Blood Vessels, Migraine, and Stroke

See related article, pages 3145–3151. The relation between migraine and stroke has been well recognized and has been the focus of several publications.1–3 Despite many hypotheses linking the 2 disorders, the precise mechanisms are unknown, and not surprisingly very complex. In this issue of Stroke , Pezzini and colleagues4 add to this complexity by suggesting that migraine with aura may “mediate” the influence of specific genotypes on stroke risk. How might this interesting association come about biologically? At the present time, we don’t know. Investigators believe that migraine is a complex genetic disorder5 in which multiple genes confer a small migraine risk burden together with a large impact from environmental events such as stress. However, genes responsible for causing common migraine subtypes such as migraine with and without aura are unknown as of this writing; therefore, it remains obscure whether a genetic component is involved in the link between migraine and stroke, and hence the study by Pezzini and colleagues is of particular interest.The methylenetetrahydrofolate reductase ( MTHFR ) C677T gene polymorphism constitutes an interesting target to further evaluate the biological link between migraine and stroke. MTHFR catalyzes the conversion of 5,10 methylene tetrahydrofolate into 5-methyl-tetrahydrofolate, the predominant …