![]() The rate of asthma was higher in the migraine group (15.4% ) than in the control II group (10.6%, P < 0.001, Table 1). The time duration from the index date to asthma was 42.4 months (SD = 33.2) in the migraine group and 43.0 months (SD = 33.8) in the control II group. We adjusted for depression and the Charlson comorbidity index (CCI) to exclude potential confounding effects. In addition, the control group subjects were matched with the study group subjects by age, sex, income, and region of residence. No previous study has concurrently evaluated the bidirectional association between asthma and migraine. In contrast, study II was designed to investigate the subsequent occurrence of asthma in migraine patients compared to a nonmigraine control group. In study I, asthma patients were evaluated for the risk of subsequent migraine and compared to a nonasthmatic control group. To prove this hypothesis, we designed two independent studies. We postulated that asthma and migraine have reciprocal relationships with each other. In addition, several epidemiologic studies reported the high rate of asthma in migraine patients and vice versa 17, 18.Ĭlinically, a considerable portion of asthma patients have comorbid headaches 19, 20, and it was questionable which disease was the first event. Due the these shared pathophysiology and recurrent symptoms, asthma was hypothesized as a acephalgic migraine or pulmonary migraine 15, 16. The pathophysiology of the hormonal imbalance and environmental triggering factors are common in both migraines and asthma 12, 13, 14. ![]() These hormonal and nervous changes induce vasodilation, the release of vascular factors, including growth factors, cytokines, nitric oxide, norepinephrine and calcitonin gene-related peptide, and interaction with endothelial cells, resulting in migraine symptoms 11. The environmental triggering factors can hyper-activate the hypothalamic-pituitary-adrenocortical axis and autonomic nervous system in migraine susceptible subjects 10. Migraines are characterized by recurrent episodic symptom sequences of a premonitory phase, an aura phase, a headache phase, and a postdrome phase 9. In Korea, approximately 6.0% of the adult population (19–69 years) suffers from migraines 8. As many as approximately 1.04 billion people suffer from migraines worldwide (95% uncertainty interval = 1.00–1.09) 7. Migraine disorder is another chronic disease characterized by multiple symptoms of headache and/or aura. In addition, both genetic factors and environmental triggering factors have been suggested to be related to asthma 5, 6. Thus, in addition to TH2-high related diseases, such as allergic rhinitis, other immune-related diseases could complicate asthma. According to the pathophysiologic mechanisms, asthma is classified as two major endotypes of T-helper type 2 cell (TH2)-high and TH2-low diseases 4. Because the diagnosis of asthma is based on the functional deterioration of the lower airway, the underlying pathophysiologic causes of asthma have been reported to vary among asthmatic patients 3. The incidence of asthma in the adult population (>20 years old) was estimated to be approximately 3.63–6.07 per 1,000 people in Korea 2. Asthma is a common disease with different prevalences according to ethnicity that range from approximately 7% to 18.0% 1. Similar content being viewed by othersĪsthma is a chronic airway disease associated with clusters of respiratory symptoms, including wheezing and dyspnea. Asthma and migraines are reciprocally associated. The asthma group demonstrated an adjusted HR of 1.47 for migraine (95% confidence interval (CI) = 1.41–1.53, P < 0.001). The hazard ratios (HRs) of migraines in the asthma patients (study I) and asthma in the migraine patients (study II) were analyzed using stratified Cox proportional hazard models after adjusting for depression and the Charlson comorbidity index. In study II, 36,044 migraine participants were matched with 114,176 control II participants. In study I, 113,059 asthma participants were matched with 113,059 control I participants. The Korean Health Insurance Review and Assessment Service - National Sample Cohort from 2002 to 2013 was used. The objective of this study was to evaluate the bidirectional association between asthma and migraines using control subjects matched by demographic factors.
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