Despite affecting over one billion people worldwide, migraines have long been considered an “invisible disease”—difficult to diagnose and often misunderstood. Diagnosis has relied solely on patients ‘ subjective descriptions with no apparent abnormalities on brain scans and no objective biomarkers.
In a breakthrough, a Taiwanese research team has identified specific microRNAs in the blood that can objectively detect migraine episodes. Their five-year study, jointly conducted by Taipei Veterans General Hospital (TVGH), National Yang Ming Chiao Tung University (NYCU), Academia Sinica, and the National Health Research Institutes (NHRI), has been published in Brain, one of the leading journals in the field of neuroscience.
A High-Impact, Underdiagnosed Disorder
Migraine is among the most prevalent neurological disorders globally, affecting approximately 15% of the population—three times more common in women than men. According to the Global Burden of Disease Study, migraine is the second leading cause of disability among people aged 15 to 49, significantly impairing work, education, and quality of life.
Yet despite its widespread impact, migraine remains elusive in clinical settings. Brain imaging typically reveals no anomalies, and its alternating “attack” and “non-attack” phases make real-time blood sampling during episodes extremely challenging—hindering scientific progress and leaving millions undiagnosed or misdiagnosed.
Building a Predictive Blood Test for Migraine
Led by Dr. Shu-Chun Wang (Vice Superintendent of TVGH and Dean of the NYCU College of Medicine), the research team recruited 120 participants—including migraine patients in both attack and non-attack phases, chronic migraine sufferers, and healthy controls. Using next-generation sequencing (NGS) of blood samples, they identified microRNA expression patterns associated with migraine states. The findings were further validated in an independent cohort of 197 individuals.
Combining microRNA profiles with genetic risk scores, the team developed a composite predictive model capable of identifying both migraine presence and risk, with over 90% accuracy.
Capturing the Biological Signature of Migraine
MicroRNAs are short, non-coding RNA molecules that regulate gene expression like molecular “dimmer switches.” Though small, they are crucial in controlling protein synthesis and are deeply involved in immune response, development, and pain perception processes. Their significance was recently recognized with the 2024 Nobel Prize in Physiology or Medicine awarded to Victor Ambros and Gary Ruvkun, who discovered microRNAs’ regulatory role in 1993.
The research team’s study found specific microRNAs—such as miR-183 and miR-1307-5p—significantly different between migraine patients and healthy individuals. Some markers served as indicators of disease status, while others fluctuated only during active migraine attacks, reflecting disease activity. Intriguingly, bioinformatics analysis revealed these microRNAs are linked to hormonal pathways involving estrogen and prolactin, suggesting a possible explanation for the disorder’s higher prevalence in women.
“This is the first time migraine has been made ‘visible’ through blood biomarkers,” the authors note. “It also opens the door for applying liquid biopsy—a minimally invasive blood-based method—to neurological conditions by detecting brain-related physiological changes through peripheral blood.”
Toward Objective and Personalized Migraine Care
“This study represents a major leap forward in migraine research,” said Dr. Shu-Chun Wang. “It deepens our understanding of the disease’s biological mechanisms and opens new possibilities for clinical application.”
Dr. Shih-Pin Chen (Director of Translational Research, TVGH; Director of Institute of Clinical Medicine, NYCU) emphasized the clinical significance: “Until now, migraine lacked objective diagnostics. Our study is one of the few worldwide to capture blood samples during active attacks and identify biomarkers. We hope this model can help clinicians detect high-risk individuals, monitor disease progression, and evaluate treatment response—realizing the promise of precision medicine.”
Dr. Hsuan-Yu Chen (Research Fellow, Academia Sinica) added: “By integrating high-throughput sequencing data with genetic risk profiles, we’ve demonstrated that even complex, highly variable neurological diseases can be predicted with high accuracy when multi-omics data is combined with clinical information.”
Dr. Ya-Hsuan Chang (Research Associate, NHRI) highlighted the gender-specific findings: “Our identification of microRNAs involved in estrogen and prolactin signaling not only sheds light on why women are more affected, but also provides important molecular insights into sex differences in neurological disease—laying the groundwork for personalized diagnostics and therapy.”
Dr. Yen-Feng Wang (Director, General Neurology, TVGH) concluded: “Many migraine patients are misunderstood, misdiagnosed, or dismissed. We hope this research provides doctors with more objective diagnostic tools and empowers patients with greater understanding and control over their condition.”
Taiwan’s Scientific Strength on the Global Stage
Beyond the scientific discovery, this research showcases Taiwan’s growing capacity in interdisciplinary, translational medicine—blending neuroscience, genomics, and data science. The team aims to accelerate clinical applications and expand cross-institutional collaboration to transform this innovation into real-world benefits for migraine patients in Taiwan and beyond.
By Taipei Veterans General Hospital
Edited by Chance Lai
Source : NYCU News
