While the exact cause of migraine is unknown, it’s thought to be caused by a combination of factors, including genetics.

Migraine is a chronic neurological disorder that causes intense, throbbing headaches. These headaches may be accompanied by a variety of other symptoms like nausea, light or noise sensitivity, or mood changes.

Migraine symptoms may appear hours or even days before the headache begins and may continue after the headache has resolved.

Though there’s likely more than one underlying cause of migraine, people with migraine have a predisposition to this type of headache, along with a sensitivity to triggers. Factors like genetics or a history of head trauma can predispose someone to migraine, while triggers like alcohol or stress can also cause someone to have a migraine episode.

People can also experience migraine without any triggers.

Learn more about the genetic nature of migraine, including how genetics are linked to migraine risk and what steps you can take to prevent migraine attacks.

People with migraine commonly have family members with migraine, too.

A 2021 review that looked at first-degree relatives of people who tested positive for one of three genetic mutations associated with migraine found that those relatives were four times more likely than the general population to develop migraine with aura. However, the first-degree relatives did not have an increased risk of migraine without aura.

Family members share more than genetics, though, including environmental exposures and stressors that could contribute to migraine risk.

Results from twin studies suggest that the heritability of migraine — a measure of how much of the variation in the population is attributed to genetics — is about 30% to 60%, suggesting there’s a genetic component to the disease.

Migraine with aura has been found to have a stronger genetic link than migraine without aura.

Migraine with aura is a type of migraine that is typically accompanied by vision and sensory changes. People with this type of migraine may experience other symptoms as well, including difficulty speaking, vision changes, and lack of coordination.

Research suggests that migraine inheritance is associated with several different genes that may collectively or independently increase the likelihood of migraine headaches. Some rare migraine subtypes are linked to specific gene alterations.

Familial hemiplegic migraine (FHM) and Mendelian migraine with aura have both been linked to changes in specific genes. These types of migraine have shown a higher degree of heritability.

Sometimes, migraine is a symptom of certain genetic syndromes that have been linked to specific genes.

For instance, migraine attacks can occur in people with certain types of:

  • ataxia (difficulty coordinating movements)
  • sleep disorders
  • retinal disorders

As of 2023, at least 180 genetic variants have been linked to migraine across several studies. The effects of some of these genetic changes have been identified, and some have small effects on blood vessels, chemicals, and structures in the brain that combine to increase the risk of developing migraine.

Alone, these changes do not necessarily lead to migraine. But when several of them occur together, it can change signaling within the brain enough to increase the likelihood of headaches, leading to the development of migraine.

In monogenic forms of migraine — that is, those types described above that have been linked to specific genes — a single genetic change is enough to cause migraine.

FHM is an example of a monogenic migraine type, and four genes that can each independently cause the condition have been identified. Each of these genes can independently cause FHM, but they each cause different headache symptoms and different kinds of non-headache symptoms.

A variety of medications and non-drug treatment options are available for managing migraine and preventing headache attacks.

While there’s hope that genetics might someday be used to guide migraine treatment, the current approach to migraine management is the same regardless of a person’s underlying genetics.

Some research suggests that genetics may influence how people respond to triptans used to treat migraine, but genetics aren’t currently used to determine how or when these types of medications should — or shouldn’t — be used.

If migraine is caused by another underlying genetic condition treating that condition may help manage migraine symptoms.

People who are experiencing significant non-headache symptoms alongside migraine attacks should talk with their healthcare team about their symptoms. They may benefit from a referral to a neurologist to determine if something else is causing their migraine symptoms.

In FHM and other forms of migraine with a genetic link, the brain is primed to become overstimulated by potential headache triggers. This increases the likelihood of migraine attacks.

So, prevention of migraine episodes requires careful attention to and avoidance of potential triggers, potentially alongside preventive medications.

Some examples of preventive medications are:

  • anticonvulsant drugs
  • beta-blockers
  • calcium channel blockers
  • antidepressants
  • botulinum toxin type A (Botox) injections
  • calcitonin gene-related peptide antibody (CGRP) agents

Migraine triggers are different for everyone but may include:

  • stress
  • weather changes
  • strong smells, loud noises, or bright lights
  • too little (or too much) sleep
  • hormonal changes
  • alcohol usage
  • certain foods or medications
  • low blood sugar

If you’re not sure what’s causing your migraine episodes, a headache diary can help you identify potential triggers and figure out how best to avoid them.

Migraine has been linked to a variety of other health conditions. Genetics may serve to explain these links — genetic changes can have wide-reaching effects throughout the body, not just within the brain.

Genetic association studies have found links between migraine-associated genes and a variety of other health conditions commonly seen in people with migraine, including:

  • hypertension (high blood pressure)
  • stroke
  • irritable bowel syndrome (IBS)
  • insomnia
  • depression
  • attention deficit hyperactivity disorder (ADHD)
  • schizophrenia
  • asthma
  • endometriosis
  • diabetes
  • autoimmune disorders

More research is needed to understand these relationships and may help influence how migraine and associated conditions are managed in the future.

Although there’s still much to learn about the causes of migraine, a growing body of research suggests that genetics play a key role in the development of the condition. These factors increase the sensitivity of the brain to outside triggers, increasing the likelihood of migraine attacks in affected people.

No matter the cause, management of migraine involves a combination of medications and lifestyle changes to prevent attacks. More research is needed to understand how genetics may be used to guide migraine care in the future.

People who experience migraine headaches should talk with their healthcare team to determine the best approach to care.