Phenogroups of Migraine Identified With Artificial Intelligence-Guided Topologic Mapping

Migraine is increasingly as a as a heterogeneous disorder, with a wide variety of headache characteristics, associated symptoms, and treatment responses. 

In a study presented at the American Headache Society meeting in Denver, CO June 9-12, 2022, Chia-Chun Chiang, MD, senior associate consultant and assistant professor of neurology at the Mayo Clinic, Rochester, MN presented research that identified 4 distinct migraine phenogroups that correlated most strongly with Migraine Disability Assessment (MIDAS) questionnaire scores. 

Dr Chiang noted, "We hope to leverage this AI-guided analysis to continue phenotyping migraine attacks with greater precision and eventually may be able to identify which types of migraine attack respond best to specific acute and preventive medications. 

The migraine attack features analyzed for this study came from database records of 4,360 people with migraine who had an intake survey and subsequent follow-up visits at the Mayo Clinic with recording of over 200 variables, including 29 clinically significant characteristics such as (eg, sex, level of education attained, age of onset, pain intensity, headache frequency, presence of aura and other specific migraine attack symptoms, disability from migraine, and family history). Records that were missing any of the 29 variables were not included in the analysis. The AI algorithm identified significant difference between the 4 groups in 22 of the 29 characteristics used in the analysis. 

This research used computer algorithms, or artificial intelligence (AI), to define the different characteristics of individual's migraines and graph these in a shape-based, or topologic, analysis. This analysis method has been extensively validated, particularly in identifying genes associated with breast cancer and subtyping type 2 diabetes mellitus. A caveat of this research is that all data analyzed came from people with relatively severe migraine who were seen at a tertiary-care headache clinic.