The association of migraine and autistic traits effects on anxiety, depression, and headache-related disability.

Abstract

Objectives: This study aimed to assess the frequency of autistic traits in patients with migraine and to examine the effect of autistic traits on migraine-related disability, as well as anxiety and depressive symptoms, through the mediating factors of anxiety sensitivity and sensory sensitivity.

Background: Autism spectrum disorder (ASD) and migraine are two distinct clinical conditions marked by impaired sensory processing. Both conditions induce widespread alterations in the brain and exhibit symptoms associated with sensory sensitivity. Research examining the relationship between migraine and autistic traits is sparse. Moreover, the occurrence of autistic traits in patients with migraine and their effect on headache-related disability and psychiatric comorbidities has not been thoroughly investigated.

Methods: This cross-sectional study included 169 patients with migraine and 112 healthy controls. Data collection for the study was conducted from November 2022 to May 2023. The Autism Spectrum Quotient (AQ), Hospital Anxiety and Depression Scale, Anxiety Sensitivity Index, and Dunn Adolescent/Adult Sensory Profile were given to participants. The Headache Impact Test-6 and the Visual Analogue Scale were used to evaluate quality of life and headache intensity for patients with migraine. Analyses examined how autism affects migraine-related disability, anxiety, and depressive symptoms through anxiety and sensory sensitivity.

Results: While 35% of patients with migraine were found to have autistic traits (AQ ≥ 23), this rate was found to be 17% in healthy controls. In the migraine group, autistic traits were positively correlated with sensory sensitivity, anxiety sensitivity, and depressive symptoms. Although autistic traits did not have a direct effect on headache-related disability and anxiety symptoms, indirect effects through anxiety sensitivity and sensory sensitivity were found to be significant (total indirect effect = 0.16, 95% confidence interval [CI] = [0.08, 0.25], total indirect effect = 0.24, 95% CI = [0.14, 0.33]). In addition, autistic traits had a direct effect on depressive symptoms. Indirect effects through anxiety sensitivity and sensory sensitivity were also significant (total indirect effect = 0.14, 95% CI = [0.08, 0.21]).

Conclusions: This study shows that autistic traits are more frequent among patients with migraine and that these traits exhibit indirect effects on headache-related disability and psychiatric comorbidities. Recognizing autistic traits in patients with migraine may be crucial for formulating methods to mitigate comorbidities and enhance the quality of life in this population.

Plain language summary: Autism and migraine are two different conditions that affect the brain and sensory traits. We do not know much about how these two conditions affect each other, so we compared autism traits in people with migraine and healthy controls. We found that people with migraine are more likely to have autism traits, which can make migraine disability, anxiety, and depression worse; understanding and treating these traits could improve life quality for migraine patients.