Sex differences in clinical characteristics of migraine and its burden: a population-based study

Mona Ameri Chalmer; Lisette J.A. Kogelman; Ida Callesen; Charlotte Grønvold Christensen; Tanya Ramdal Techlo; Peter L. Møller; Olafur B. Davidsson; Isa A. Olofsson; Michael Schwinn; Susan Mikkelsen; Khoa Manh Dinh; Kaspar Nielsen; Mie Topholm; Christian Erikstrup; Sisse Rye Ostrowski; Ole Birger Pedersen; Henrik Hjalgrim; Karina Banasik; Kristoffer S. Burgdorf; Mette Nyegaard; Jes Olesen; Thomas Folkmann Hansen; DBDS Genomic Consortium

doi:10.1111/ene.15778

Sex differences in clinical characteristics of migraine and its burden: a population-based study

Mona Ameri Chalmer^*, Lisette J.A. Kogelman, Ida Callesen, Charlotte Grønvold Christensen, Tanya Ramdal Techlo, Peter L. Møller, Olafur B. Davidsson, Isa A. Olofsson, Michael Schwinn, Susan Mikkelsen, Khoa Manh Dinh, Kaspar Nielsen, Mie Topholm, Christian Erikstrup, Sisse Rye Ostrowski, Ole Birger Pedersen, Henrik Hjalgrim, Karina Banasik, Kristoffer S. Burgdorf, Mette NyegaardJes Olesen, Thomas Folkmann Hansen^*, DBDS Genomic Consortium

^*Corresponding author for this work

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Abstract

Background and purpose: Understanding migraine in a sex-specific manner is crucial for improving clinical care, diagnosis and therapy for both females and males. Here, data on sex differences are provided in the presentation of migraine in a large European-based population cohort, which is representative of the general population. Methods: A population-based study of 62,672 Danish blood donors (both present and previous donors), of whom 12,658 had migraine, was performed. All participants completed a 105-item diagnostic migraine questionnaire sent via an electronic mailing system (e-Boks) between May 2020 and August 2020. The questionnaire allowed for correct diagnosis of migraine according to the International Classification of Headache Disorders, third edition. Results: The migraine questionnaire was in-cohort validated and had a positive predictive value of 97% for any migraine, a specificity of 93% and a sensitivity of 93%. There were 9184 females (mean age 45.1 years) and 3434 males (mean age 48.0 years). The 3-month prevalence of migraine without aura was 11% in females and 3.59% in males. The 3-month prevalence of migraine with aura was 1.72% in females and 1.58% in males. In females, the age-related 3-month prevalence of migraine without aura increased markedly during childbearing age. In males, migraine both with and without aura showed less age variation. Females had a higher frequency of migraine attacks (odds ratio [OR] 1.22) but a lower frequency of non-migraine headaches (OR = 0.35). Females also had a greater intensity of pain, more unilateral and pulsatile pain, and exacerbation by physical activity (OR = 1.40–1.49) as well as more associated symptoms (OR = 1.26–1.98). Females carried 79% of the total migraine disease burden, which was almost exclusively driven by migraine without aura (77%), whilst there was no sex difference in the disease burden of migraine with aura. Conclusion: Females have more severe disease, resulting in a much higher migraine disease burden than indicated by prevalence alone.

Original language	English
Journal	European Journal of Neurology
Volume	30
Issue	6
Pages (from-to)	1774-1784
Number of pages	11
ISSN	1351-5101
DOIs	https://doi.org/10.1111/ene.15778
Publication status	Published - Jun 2023

Keywords

blood donors
burden
migraine
population-based study
sex differences
sex stratification
Migraine with Aura/diagnosis
Headache/epidemiology
Humans
Middle Aged
Male
Sex Characteristics
Migraine without Aura
Female
Surveys and Questionnaires

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10.1111/ene.15778Licence: CC BY-NC-ND

Euro J of Neurology - 2023 - Chalmer - Sex differences in clinical characteristics of migraine and its burden aFinal published version, 1.33 MBLicence: CC BY-NC-ND

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Chalmer, M. A., Kogelman, L. J. A., Callesen, I., Christensen, C. G., Techlo, T. R., Møller, P. L., Davidsson, O. B., Olofsson, I. A., Schwinn, M., Mikkelsen, S., Dinh, K. M., Nielsen, K., Topholm, M., Erikstrup, C., Ostrowski, S. R., Pedersen, O. B., Hjalgrim, H., Banasik, K., Burgdorf, K. S., ... DBDS Genomic Consortium (2023). Sex differences in clinical characteristics of migraine and its burden: a population-based study. European Journal of Neurology, 30(6), 1774-1784. https://doi.org/10.1111/ene.15778

