Depression and anxiety disorders associated with headache frequency. The Nord‐Trøndelag Health Study

The aim of this large cross‐sectional population‐based study was to examine the association between migraine, non‐migrainous headache and headache frequency with depression, and anxiety disorders. From 1995 to 1997, all 92 566 inhabitants aged 20 years and above in Nord‐Trøndelag County in Norway were invited to participate in the Nord‐Trøndelag Health Study (‘Helseundersøkelsen i Nord‐Trøndelag’ = HUNT‐2). A total of 64 560 participated, whereof 51 383 subjects (80%) completed a headache questionnaire that was included. Of these 51 383 individuals, 47 257 (92%) completed the depression subscale items and 43 478 (85%), the anxiety subscale items of the Hospital Anxiety and Depression Scale (HADS). Associations were assessed in multivariate analyses, estimating prevalence odds ratios (OR) with 95% confidence intervals (CI). Depression and anxiety disorders as measured by HADS, were significantly associated with migraine (OR = 2.7, 95% CI 2.3–3.2; OR = 3.2, 95% CI 2.8–3.6) and non‐migrainous headache (OR = 2.2, 95% CI 2.0–2.5; OR = 2.7, 95% CI 2.4–3.0) when compared with headache‐free individuals. The association was stronger for anxiety disorders than for depression. The ORs for depression and anxiety disorders amongst both migraine and non‐migrainous sufferers increased with increasing headache frequency. Depression and anxiety disorders are associated with both migraine and non‐migrainous headache, and this association seems more dependent on headache frequency than diagnostic category.     

Epidemiology of migraine and other types of headache in Asia

Earlier studies have raised the issue that Asians have a much lower migraine prevalence than Westerners. This article reviews the recent epidemiologic studies of headache in Asia using International Headache Society (IHS) classification criteria. Except for the Korean study and the first Hong Kong study (1992 to 1993), the prevalence of migraine has been quite consistent, ranging from 8.4% to 12.7%. The sex-specific migraine prevalence was 11.3% to 14.4% in women and 3.6% to 6.7% in men. The prevalence of IHS tension-type headache has also been similar among these studies (15.6% to 25.7%). The consistency of the prevalence of migraine and tension-type headache among these Asian countries is interesting in a region where the cultural background and development are so diverse. These IHS migraine surveys show that migraine is a significant disease in Asia and that its prevalence rate is close to but in the low range of the those reported in Western countries. Two surveys of chronic daily headache conducted in Taiwan, one in the general population and the other in the elderly population, have also revealed prevalence rates (3.2% to 3.9%) similar to those of Western countries (3.0% to 4.7%). The geographic or ethnic diversity of migraine or other types of headache could be downplayed if a similar epidemiologic methodology and an identical case definition were used in the surveys among different regions of the world.     

Increased headache prevalence in female adolescents and adult women with early menarche. The Head‐HUNT Studies

Background: Age at menarche is associated with cardiovascular events and lifestyle factors such as body mass index (BMI), certain women’s diseases like breast cancer and endometriosis and with occurrence of certain physical symptoms during puberty. It is unclear whether age at menarche is an independent determinant of headache. Objectives: The aim of the study was to explore age of menarche in relation to headache prevalence in a large population‐based study of both adolescents and adult women (HUNT). Methods: In the Nord‐Trøndelag Health Study in Norway 1995–97 (HUNT 2), a total of 26 636 (57%) of 46 506 invited women responded to questions regarding menarche and headache (Head‐HUNT). In the youth part of HUNT 2, 3196 female students were interviewed about their headache complaints and 2766 (87%) responded to questions regarding menarche. All the final analyses were adjusted for age, use of oral contraceptives and BMI, and for adults also for educational level. Results: Headache was more prevalent amongst females with menarche ≤ 12 years, both amongst adolescents (OR = 1.3, 95% CI = 1.1–1.5) and adults (OR = 1.1, 95% CI = 1.1–1.2), evident for migraine and non‐migrainous headache. Conclusion: Headache, both migraine and non‐migrainous headache, was more prevalent amongst both adolescents and adult females with early menarche. Early menarche may increase headache susceptibility, or be a consequence of a common pathogenetic factor, e.g., sensitivity to estrogens.     

