Evidence map›Paper›PMID 39405806›Full record

Observational studyClinical neurology and neurosurgery2024

Migraine May Represent an Independent Risk Factor for Retinal Stroke: A Population-Based Cohort Study.

Jay B Lusk, Ailin Song, Shakthi Unnithan, Hussein R Al-Khalidi, Adam de Havenon, Valérie Biousse, Matthew Schrag, Elena Solopova, Sven Poli, Nosayaba Osazuwa-Peters and 3 more

Abstract readObservational Study
In one paragraph

Observational study in Clinical neurology and neurosurgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Atrial fibrillation in Retinal Artery Occlusions.Cardiology and cardiovascular medicine · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Jay B LuskDepartment of Neurology, Duke University School of Medicine, Durham, North Carolina. Electronic address: jay.lusk@duke.edu.
Ailin SongDepartment of Ophthalmology, Duke University School of Medicine, Durham, North Carolina. Electronic address: ailin.song@duke.edu.
Shakthi UnnithanDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina. Electronic address: shakthi.unnithan@duke.edu.
Hussein R Al-KhalidiDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina. Electronic address: hussein.al-khalidi@duke.edu.
Adam de HavenonDepartment of Neurology, Yale University School of Medicine, New Haven, Connecticut. Electronic address: adam.dehavenon@yale.edu.
Valérie BiousseDepartments of Ophthalmology and Neurology, Emory University School of Medicine, Atlanta, Georgia. Electronic address: vbiouss@emory.edu.
Matthew SchragDepartment of Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee. Electronic address: matthew.schrag@vumc.org.
Elena SolopovaDepartment of Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee. Electronic address: elena.solopova@vanderbilt.edu.
Sven PoliDepartment of Neurology & Stroke, University of Tübingen, Tübingen, Germany; Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany. Electronic address: sven.poli@icloud.com.
Nosayaba Osazuwa-PetersDepartment of Population Health Sciences, Duke University, Durham, North Carolina; Department of Health and Neck Surgery & Communication Sciences, Duke University, Durham, North Carolina. Electronic address: nosa.peters@duke.edu.
Ying XianDepartment of Neurology, University of Texas-Southwestern Medical Center, Dallas, Texas. Electronic address: Ying.Xian@UTSouthwestern.edu.
Emily O'BrienDepartment of Neurology, Duke University School of Medicine, Durham, North Carolina; Department of Population Health Sciences, Duke University, Durham, North Carolina; Duke Clinical Research Institute, Durham, North Carolina. Electronic address: emily.obrien@duke.edu.
Brian Mac GroryDepartment of Neurology, Duke University School of Medicine, Durham, North Carolina; Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Durham, North Carolina. Electronic address: brianmacgrory@yahoo.ie.