@article{4a9ed09e521e482b8dcf4a0218333030,

title = "Sex differences in clinical characteristics of migraine and its burden: a population-based study",

abstract = "Background and purpose: Understanding migraine in a sex-specific manner is crucial for improving clinical care, diagnosis and therapy for both females and males. Here, data on sex differences are provided in the presentation of migraine in a large European-based population cohort, which is representative of the general population. Methods: A population-based study of 62,672 Danish blood donors (both present and previous donors), of whom 12,658 had migraine, was performed. All participants completed a 105-item diagnostic migraine questionnaire sent via an electronic mailing system (e-Boks) between May 2020 and August 2020. The questionnaire allowed for correct diagnosis of migraine according to the International Classification of Headache Disorders, third edition. Results: The migraine questionnaire was in-cohort validated and had a positive predictive value of 97% for any migraine, a specificity of 93% and a sensitivity of 93%. There were 9184 females (mean age 45.1 years) and 3434 males (mean age 48.0 years). The 3-month prevalence of migraine without aura was 11% in females and 3.59% in males. The 3-month prevalence of migraine with aura was 1.72% in females and 1.58% in males. In females, the age-related 3-month prevalence of migraine without aura increased markedly during childbearing age. In males, migraine both with and without aura showed less age variation. Females had a higher frequency of migraine attacks (odds ratio [OR] 1.22) but a lower frequency of non-migraine headaches (OR = 0.35). Females also had a greater intensity of pain, more unilateral and pulsatile pain, and exacerbation by physical activity (OR = 1.40–1.49) as well as more associated symptoms (OR = 1.26–1.98). Females carried 79% of the total migraine disease burden, which was almost exclusively driven by migraine without aura (77%), whilst there was no sex difference in the disease burden of migraine with aura. Conclusion: Females have more severe disease, resulting in a much higher migraine disease burden than indicated by prevalence alone.",

keywords = "blood donors, burden, migraine, population-based study, sex differences, sex stratification, Migraine with Aura/diagnosis, Headache/epidemiology, Humans, Middle Aged, Male, Sex Characteristics, Migraine without Aura, Female, Surveys and Questionnaires",

author = "Chalmer, {Mona Ameri} and Kogelman, {Lisette J.A.} and Ida Callesen and Christensen, {Charlotte Gr{\o}nvold} and Techlo, {Tanya Ramdal} and M{\o}ller, {Peter L.} and Davidsson, {Olafur B.} and Olofsson, {Isa A.} and Michael Schwinn and Susan Mikkelsen and Dinh, {Khoa Manh} and Kaspar Nielsen and Mie Topholm and Christian Erikstrup and Ostrowski, {Sisse Rye} and Pedersen, {Ole Birger} and Henrik Hjalgrim and Karina Banasik and Burgdorf, {Kristoffer S.} and Mette Nyegaard and Jes Olesen and Hansen, {Thomas Folkmann} and {DBDS Genomic Consortium}",

note = "Funding Information: The study was financed by a grant from Candys Foundation, the CEHEAD program (J.O.) and the Research Funding Pool at Rigshospitalet (M.A.C.). The funding sources had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: {\textcopyright} 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.",

year = "2023",

month = jun,

doi = "10.1111/ene.15778",

language = "English",

volume = "30",

pages = "1774--1784",

journal = "European Journal of Neurology",

issn = "1351-5101",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "6",

}

Chalmer, MA, Kogelman, LJA, Callesen, I, Christensen, CG, Techlo, TR, Møller, PL, Davidsson, OB, Olofsson, IA, Schwinn, M, Mikkelsen, S , Dinh, KM, Nielsen, K, Topholm, M, Erikstrup, C, Ostrowski, SR, Pedersen, OB, Hjalgrim, H, Banasik, K, Burgdorf, KS, Nyegaard, M, Olesen, J, Hansen, TF & DBDS Genomic Consortium 2023, 'Sex differences in clinical characteristics of migraine and its burden: a population-based study', European Journal of Neurology, vol. 30, no. 6, pp. 1774-1784. https://doi.org/10.1111/ene.15778

Sex differences in clinical characteristics of migraine and its burden: a population-based study. / Chalmer, Mona Ameri; Kogelman, Lisette J.A.; Callesen, Ida et al.
In: European Journal of Neurology, Vol. 30, No. 6, 06.2023, p. 1774-1784.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Sex differences in clinical characteristics of migraine and its burden

T2 - a population-based study

AU - Chalmer, Mona Ameri

AU - Kogelman, Lisette J.A.

AU - Callesen, Ida

AU - Christensen, Charlotte Grønvold

AU - Techlo, Tanya Ramdal

AU - Møller, Peter L.

AU - Davidsson, Olafur B.

AU - Olofsson, Isa A.

AU - Schwinn, Michael

AU - Mikkelsen, Susan

AU - Dinh, Khoa Manh

AU - Nielsen, Kaspar

AU - Topholm, Mie

AU - Erikstrup, Christian

AU - Ostrowski, Sisse Rye

AU - Pedersen, Ole Birger

AU - Hjalgrim, Henrik

AU - Banasik, Karina

AU - Burgdorf, Kristoffer S.

