Comorbidities in migraine

Migraine is a prevalent and debilitating disorder. Migraine is linked to a high occurrence of several problems affecting the central and systemic systems, including neurological, psychiatric, cardiovascular, cerebrovascular, gastrointestinal, metabolic, and immunological conditions. Frequently, comorbidity exhibits bidirectionality, meaning that one condition increases the likelihood of the other. Insomnia is the most common comorbidity, whereas the cerebrovascular condition is the most feared. Comorbidity primarily arises from the common genetic basis of diseases. This genetic burden can stimulate atypical functioning or adaptability in the network connecting the brainstem, thalamus, and cortex, resulting in heightened energy demands and a transient or enduring state of inflammation in several organs. In this favorable context, various extra internal and external stimuli might disturb the usual equilibrium of the brain, resulting in the activation of the hypothalamic stress response system and triggering a migraine attack. Migraine can be either triggered by or contribute to the presence of concomitant disease, which can be viewed as an additional source of stress. In general, it is crucial for patients to undertake a comprehensive approach involving multiple disciplines to identify and, if necessary, eliminate probable factors that could increase the risk of complications and the presence of multiple medical conditions.