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Research Education Component CoreP30AG072958 · NIA · DUKE UNIVERSITY · PI ALLEN W SONG · 2021 to 2026
$24.1M
P30-Core Grant for Vision Research Core CP30EY006360 · NEI · EMORY UNIVERSITY · PI BOATRIGHT, JEFFREY H · 1986 to 2025
$15.3M
Perivascular fibroblasts, vascular fibrosis, and their contributions to cerebral amyloid angiopathyRF1NS130334 · NINDS · VANDERBILT UNIVERSITY · PI LIPPMANN, ETHAN, SCHRAG, MATTHEW · 2022 to 2025
$3.9M
Elucidating Molecular Drivers of Aging and Alzheimer's Disease via Multimodal Imaging Mass SpectrometryR01AG078803 · NIA · VANDERBILT UNIVERSITY · PI Rena A. S. Robinson, Matthew Schrag · 2022 to 2026
$3.5M
Balancing Risks and Benefits of Direct Oral Anticoagulants in Older Ischemic Stroke Patients with Atrial FibrillationR01AG066672 · NIA · UT SOUTHWESTERN MEDICAL CENTER · PI XIAN, YING · 2020 to 2025
$2.6M
STAT3 activation in astrocytes as a driver of neurovascular dysfunction in Alzheimer's disease and related dementiasRF1NS129735 · NINDS · VANDERBILT UNIVERSITY · PI LIPPMANN, ETHAN, SCHRAG, MATTHEW · 2022 to 2023
$2.5M
Antiplatelet in Stroke: Safety and Effectiveness in Seniors (ASSESS)R01AG062770 · NIA · UT SOUTHWESTERN MEDICAL CENTER · PI XIAN, YING · 2019 to 2023
$2.2M
Defective lysosomal membrane fission mediates axonal lysosome accumulation in dystrophic neurites in Alzheimer's disease.K76AG060001 · NIA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI SCHRAG, MATTHEW · 2019 to 2023
$1.2M
Treatment Targets for Inflamed Intracranial Atherosclerosis on Vessel Wall MRIK23NS105924 · NINDS · YALE UNIVERSITY · PI DE HAVENON, ADAM H. · 2019 to 2023
$988k
Cardioembolism as a Mechanism of Central Retinal Artery OcclusionK23HL161426 · NHLBI · DUKE UNIVERSITY · PI Brian Mac Grory · 2022 to 2026
$951k
Defective lysosome acidification in dystrophic neurites in Alzheimer's disease contributes to failure of autophagyR56AG074279 · NIA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI SCHRAG, MATTHEW · 2022 to 2022
$739k
NCATS NIH HHS UL1 TR001863NEI NIH HHS P30 EY006360NHLBI NIH HHS K23 HL161426NIA NIH HHS K76 AG060001NIA NIH HHS P30 AG072958NIA NIH HHS R01 AG062770NIA NIH HHS R01 AG066672NIA NIH HHS R01 AG078803NIA NIH HHS R21 AG070859NIA NIH HHS R56 AG074279NINDS NIH HHS K23 NS105924NINDS NIH HHS RF1 NS129735NINDS NIH HHS RF1 NS130334
6 · The paper itself

Abstract

introductionMigraine is an established risk factor for cerebral ischemic stroke, with an especially robust association in patients with migraine with aura. However, it is not known if migraine is a risk factor for retinal stroke (central or branch retinal artery occlusion; CRAO or BRAO).

methodsWe performed a retrospective, observational, cohort study using population-based data from the State Inpatient Databases and State Emergency Department Databases from New York (2006-2015), California (2003-2011), and Florida (2006-2015) to determine the association between hospital-documented migraine and retinal stroke. The primary exposure was hospital-documented migraine (ascertained from admission or emergency department diagnosis codes). The primary endpoint was time to hospital-documented CRAO (ICD-9-CM code 362.31 in the primary diagnosis position) and secondary endpoints included time to BRAO and any retinal artery occlusion (RAO). Cause-specific hazard models were used to model the association between migraine and subsequent CRAO.

resultsOf 39,835,024 patients included in the study, 1109,140 had migraine documented during our two year ascertainment window. Patients with migraine were younger (40.2±15.2 vs. 46.9±19.8, standardized difference (SD) 0.38), more likely to be female (81.4 % vs. 54.7 %, SD 0.6), and had a lower burden of atrial fibrillation (4.5 % vs. 6.9 %, SD 0.1), chronic kidney disease (1.9 % vs. 3.6 %, SD 0.2), and congestive cardiac failure (2.7 % vs. 5.1 %, SD 0.12). Migraine was not associated with CRAO in the primary diagnostic position (adjusted hazard rate (aHR) 1.15 (95 % CI: 0.79-1.67). However, it was associated with CRAO in any diagnostic position (aHR 1.39 (95 % CI: 1.08-1.78). As positive controls, we replicated previously established associations of migraine with cerebral ischemic stroke (aHR 1.35 (95 % CI: 1.32-1.38) and embolic ischemic stroke (aHR 1.15 (95 % CI: 1.08-1.22).

conclusionsIn a large, nationally-representative, claims-based study of patients from 3 regions in the United States (US), we did not find an adjusted association between migraine and a primary discharge diagnosis of CRAO. Our hypothesis-generating finding that migraine was associated with CRAO when using a broader definition sets the stage for future work leveraging both outpatient and pharmacy based claims to further explore this finding.

Indexed as

Migraine DisordersRetinal Artery OcclusionAdultAgedCohort StudiesFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsStrokeYoung AdultCentral retinal artery occlusionCerebrovascular diseaseIschemic strokeMigraineRetina

Identifiers

PMID39405806
PMCPMC11527560

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.