June 5, 2023

Are Migraines Hereditary?

Your genes may offer some insight when learning about your migraine symptoms

Person lying on couch holding head in darkened room.

After mentioning your migraine to your aunt, they mention that your grandmother used to experience them, too.

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If you’ve gone to see a doctor for migraines, they may have even asked you if someone in your family has also dealt with migraine headaches.

Is it a coincidence? Or could there be a familial link between migraines?

Turns out, our genes may have some input on whether or not we experience this condition.

Julia Bucklan, DO, explains how genetics play a role in migraine diagnosis and treatment.

Are migraines hereditary?

Migraines — and their overall cause — are a tough nut to crack. This is because they’re caused by a combination of environmental, medical and genetic factors. So, it can be hard to pin down when your migraines are coming from the stressors around you or if they’re something that’s been passed down to you through genetics.

Here’s what the numbers tell us: Migraines tend to run in families. So, if at least one of your biological parents experienced migraines, there’s a 50% to 75% chance that you will also.

But migraines are a culmination of many factors, both genetic and environmental. “So, there is no one gene that dictates whether a person will develop migraines,” says Dr. Bucklan.

“However, there are known genes that promote the development of migraine,” she continues. These identified genes increase the likelihood of something called cortical spreading depression, which is a change in brain activity that manifests as different neurological disorders, such as migraines.

So, in short, yes — migraines can be hereditary. And several genes have been identified that may be involved in the development of migraines (more on that in a moment).

But it’s important to know that it takes more than just one mutated gene for you to be more susceptible to migraines. Rather, it’s a combination of different genes coming together. And having these certain genes doesn’t automatically mean you’ll have migraines either.

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How inherited genes impact migraines

So, how do your genes affect whether you experience migraines? A gene stores information from your DNA on how to make proteins in your body.

When a gene changes or becomes mutated, a “miscommunication” happens and can cause someone to become predisposed to certain health issues — this can manifest differently depending on the gene. Then, it’s possible for this gene to get passed down to that person’s children.

“I always explain migraines as an electrical storm, with activation of various receptors and the opening of certain ion channels that cause the symptoms of migraine,” illustrates Dr. Bucklan. “And so these gene mutations can make you more susceptible to migraines, but they aren’t something we can actually test clinically.”

But it’s important to know that our genetics is only one factor in the development of migraines, and other factors such as environmental triggers and lifestyle factors also play a role.

Are all types of migraines hereditary?

From chronic migraines to episodic migraines to migraines with auras, you may be wondering if certain types of migraines have more of a genetic link.

“The genes that people talk about more are those associated with hemiplegic migraine,” notes Dr. Bucklan.

The ATP1A2, CACNA1A and SCN1A genes are three of the common genes associated with this subtype of migraine, known as familial hemiplegic migraine (FHM). FHM is a rare form of migraine characterized by temporary paralysis or weakness on one side of the body (hemiplegia) during or before the headache phase.

Here’s what we know about these genes so far:

  • CACNA1A: This gene opens up the calcium channel and plays a crucial role in regulating the flow of calcium ions into neurons. Mutations on this gene can either increase the flow of calcium ions, making the neurons become more excited, or it can decrease neuron firing because the channel becomes too closed.
  • ATP1A2: According to various studies, mutations on the ATP1A2 gene disrupt the normal activity of sodium-potassium enzymes, which help with cell membrane health. Mutations on this gene can lead to abnormal ion transport and dysfunction of nerve cells.
  • SCN1A: The SCN1A gene is primarily associated with a neurological disorder called Dravet syndrome, which is characterized by seizures and developmental delays. While SCN1A mutations aren’t directly linked to migraines, theres some evidence suggesting a potential connection between SCN1A gene variants and an increased risk of migraines or migraine-like symptoms in some people.

But this doesn’t mean that only familial hemiplegic migraines have a genetic association — it just means that this is the one that has been studied and understood the most.

It’s also worth noting again that even if migraines do run in your family, not all members may be affected, and the severity and frequency of migraines can vary widely from person to person.

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How can understanding the genetics of migraines help treat them?

So, why is it important to consider genetics when treating your migraine?

According to Dr. Bucklan, this information is helpful when making a diagnosis. And as we continue to learn more, genetics may be valuable when developing more treatment and management options for migraines.

“We haven’t really mapped out all of the genes involved in migraine, and there’s still just so much to learn,” she explains. “But the hope is that as we learn more, it can help guide our treatment strategies for migraine. Right now, we certainly use evidence-based medicine, but it’s more broad and generalized. Our hope is for one day to narrow it down and figure out how each individual person responds to different treatments.”

Knowing your genetics can potentially help you manage your migraines in several ways:

  • Early diagnosis and intervention: According to Dr. Bucklan, one of the best things that genetic knowledge can do in your migraine treatment journey is help with clarity in diagnosis. By identifying these factors early on, you and your healthcare provider may be able to apply preventive measures to reduce the frequency and severity of migraines and avoid their progression to chronic migraines.
  • Identifying triggers: By understanding the genetic factors that may be contributing to your migraines, you may be able to identify specific triggers that are more likely to cause migraine attacks. If you have a genetic variant that makes you more sensitive to certain foods or environmental factors, you may be able to avoid or reduce your exposure to those triggers to help prevent migraines.
  • Dealing with stigma: Living with migraines can not only be painful but also confusing. A genetic link might help you understand where your migraine symptoms come from. As Dr. Bucklan points out, “Knowing that you’re not alone in dealing with your migraine can, at the very least, start a productive conversation. It does help with stigma, and I think it helps with personal acceptance.”

As always, it’s important to work with a healthcare provider who’s experienced in treating migraines and can help interpret the results of any genetic testing and develop an individualized treatment plan.

How can you find out if your migraines are hereditary?

If you have a family history of migraines, you might be wondering if it’s in your genes for you to have migraines as well. But at this time, there isn’t a specific medical test or diagnostic tool to actually determine whether migraines are hereditary.

If you’re experiencing migraines and have a family history of migraines, it’s important to discuss this with a healthcare provider. They may ask you questions about your family history of migraines and other medical conditions, as well as perform a physical exam and possibly order diagnostic tests to rule out other underlying conditions that may be causing your headaches.

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