Migraine is one of the most common neurological disorders globally, affecting an estimated 15% of the population, with over 1 billion sufferers worldwide—three times more common in women than in men. According to the Global Burden of Disease Study, migraine is the second leading cause of disability among individuals aged 15 to 49, severely impacting work, education, and quality of life. In Taiwan, approximately 2 million people experience migraine attacks each year.

A Taiwan-based research team, led by Taipei Veterans General Hospital (Taipei VGH) in collaboration with National Yang Ming Chiao Tung University, Academia Sinica, and the National Health Research Institutes (NHRI), has spent five years developing a blood-based diagnostic model. By identifying microRNA (miRNA) biomarkers associated with migraine states, the team has laid a critical foundation for future precision diagnostics and personalized treatment.

Currently, migraine lacks quantifiable biomarkers and objective diagnostic tools, and brain imaging often reveals no abnormalities. Physicians must rely primarily on patients’ subjective descriptions. Dr. Shih-Pin Chen, Director of the Translational Research Division at Taipei VGH, noted that migraines are characterized by distinct “attack” and “non-attack” phases, making it extremely challenging to collect timely blood samples during episodes—one of the major hurdles in related research.

Dr. Chen explained that microRNAs are short, non-coding RNA molecules that regulate gene expression rather than producing proteins directly. They act as "gene expression fine-tuners" in cells, controlling when proteins are synthesized or suppressed, playing essential roles in cell differentiation, development, immune function, and pain perception.

The research team recruited 120 participants, including those in active migraine attacks, non-attack phases, chronic migraine sufferers, and healthy controls. Using next-generation sequencing (NGS), they analyzed miRNA expression in blood samples, followed by validation in an independent cohort of 197 individuals. By integrating these findings with innate genetic risk scores, the team successfully developed a predictive model capable of identifying migraine status and risk with high accuracy.

The study found that specific microRNAs—such as miR-183 and miR-1307-5p—differ significantly between migraine patients and healthy individuals, serving as markers of "disease state." Others showed variation only during migraine attacks, acting as indicators of "disease activity." When these biomarkers were combined with genetic risk profiles, the model achieved an accuracy rate of up to 90% in identifying migraine sufferers.

Dr. Shu-Chun Wang, Deputy Superintendent of Taipei VGH, noted that the prevalence of migraine in Taiwan is around 5% in men and 15% in women, averaging about 10% overall. Chronic migraine—defined as headaches occurring more than 15 days a month—is especially debilitating, affecting an estimated 300,000 to 400,000 people in Taiwan. In schools, students with chronic migraines may frequently miss classes and are often misunderstood or accused of faking symptoms.

By detecting changes in miRNA in the blood of migraine patients, the Taiwanese team has made a major breakthrough in migraine research. Their findings were published in June in Brain, a leading journal in the field of neuroscience.

Bioinformatics analysis revealed that the identified miRNAs are involved in estrogen and prolactin signaling pathways, suggesting a strong link between hormonal fluctuations and migraine—providing a biological explanation for the higher prevalence in women.

This marks the first time migraine has been shown to be "visible" through blood, opening the door to “liquid biopsy” approaches in neurology. By using minimally invasive blood tests to detect biomarkers reflective of brain pathophysiology, physicians may one day achieve diagnostic precision akin to brain tissue biopsy.

Dr. Chen emphasized that migraine currently lacks objective diagnostic methods or reliable biomarkers. This study is one of the few worldwide that has successfully collected blood during active migraine episodes and identified meaningful biomarkers. He hopes the technology will one day be adopted in clinical practice to help identify high-risk patients before onset, monitor disease progression, and evaluate treatment response—ultimately enabling precision medicine in migraine care.

Dr. Hsuan-Yu Chen, Research Fellow at the Institute of Statistical Science and the Smart Medicine Research Center at Academia Sinica, noted that the study integrated high-throughput multi-omic data and clinical information to construct a predictive model combining miRNA profiles and genetic risk, achieving over 90% accuracy in a large validation cohort. This demonstrates the feasibility of precision prediction for complex, variable neurological disorders.

Dr. Ya-Hsuan Chang, Assistant Research Fellow at the NHRI Institute of Molecular and Genomic Medicine, added that advanced NGS and bioinformatics revealed how migraine-related miRNAs interact with hormonal pathways such as estrogen and prolactin. These findings not only shed light on gender differences in migraine susceptibility but also pave the way for precision diagnostics and personalized treatment strategies.

Dr. Chen concluded that the study, published in a top-tier neuroscience journal, highlights Taiwan's strength in neuroscience, multi-omics big data, and translational research. The team plans to continue driving clinical applications and cross-institutional collaborations to transform this innovative breakthrough into a practical tool for safeguarding the health of migraine patients.

Resource: 一滴血驗偏頭痛成真！北榮主導台灣團隊花5年建診斷模型 準確高達9成