A Cross-Sectional Analysis of Migraine-Related Disability in CADASIL: A Mayo Clinic Cohort

Eric D. Goldstein, Mohammed K. Badi, James P. Klaas, Patrick Glover, Todd D. Rozen, Josephine F. Huang, Michelle P. Lin, James F. Meschia

Research output: Contribution to journalArticlepeer-review


Objectives:Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is inherited microangiopathy characterized by recurrent subcortical infarcts. A majority of those with CADASIL report coexistent migraine with aura. The authors aim to quantitatively describe migraine-related disability within a CADASIL cohort.Methods:A cross-sectional analysis was performed in a cohort of CADASIL. The Migraine Disability Assessment (MIDAS) quantified migraine-related disability. Further metrics obtained include first and last migraine, aura semiology, and therapeutic measures.Results:Twenty-four individuals were included [63% (15/24) female individuals; mean age, 56 y; range, 34 to 81 y]. Fifty-four percent (13/24) reported migraine, whereas 46% (11/24) reporting varying degrees of migraine-related disability. MIDAS Questionnaire scores appeared bimodal: 58% (14/24) scored 0 to 5, 7% (1/24) scored 6 to 10, 7% (1/24) scored 11 to 20 and 33% (8/24) scored over 20. Severe disability was associated with the multiplicity of aura semiologies and poor response to pharmacologic prophylaxis.Conclusions:A bimodal distribution of migraine-related disability was observed. A third of individuals had a severe disability and appeared medically refractory to medical migraine prophylactic measures. This study may serve as a reference point for future trials quantitatively gauging response of novel migraine treatment strategies within this unique population.

Original languageEnglish (US)
Pages (from-to)161-164
Number of pages4
Issue number6
StatePublished - Nov 1 2019


  • Migraine Disability Assessment questionnaire
  • aura
  • migraine

ASJC Scopus subject areas

  • Clinical Neurology


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