Epidemiology And Comorbidity A Migraine Prevalence

Migraine is a highly prevalent condition affecting approximately 10% of the population. Migraine prevalence is age, gender, and race dependent. Women are more affected (lifetime prevalence, 12-17%) than men (4-6%). In the American Migraine Study, the 1-year prevalence of migraine increased with age among women and men, reaching the maximum at ages 35-45 and declining thereafter. Migraine prevalence decreases in older women but never decreases to prepubertal or even male prevalence. Migraine prevalence is influenced by race and geographical region. It is highest in North America and Western Europe and more prevalent among Caucasians than African or Asian Americans. The influence of environmental and genetic factors varies. Migraine without aura is influenced by a combination of genetic and environmental factors, whereas migraine with aura has a stronger genetic influence. Behavioral, emotional, and climatologic changes may trigger migraine, modify the vulnerability to migraine, or impact on its prevalence.

Recent evidence suggests that migraine incidence is increasing. Stang and colleagues, in a population-based survey of migraine in Olmsted County, found that from 1979 to 1981 there was a striking increase in the age-adjusted incidence in those under 45 years of age. Migraine incidence increased 34% for women and 100% for men. In this study, the overall age-adjusted incidence was 137 per 100,000 person years for men and 294 per 100,000 person years for women. This was confirmed in a study conducted among schoolchildren in Finland: The prevalence of migraine increased over

Encyclopedia of the Human Brain Volume 3

Copyright 2002, Elsevier Science (USA).

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an 18-year period from 1.9 to 5.7%. Neither study provided evidence for the cause of this increase.

Migraine incidence and prevalence also vary by age and sex. Migraine without aura reaches its peak at ages 14-17 in females (0.2%) and 10 or 11 in males (0.1%). Migraine with aura has maximum incidence at the age of 12 or 13 in females (0.14%) and at the age of 5 in males (0.6%). This suggests that migraine with aura in men appears very early in life. In contrast, women more often develop migraine (with or without aura) as teenagers, during or following puberty.

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