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PreprintCC BYmedRxiv

Genetic liability to ADHD and migraine risk: Mendelian randomization evidence for behavioural and psychiatric pathways

  1. 1University of Bristol

Abstract

BackgroundAttention-deficit/hyperactivity disorder (ADHD) and migraine frequently co-occur, but the mechanisms underlying this association remain unclear. Examining migraine with aura and without aura separately may help clarify whether ADHD-related pathways are shared across migraine subtypes or differ by aura status.

MethodsTwo-sample Mendelian randomization (MR) was used to examine the effect of genetic liability to ADHD on overall migraine and on migraine subtypes defined by aura status. MR-based mediation was then used to assess whether behavioural, psychiatric, sleep-related, education, and cardiometabolic traits contribute to these effects.

ResultsMR provided evidence for an effect of ADHD genetic liability on overall migraine risk (OR = 1.48, 95% CI =1.2, 1.82), with similar effect sizes for migraine with aura (MA) (OR=1.52, 95% CI = 1.18, 1.96) and migraine without aura (MO) (OR = 1.65, 95% CI = 1.19, 2.31). Depression, alcohol intake frequency, lifetime smoking index, ever smoke, risk taking behaviours, insomnia, and college education showed evidence for partial mediation, explaining approximately 34.17% (95% CI = 6.17%, 61.63%), 14.44% (95% CI = 0%, 28.87%), 37.25% (95% CI = 11.86%, 63.64%), and 29.24% (95% CI = 6.12%, 52.37%) of the total effect, individually. Subtype analyses suggested broadly similar patterns across MA and MO, with no clear subtype-specific differences.

ConclusionOur findings provide evidence that ADHD common variant genetic liability increases migraine risk, including both MA and MO. The association appears unlikely to be explained by a single pathway and may involve the contribution of depression-related, lifestyle-related, and education-related processes.

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BibTeX
@misc{luo2026genetic,
  title = {{Genetic liability to ADHD and migraine risk: Mendelian randomization evidence for behavioural and psychiatric pathways}},
  author = {Y. Luo and C. Dardani and R. E. Wootton and E. Sanderson and E. Stergiakouli},
  howpublished = {medRxiv},
  year = {2026},
  month = sep,
  doi = {10.64898/2026.09.08.26362527},
  url = {https://www.medrxiv.org/content/10.64898/2026.09.08.26362527v1},
  note = {CC BY},
}
RIS
TY  - UNPB
TI  - Genetic liability to ADHD and migraine risk: Mendelian randomization evidence for behavioural and psychiatric pathways
AU  - Y. Luo
AU  - C. Dardani
AU  - R. E. Wootton
AU  - E. Sanderson
AU  - E. Stergiakouli
PY  - 2026
DA  - 2026/09/08
PB  - medRxiv
DO  - 10.64898/2026.09.08.26362527
UR  - https://www.medrxiv.org/content/10.64898/2026.09.08.26362527v1
AB  - BackgroundAttention-deficit/hyperactivity disorder (ADHD) and migraine frequently co-occur, but the mechanisms underlying this association remain unclear. Examining migraine with aura and without aura separately may help clarify whether ADHD-related pathways are shared across migraine subtypes or differ by aura status.  MethodsTwo-sample Mendelian randomization (MR) was used to examine the effect of genetic liability to ADHD on overall migraine and on migraine subtypes defined by aura status. MR-based mediation was then used to assess whether behavioural, psychiatric, sleep-related, education, and cardiometabolic traits contribute to these effects.  ResultsMR provided evidence for an effect of ADHD genetic liability on overall migraine risk (OR = 1.48, 95% CI =1.2, 1.82), with similar effect sizes for migraine with aura (MA) (OR=1.52, 95% CI = 1.18, 1.96) and migraine without aura (MO) (OR = 1.65, 95% CI = 1.19, 2.31). Depression, alcohol intake frequency, lifetime smoking index, ever smoke, risk taking behaviours, insomnia, and college education showed evidence for partial mediation, explaining approximately 34.17% (95% CI = 6.17%, 61.63%), 14.44% (95% CI = 0%, 28.87%), 37.25% (95% CI = 11.86%, 63.64%), and 29.24% (95% CI = 6.12%, 52.37%) of the total effect, individually. Subtype analyses suggested broadly similar patterns across MA and MO, with no clear subtype-specific differences.  ConclusionOur findings provide evidence that ADHD common variant genetic liability increases migraine risk, including both MA and MO. The association appears unlikely to be explained by a single pathway and may involve the contribution of depression-related, lifestyle-related, and education-related processes.
ER  -