AU - Nyegaard, Mette

AU - Olesen, Jes

AU - Hansen, Thomas Folkmann

AU - DBDS Genomic Consortium

N1 - Funding Information: The study was financed by a grant from Candys Foundation, the CEHEAD program (J.O.) and the Research Funding Pool at Rigshospitalet (M.A.C.). The funding sources had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: © 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

PY - 2023/6

Y1 - 2023/6

N2 - Background and purpose: Understanding migraine in a sex-specific manner is crucial for improving clinical care, diagnosis and therapy for both females and males. Here, data on sex differences are provided in the presentation of migraine in a large European-based population cohort, which is representative of the general population. Methods: A population-based study of 62,672 Danish blood donors (both present and previous donors), of whom 12,658 had migraine, was performed. All participants completed a 105-item diagnostic migraine questionnaire sent via an electronic mailing system (e-Boks) between May 2020 and August 2020. The questionnaire allowed for correct diagnosis of migraine according to the International Classification of Headache Disorders, third edition. Results: The migraine questionnaire was in-cohort validated and had a positive predictive value of 97% for any migraine, a specificity of 93% and a sensitivity of 93%. There were 9184 females (mean age 45.1 years) and 3434 males (mean age 48.0 years). The 3-month prevalence of migraine without aura was 11% in females and 3.59% in males. The 3-month prevalence of migraine with aura was 1.72% in females and 1.58% in males. In females, the age-related 3-month prevalence of migraine without aura increased markedly during childbearing age. In males, migraine both with and without aura showed less age variation. Females had a higher frequency of migraine attacks (odds ratio [OR] 1.22) but a lower frequency of non-migraine headaches (OR = 0.35). Females also had a greater intensity of pain, more unilateral and pulsatile pain, and exacerbation by physical activity (OR = 1.40–1.49) as well as more associated symptoms (OR = 1.26–1.98). Females carried 79% of the total migraine disease burden, which was almost exclusively driven by migraine without aura (77%), whilst there was no sex difference in the disease burden of migraine with aura. Conclusion: Females have more severe disease, resulting in a much higher migraine disease burden than indicated by prevalence alone.

AB - Background and purpose: Understanding migraine in a sex-specific manner is crucial for improving clinical care, diagnosis and therapy for both females and males. Here, data on sex differences are provided in the presentation of migraine in a large European-based population cohort, which is representative of the general population. Methods: A population-based study of 62,672 Danish blood donors (both present and previous donors), of whom 12,658 had migraine, was performed. All participants completed a 105-item diagnostic migraine questionnaire sent via an electronic mailing system (e-Boks) between May 2020 and August 2020. The questionnaire allowed for correct diagnosis of migraine according to the International Classification of Headache Disorders, third edition. Results: The migraine questionnaire was in-cohort validated and had a positive predictive value of 97% for any migraine, a specificity of 93% and a sensitivity of 93%. There were 9184 females (mean age 45.1 years) and 3434 males (mean age 48.0 years). The 3-month prevalence of migraine without aura was 11% in females and 3.59% in males. The 3-month prevalence of migraine with aura was 1.72% in females and 1.58% in males. In females, the age-related 3-month prevalence of migraine without aura increased markedly during childbearing age. In males, migraine both with and without aura showed less age variation. Females had a higher frequency of migraine attacks (odds ratio [OR] 1.22) but a lower frequency of non-migraine headaches (OR = 0.35). Females also had a greater intensity of pain, more unilateral and pulsatile pain, and exacerbation by physical activity (OR = 1.40–1.49) as well as more associated symptoms (OR = 1.26–1.98). Females carried 79% of the total migraine disease burden, which was almost exclusively driven by migraine without aura (77%), whilst there was no sex difference in the disease burden of migraine with aura. Conclusion: Females have more severe disease, resulting in a much higher migraine disease burden than indicated by prevalence alone.

KW - blood donors

KW - burden

KW - migraine

KW - population-based study

KW - sex differences

KW - sex stratification

KW - Migraine with Aura/diagnosis

KW - Headache/epidemiology

KW - Humans

KW - Middle Aged

KW - Male

KW - Sex Characteristics

KW - Migraine without Aura

KW - Female

KW - Surveys and Questionnaires

UR - http://www.scopus.com/inward/record.url?scp=85151278558&partnerID=8YFLogxK

U2 - 10.1111/ene.15778

DO - 10.1111/ene.15778

M3 - Journal article

C2 - 36905094

AN - SCOPUS:85151278558

SN - 1351-5101

VL - 30

SP - 1774

EP - 1784

JO - European Journal of Neurology

JF - European Journal of Neurology

IS - 6

ER -

Sex differences in clinical characteristics of migraine and its burden: a population-based study

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