The cost of headache disorders in Europe: the Eurolight project

Background and purpose: Headache disorders are very common, but their monetary costs in Europe are unknown. We performed the first comprehensive estimation of how economic resources are lost to headache in Europe. Methods: From November 2008 to August 2009, a cross‐sectional survey was conducted in eight countries representing 55% of the adult EU population. Participation rates varied between 11% and 59%. In total, 8412 questionnaires contributed to this analysis. Using bottom‐up methodology, we estimated direct (medications, outpatient health care, hospitalization and investigations) and indirect (work absenteeism and reduced productivity at work) annual per‐person costs. Prevalence data, simultaneously collected and, for migraine, also derived from a systematic review, were used to impute national costs. Results: Mean per‐person annual costs were €1222 for migraine (95% CI 1055–1389; indirect costs 93%), €303 for tension‐type headache (TTH, 95% CI 230–376; indirect costs 92%), €3561 for medication‐overuse headache (MOH, 95% CI 2487–4635; indirect costs 92%), and €253 for other headaches (95% CI 99–407; indirect costs 82%). In the EU, the total annual cost of headache amongst adults aged 18–65 years was calculated, according to our prevalence estimates, at €173 billion, apportioned to migraine (€111 billion; 64%), TTH (€21 billion; 12%), MOH (€37 billion; 21%) and other headaches (€3 billion; 2%). Using the 15% systematic review prevalence of migraine, calculated costs were somewhat lower (migraine €50 billion, all headache €112 billion annually). Conclusions: Headache disorders are prominent health‐related drivers of immense economic losses for the EU. This has immediate implications for healthcare policy. Health care for headache can be both improved and cost saving.     

Epidemiology of headache

Previous classifications of headache have lacked accuracy. In 1988, the Headache Classification Committee of the International Headache Society (IHS) introduced operational diagnostic criteria for all headache disorders. Since then, epidemiological headache research has been substantially made easily. Although the use of uniform and specific diagnostic criteria may reduce diagnostic variability, several other methodologic problems remain: episodicity, coexisting headaches, measurement techniques, sample source, may explain the differences among studies. All these difficulties overlap and explain the wide range of overall prevalence from 35p.100 to 100 p. 100. Information on migraine epidemiology are available: a one-year prevalence of migraine in America and Western Europe in adults is about 10 à 15 p.100. In France, Henry et al. found a prevalence of 12.1 p.100 (6.1 p.100 for men and 17.6 p.100 for women) for migraine. The aura symptoms are extremely difficult to describe, explaining the heterogeneity of prevalence for migraine with aura. Sex and age distribution as well as the relationship with sociodemographic factors and associated pathologies (stroke, epilepsia.) are now well-known. Epidemiology of tension-type headaches has received less attention. This headache varies both in frequency and severity; this fact make epidemiologic studies more difficult. Cluster headache is better defined by IHS criteria, but its prevalence remains debated. Different methodological approaches could explain these difficulties, rather real differencies in frequency among various population. Cluster Headache prevalence varies from 0.006 p.100 in China to 0.07 p.100 of the population in the republic of San Marino and 0.24 p.100 in the general population of the United states. In conclusion, the development of IHS criteria has made possible the progress of epidemiologic research. Additional studies are required to better define the risk factors and conditions that act as co-morbidity factors.     

The prevalence of migraine and tension headache in Saudi Arabia: a community-based study

The prevalence of migraine and tension headache was determined in a 2-stage, door-to-door community survey in Thugbah, Saudi Arabia. Out of 22630 subjects surveyed, 2742 individuals had headaches thus yielding a crude prevalence of 12.1% (95% CI = 11.7–12.5%) and with age-adjustment, it rose to 15.9% (95% CI = 15.4–16.4%). There was female preponderance overall and the peak frequency was in the 3rd decade. The age-specific rates rose from 2.4% in the first decade to 37.2% in the 7th decade. The prevalence of tension-type headache (PR 9.5%; 95% CI = 9.1–9.9%) was higher than migraine (PR = 5.0%; 95% CI = 4.7-5.3%). The low headache prevalence in this community compared to findings in western countries could be ascribed to the young age of the population and/or could possibly reflect the influence of traditional life styles and cultural factors in the Kingdom.     

The Zurich Study: XXIII. Epidemiology of headache syndromes in the Zurich cohort study of young adults

This study examines the 1 year prevalence rates of headache syndromes in an epidemiologic cohort study of young adults ages 29–30 in Zurich, Switzerland. The 1 year prevalence rates of headache subtypes were 3.3% for migraine with aura and 21.3% of migraine without aura as defined by the International Headache Society (IHS) criteria. The demographic distribution, clinical features, sequelae, and treatment patterns of subjects with specifc headache subtypes are described. The rates of migraine are compared to those of other community samples that have employed the IHS criteria for headache subtypes. Subjects with migraine reported pervasive impairment in nearly every life role including occupation, leisure, and social relationships. Despite the substantial degree of impairment in occupational and social functioning that was associated with migraine, an extremely low proportion of subjects had received professional treatment for headache. These results suggest that a concerted effort should be directed towards education regarding the classification of headache and the availability of efficacious treatment for migraine.     

