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• Vol.44 No.11
• CLINICA NEUROL, 44: 944−947, 2004
• Vol.44 No.11 contents

The 45th Annual Meeting of the Japanese Society of Neurology

An update on the familial headache syndromes

Takao Takeshima, M.D., Masayoshi Kusumi, M.D., Yoko Fukuhara, M.D., Hisanori Kowa, M.D., Yoshiki Adachi, M.D. and Kenji Nakashima, M.D.

Department of Neurology, Institute of Neurological Sciences, Tottori University Faculty of Medicine

Migraine is a common form of the chronic headache syndromes. Although the pathogenesis of migraine still remains enigmatic, there have been remarkable progress in headache research.
Point mutations of P/Q-type Ca²⁺channel alpha 1 subunit (CACNA1A) gene have been identified in familial hemiplegic migraine (FHM), which linked to chromosome 19 (FHM-1, OMIM 141500). Na-K ATPase α2 gene has been identified as the causative gene for FHM linked to 1q21-23 (FHM-2, OMIM 602481).
Common forms of migraine (i.e. migraine with and without aura) seems to be caused from multifactorial genetic factors and environmental factors.
An association study of allelic variation at Codon 23 (Cys or Ser) of 5HT_2C-R gene in Japanese samples revealed that the Ser allele frequency in migraine with aura was significantly higher than that in the non-headache controls. However, negative association of this polymorphism have been reported in Caucasian migrainures. The C677T allelic variation of 5, 10-methylenetetrahydrofolate reductase (MTHFR) are focused on in association with the coronary heart diseases and the cerebrovascular diseases. The T allelic frequency in migraine sufferers was significantly higher than that in controls. The C677T mutation of MTHFR is one of the genetic risk factors for migraine. These observations are confirmed in Turkish, Australian and Spanish samples. Positive associations of angiotensin converting enzyme (ACE) gene, endotheline receptor-A (ET-A) gene, and insulin receptor gene have been reported. Using the genomewide screen technology, significant linkage between the migraine with aura and a marker on 4q24 has been reported in Finnish families. The genome wide screen analysis will be one of the powerful strategies on exploring migraine gene. Genetic study of migraine headache is a promised and fruitful field and will provide deep understanding to migraine headache. Discovery of new responsible or susceptible genes to migraine will also open an avenue to develop new therapeutic strategy of migraine.

(CLINICA NEUROL, 44: 944−947, 2004)
key words: Familial hemiplegic migraine, P/Q-type Ca²⁺channel α1 subunit (CACNA1A), ATPase, Methylene-tetrahydrofolate reductase (MTHFR), 5HT2c-receptor

(Received: 13-May-04)