The study is published in the February 17, 2009, print issue of Neurology, the medical journal of the American Academy of Neurology.

The study involved 25,000 women who answered a questionnaire about their history of migraines and migraines with aura. Aura is usually described as visual disturbances, such as flashing lights or geometric patterns. The women were tested for a genetic variant called the angiotensin-converting enzyme (ACE) D/I polymorphism.

A total of 4,577 women reported a history of migraine and of those, 1,275 had migraine with aura. Twelve years after the start of the study, 625 strokes and heart attacks were reported.

The study did not find a link between the gene variant and migraine, migraine with aura, stroke or heart attacks. However, women who had migraine with aura and also were carriers of certain genotypes, called the DD and the DI genotypes, had double the risk of stroke and heart attacks. In contrast, women who had migraine with aura and were carriers of a third genotype, called the II genotype, were not at increased risk. The authors add the caution that this relationship was identified with very little information and must be tested in other studies to determine if it is real.

"The complex relationship among this gene variant, migraine, stroke and heart disease has been the focus of many studies and the results have been controversial," says study author Markus Sch rks, MD, MSc, with the Division of Preventive Medicine at Brigham and Women's Hospital in Boston. "Getting to the bottom of whether there is a connection and why may help to develop ways to prevent issues like stroke and heart disease, which are leading causes of death in the United States."

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All participants were offered genetic testing for mutations in GJB2. Of the 144 patients who underwent this screening, 27 (18.8 percent) had two mutated copies of the GJB2 gene, and one (3.7 percent) of those had ophthalmologic abnormalities. This compares with none of the 11 patients with a single copy of the mutated gene and 22 of 106 patients (20.8 percent) with no mutations. "This is consistent with the impression that GJB2 mutations result in sensorineural hearing loss but not in additional anomalies or syndromes," the authors write.

"A multidisciplinary approach is important in the evaluation and treatment of children with sensorineural hearing loss to ensure that their medical, education and social needs are met," the authors conclude. "Ophthalmologic evaluation can be beneficial for patients by allowing ophthalmologists to diagnose (and possibly treat) co-existing disorders that affect vision and by helping otolaryngologists to determine the cause of sensorineural hearing loss."

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