The interrelations of migraine, vertigo, and migrainous vertigo

OBJECTIVE: To assess the prevalence of migrainous vertigo in patients with migraine and in patients with vertigo according to explicit diagnostic criteria that are presented for discussion. METHODS: The authors prospectively evaluated 200 consecutive patients from a dizziness clinic and 200 patients from a migraine clinic for migrainous vertigo based on the following criteria: 1) recurrent vestibular symptoms (rotatory/positional vertigo, other illusory self or object motion, head motion intolerance); 2) migraine according to the criteria of the International Headache Society (IHS); 3) at least one of the following migrainous symptoms during at least two vertiginous attacks: migrainous headache, photophobia, phonophobia, visual or other auras; and 4) other causes ruled out by appropriate investigations. In addition, the authors compared the prevalence of migraine according to the IHS criteria in the dizziness clinic group with a sex- and age-matched control group of 200 orthopedic patients. RESULTS: The prevalence of migraine according to the IHS criteria was higher in the dizziness clinic group (38%) compared with the age- and sex-matched control group (24%, p < 0.01). The prevalence of migrainous vertigo was 7% in the dizziness clinic group, and 9% in the migraine clinic group. In 15 of 33 patients with migrainous vertigo, vertigo was regularly associated with migrainous headache. In 16 patients, vertigo occurred both with and without headache, and in two patients headache and vertigo never occurred together. The duration of attacks varied from minutes to days. CONCLUSION: These results substantiate the epidemiologic association between migraine and vertigo and indicate that migrainous vertigo affects a significant proportion of patients both in dizziness and headache clinics.     

Prevalence and clinical characteristics of migraine in France

OBJECTIVE: To determine the prevalence and clinical features of migraine and related headache types in France. METHODS: The authors recruited a population of subjects with headache representative of the national population using a stratified sampling method. They screened 10,585 subjects aged 15 and older who were representative of the general population. They identified 1,486 of these as having headaches, and these subjects were subsequently interviewed for information on clinical features, natural history, and functional impact of headache. The authors categorized subjects based on the International Headache Society (IHS) classification and assessed disability using the MIDAS questionnaire. RESULTS: The authors found a standardized prevalence for migraine (IHS categories 1.1 and 1.2) of 7.9% (11.2% for women and 4.0% for men) and 9.1% for migrainous disorder (IHS category 1.7). Migraine attacks were associated with a considerable degree of handicap in activities of daily living, with a MIDAS grade distribution of 74.7% (grade 1), 13.3% (grade 2), 7.7% (grade 3), and 4.3% (grade 4). The prevalence of migraine with MIDAS grade 3 or 4 was 1.6%. CONCLUSIONS: The prevalence of migraine (IHS categories 1.1 and 1.2) in France is 7.9%, and that of total migraine is 17.0%; this does not seem to have evolved over the past 10 years.     

Frequency of headache and migraine in Qatar

BACKGROUND: Headache is a worldwide problem that affects all ages. To date there are no epidemiological data regarding headaches in Qatar. AIM: The aim of this study was to use the International Headache Society (IHS) diagnostic criteria to estimate the prevalence of migraine and headache in an adult population. DESIGN: This is a cross-sectional population-based study. SETTING: The study was carried out at 12 Primary Health Care Centers during the period from October to December 2004 in Qatar. SUBJECTS: Of the 1,200 subjects who were approached to participate in this study, 913 gave their consent, representing a response rate of 76.1%. METHODS: Subjects were selected by a multistage stratified sampling procedure. We used the IHS criteria for migraine. Face-to-face interviews were based on a questionnaire that included variables such as age, sex, socioeconomic status, lifestyle habits, exacerbating factors, warning symptoms, associated features, family history and associated factors. RESULTS: Of the studied subjects, 54.9% were males and 45.1% females. The prevalence of headache and migraine among men was 67.9%, 7.8%, and among women 78.2%, 8.0%, respectively. Subjects aged 25-34 years had higher prevalence of headache comparing to other age groups (27.3%). Prevalence of headache was higher in women. Subjects with less than a high school education had higher frequency of headache (49.1%). The most common warning symptoms prior to headache were abnormal vision (53.0%) and weakness (30.4%). Stress (71.8%) and weather (49.5%) made headache worse in subjects. The majority of the headache sufferers looked for a dark (33.7%) and quiet place (74.5%) to rest. CONCLUSION: Headachedisorders constitute a public health problem in a newly developed Qatari society, due to fast urbanization. More women suffered from headache and migraine than men. The study revealed that there was a strong association between hemoglobin level and headache and its severity. Furthermore, the prevalence of headache and migraine in Qatar is higher than in Western and African countries.     

