Association between Blood Biomarkers and Migraine in Patients with Tinnitus

Editor’s note: The research described below comes from a recipient of a 2023 MSC Travel Grant supporting travel to the 65th Annual Scientific Meeting of the American Headache Society. These grants reimburse travel expenses for those who have had their abstract for a presentation or poster accepted at a meeting.

By Cynthia Tsang, MD student, University of California, Irvine School of Medicine, US.

What is the research gap that your study addresses?

My research is exploring potential associations between blood biomarkers and migraine diagnosis. In addition, our study assesses the correlations between migraine diagnosis and tinnitus frequency and severity.

What is your research hypothesis?

Based on foundational research on patients diagnosed with migraines, we hypothesize that there will be significant blood biomarker associations in patients suffering from migraines compared to those without migraine. This is based on previous studies that have considered how migraine and CGRP, calcitonin, amino acids and more are related.

What methodology did you use to address your research hypothesis?

Our study uses deidentified data from the National Health and Nutrition Examination Survey (NHANES) database over a period of three years (1999-2000, 2001-2002, and 2003-2004). We included adult patients who answered yes to having severe headaches or migraines in the last three months. Pregnant women and patients who self-reported regular analgesic use were excluded from the cohort. The study collected demographic information, as well as information on body mass index, platelet count and volume, white blood cells, red blood cells, hemoglobin, C-reactive protein, and severity of tinnitus from NHANES. The study used a two-tailed t-test to compare means for numerical variables and a chi-squared test to compare incidences for categorical variables. Multivariate binary logistic regression was also conducted for variables that were statistically significant.

What are the main results of your study?

The study included 1,990 patients with a mean age of 42.8 years. Variables with statistically significant differences between non-migraineurs and migraineurs included BMI (27.23 vs 29.39, p<0.001), WBC (71.9 vs 7.43, p=0.026), RBC (4.83 vs 4.7, p<0.001), hemoglobin (14.76 vs 14.23, p<0.001), and CRP (0.42 vs 0.57, p<0.001). For the multivariate regression analysis, we found that migraine was over twice (OR=2.12, 95% CI:1.54-2.92, p<0.001) as frequent in women than men. Decreased hemoglobin levels were significantly associated with having more migraines (OR=0.85, 95% CI = 0.75-0.99, p=0.035). Finally, compared to patients who reported tinnitus less frequently than once a month, increased frequency of tinnitus episodes was correlated to higher migraine risk. Specifically, participants who reported tinnitus at least once a month (OR=1.42, 95% CI=1.01-1.98, p=0.041) or at least once a week (OR=1.69, 95% CI=1.16-2.44, p=0.006) had elevated odds of migraine. Those who reported episodes at least once a day had an over two-fold increase in their odds of migraine (OR=2.62, 95% CI=1.63-4.22, p<0.001). Respondents who reported constant or almost always enduring tinnitus had moderately increased odds of migraine (OR=1.59, 95% CI=1.11-2.27, p=0.011).

What conclusions did you reach based on your results?

Based on our results, we found that there were no significant differences in blood biomarker profiles between migraine and non-migraine patients with tinnitus. We did find evidence to support an association of migraine with tinnitus.

What are the limitations of your study?

Study limitations include the cross-sectional design of the study, which prevented us from drawing causal relationships between migraine and metabolic markers. Our results are also subject to self-reporting biases. Finally, we were limited by the database itself, which did not have information on frequency of analgesic use, analgesic type, and headache quality, to name a few.

What is the relevance of your study to migraine?

 This study explores associations between hematologic biomarkers and migraine diagnosis. It also considers correlations between migraine diagnosis and tinnitus severity and frequency. Results from this study can further therapeutic development by contributing to the understanding of migraine pathogenesis and pathophysiology.