Prevalence of lifetime depression in a large hemiplegic migraine cohort.

Objective: To determine the prevalence of depression and determinants associated with depression in a large population of hemiplegic migraine (HM) patients. Methods: We conducted a cross-sectional, validated questionnaire study among 89 well-defined HM patients and 235 headache-free controls. The prevalence of lifetime depression and its relation to migraine characteristics was assessed. Results: HM patients had increased odds for lifetime depression (odds ratio 3.73, 95% confidence interval 2.18-6.38) compared with controls. Use of acute antimigraine medication was associated with lifetime depression. Conclusions: Depression is part of the monogenic hemiplegic migraine phenotype. Further studies are needed to elucidate the pathophysiologic role of HM genes in comorbid depression. For now, clinicians should take comorbid depression into consideration when starting prophylactic treatment of HM.