Author(s)

Jonathan Eskenazi¹, Miriam Nuno², Steven Graff-Radford³, Oana M. Dumitrascu^1*

¹Department of Neurology Cedars-Sinai Medical Center, Los Angeles, CA, USA.
²Department of Public Health Sciences, Division of Biostatistics, University of California Davis, Davis, CA, USA.
³The Pain Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Background: Pharmacogenetics information about cytochrome p450 (CYP450) polymorphism in patients with headaches is limitedly reported. Similarly, the genetic factors linking various headache types and vascular disorders are poorly described. We aimed to characterize the genetic profile of a cohort of headache and facial pain subjects. Methods: Medical records of consecutive headache subjects that underwent PersonaGene^TM testing were reviewed. PersonaGene^TM panel assessed CYP450, apolipoprotein E (ApoE), methylene tetrahydrofolate reductase (MTHFR), Factor II, Factor V Leiden and Vitamin K epoxide reductase complex subunit 1 (VKORC1). Demographic information, headache diagnosis and genetic profiling were analyzed and compared with data obtained from the general population. Results: Out of 130 headache patients, 91.3% were Caucasian and 70.8% had migraine. Compared to the general Caucasian population, our Caucasian headache patients were significantly different for CYP3A4/A5 and CYP2D6 (p < 0.001) and comparable regarding CYP2C9 and CYPC19. Whereas MTHFR genotype was similar, ApoE and Factor V Leiden were different in headache patients (p = 0.001). Less headache patients showed intermediate sensitivity to warfarin (p = 0.009) based on VQORC1 genotyping. No differences were noticed between migraine and other headache type diagnoses for all the genetic tests. Conclusion: Distinctive profiles for CYP450, ApoE, Factor V Leiden and VQORC1 were observed in our Caucasian headache cohort. These results may impact headache subjects’ pharmacological treatment options and vascular risk ascertainment.

Headache, Pharmacogenetics, Cytochrome P450, Cerebrovascular Risk, Cardiovascular Risk

Eskenazi, J. , Nuno, M. , Graff-Radford, S. and Dumitrascu, O. (2018) Genetic and Demographic Outcomes in a Population of Patients with Headache and Facial Pain. Journal of Behavioral and Brain Science, 8, 339-350. doi: 10.4236/jbbs.2018.86022.