title: Migraine, depression, and brain volume: the AGES-Reykjavik Study.
abstract: OBJECTIVE
  To examine the joint association of migraine headache and major depressive disorder on brain volume in older persons without dementia.
  
  
  METHODS
  Participants (n = 4,296, 58% women) from the population-based Age, Gene/Environment Susceptibility-Reykjavik Study were assessed for migraine headache in 1967-1991 (age 51 years [range 33-65]) according to modified International Classification of Headache Disorders-II criteria. In 2002-2006 (age 76 years [range 66-96]), lifetime history of major depressive disorder (depression) was diagnosed according to DSM-IV criteria, and full-brain MRI was acquired, which was computer postprocessed into total brain volume (TBV) (gray matter [GM], white matter [WM], white matter hyperintensities) and CSF volume for each study subject. We compared brain tissue volumes by headache categories with or without depression using linear regression, adjusting for intracranial volume and other factors.
  
  
  RESULTS
  Compared with the reference group (no headache, no depression) TBV and WM and GM volumes were smaller in those with both migraine and depression (TBV -19.2 mL, 95% confidence interval [CI] -35.3, -3.1, p = 0.02; WM -12.8 mL, CI -21.3, -4.3, p = 0.003; GM -13.0 mL, CI -26.0, 0.1, p = 0.05) but not for those with migraine alone (TBV 0.4 mL, WM 0.2 mL, GM 0.6 mL) or depression alone (TBV -3.9 mL, WM -0.9 mL, GM -2.9 mL).
  
  
  CONCLUSIONS
  Reporting both migraine and major depressive disorder was associated with smaller brain tissue volumes than having one or neither of these conditions. Migraineurs with depression may represent a distinct clinical phenotype with different long-term sequelae. Nonetheless, the number of subjects in the current study is relatively small and these findings need to be confirmed in future studies.
authors.affiliation: Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, National Institute on Aging, Bethesda, MD, USA. larus.gudmundsson@usuhs.edu
authors.forename: Larus S
authors.initials: LS
authors.lastname: Gudmundsson
authors.forename: Ann I
authors.initials: AI
authors.lastname: Scher
authors.forename: Sigurdur
authors.initials: S
authors.lastname: Sigurdsson
authors.forename: Mirjam I
authors.initials: MI
authors.lastname: Geerlings
authors.forename: Jean-Sebastien
authors.initials: JS
authors.lastname: Vidal
authors.forename: Gudny
authors.initials: G
authors.lastname: Eiriksdottir
authors.forename: Melissa I
authors.initials: MI
authors.lastname: Garcia
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.forename: Olafur
authors.initials: O
authors.lastname: Kjartansson
authors.forename: Thor
authors.initials: T
authors.lastname: Aspelund
authors.forename: Mark A
authors.initials: MA
authors.lastname: van Buchem
authors.forename: Vilmundur
authors.initials: V
authors.lastname: Gudnason
authors.forename: Lenore J
authors.initials: LJ
authors.lastname: Launer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology*; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology / Q000473:pathology*