As brainstem mechanisms and dopaminergic neurotransmission are involved in
migraine pathophysiology, we decided to investigate the course of migraine
in Parkinson's disease (PD), the paradigm of brainstem dopaminergic disease
. We screened 237 consecutive PD out-patients by direct interview to assess
the prevalence of lifetime and current migraine. Moreover, we compared the
course of migraine in PD patients with that of otherwise healthy age- (+/-
3 years) and sex-paired migraine controls in a cross-sectional study. PD p
atients showed a lifetime migraine prevalence of 27.8% and a current migrai
ne prevalence of 13.1%. A positive family history of migraine was less freq
uent in PD patients than in controls. The frequency of current migraine was
significantly lower in PD patients than in controls (47.0% vs. 68.2%; odds
ratio = 0.41, 95% confidence interval = 0.19-0.89). Approximately two-thir
ds of PD patients reported an improvement in or remission of migraine after
PD onset. Effects of menopause on migraine course were similar in patients
and controls. These findings suggest that PD might somehow shorten the cli
nical course of migraine. Possible explanations include a prolonged prophyl
actic effect by chronic dopaminergic therapy or a positive effect of PD pat
hophysiology, namely nigral degeneration, on migraine mechanisms.