Shouldn't all the brains or at least those with MS and SLE have been scanned?
- Vital information from the control group on chronic tension-type headache is missing. How can a study be accurate and not include all its data?
- The implication that patients "happiness" is a reason to rule out headache as a symptoms or rule our Migraine as a FACTOR in SLE is bizarre. Stress is a possible trigger in tension-type headache, but there is plenty of evidence to show that tension-type headache has a neurobiological cause too.
- Depression and Migraine can be comorbid; Anxiety and Migraine can be comorbid. If depression and anxiety are symptoms of SLE and MS, doesn't that make Migraine a factor in SLE?
Mitsikostas says he finds "no pathophysiological links between SLE and Migraine." Let's look at this a different way. Is it possible that Migraine disease and SLE are comorbid? Not causing one another but occurring at the same time? The above study shows a clear cut connection between SLE and chronic tension-type headaches, but we know many people with SLE who have Migraines, and I bet they would argue that Migraine isn't connected to SLE in some way.
Christina G. Katsiari, MD, PhD; Michail Vikelis, MD, MSc; Eleftheria S. Paraskevopoulou, MD; Petros P. Sfikakis, MD; Dimos D. Mitsikostas, MD, PhD. "Headache in Systemic Lupus Erythematosus vs Multiple Sclerosis: A Prospective Comparative Study." Headache 2011, Early View. doi: 10.1111/j.1526-4610.2011.01962.x
Reuters. "Migraines are not a lupus symptom: study." MedlinePlus. Health Topics. August 30, 2011.
Thanks for reading and feel well,
visit my blog, Migraine and Other Headache Disorders
© HealthCentral Network, 2011.
Last updated October 1, 2011.
Published On: October 01, 2011