The classification of chronic daily headache in French children and adolescents: a comparison between the second edition of the International Classification of Headache Disorders and Silberstein-Lipton criteria

Few data are available on the applicability of both the criteria proposed by Silberstein and Lipton (S-L) and the International Classification of Headache Disorders-II (ICHD-II) in the classification of children and adolescents with chronic daily headache (CDH). The International Headache Society recently added revised criteria (ICHD-IIR) for chronic migraine to its Appendix. We retrospectively reviewed all charts of 34 children and adolescents (<17 years) with primary CDH presenting to the outpatient clinic of the Universitary Department of Neuropediatrics of Lille between February 2004 and February 2006 and tried to classify their CDH according to both S-L criteria and the recently published ICHD-IIR. Thirty-two children (94%) and 33 children (97%) could respectively be successfully classified into one subtype of CDH according to the S-L classification and the ICHD-IIR. Transformed migraine was the most common diagnosis (61.8%), followed by new daily-persistent headache (20.6%) when the S-L criteria were used. Twenty-three children and adolescents (67.6%) could be classified under one of the migraine categories according to the ICHD-IIR classification. We think that both S-L and ICHD-II classifications, when used with detailed headache histories and diaries, are adequate to classify chronic daily headache in children and adolescents.     

Increased frequency of migraine in narcoleptic patients

We explored the relationship between narcolepsy and different types of headaches. We interviewed 68 patients with idiopathic narcolepsy for the presence of headache symptoms based on the criteria of the International Headache Society (IHS). Eighty-one percent of the patients reported headaches that warranted an IHS headache diagnosis. Fifty-four percent of the patients (64% women, 35% men) had migraine with all IHS criteria fulfilled.     

Headache,migraine and cardiovascular risk factors: The HUNT study

Background: Migraine with aura (MA) has been found to be a risk factor for cardiovascular disease including ischaemic stroke and myocardial infarction. Studies have also reported a higher prevalence of unfavourable cardiovascular risk factors amongst migraineurs, but results have been conflicting as to whether this is restricted to MA or also holds true for migraine without aura (MO). This study aims to examine the relation between headache and cardiovascular risk factors in a large cross‐sectional population‐based study. Methods: A total of 48 713 subjects (age ≥20 years) completed a headache questionnaire and were classified according to the headache status in the Nord‐Trøndelag Health Study in Norway 1995–1997 (HUNT 2). Framingham 10‐year risk for myocardial infarction and coronary death could be calculated for 44 098 (90.5%) of these. Parameters measured were blood pressure, body mass index, serum total and high‐density lipoprotein cholesterol. Results: Compared to controls, Framingham risk score was elevated in non‐migraine headache sufferers (OR 1.17, 95% CI 1.10–1.26), migraineurs without aura (OR 1.17, 95% CI 1.04–1.32) and most pronounced amongst migraineurs with aura (OR 1.54, 95% CI 1.21–1.95). Framingham risk score consistently increased with headache frequency. For non‐migrainous headache and MO, the increased risk was accounted for by the lifestyle factors smoking, high BMI and low physical activity, whilst such factors did not explain the elevated risk associated with MA. Conclusions: Both MA, MO and non‐migrainous headache are associated with an unfavourable cardiovascular risk profile, but different mechanisms seem to underlie the elevated risk in MA than in the other headache types.     

No increase in headache after previous intracranial infections: a historical cohort study (HUNT)

Background and purpose: Despite the absence of robust scientific evidence, it is today generally accepted that the acute headache typical for intracranial infections can develop into permanent headache complaints. This widespread concept was explored in the first, large, longitudinal, population‐based study. Methods: Data on confirmed exposure to intracranial infections amongst all adult inhabitants in a geographical area during a 20‐year period were assembled from hospital records. Surviving individuals were later invited to the third Nord‐Trøndelag Health Survey (HUNT 3), where 39 690 (42%) of 94 194 invited inhabitants aged ≥20 years responded to a validated headache questionnaire. Using logistic regression, the 1‐year prevalence of headache and its subtypes according to the diagnostic criteria of the International Headache Society was assessed and compared between those with and without previous confirmed intracranial infection. Age and sex were used as covariates. Results: Overall, 43 participants were identified with earlier intracranial infection, whereof three had more than one infection: bacterial meningitis (n = 19), lymphocytic meningitis (n = 18), encephalitis (n = 9), and brain abscess (n = 1).The mean interval from infection to participation in HUNT 3 was 11.2 (range 1.5–19.7) years. There was no significant increase in the prevalence of headache (OR 1.10, 95% CI 0.58–2.07), its subtypes (migraine, or tension‐type headache), or chronic daily headache (OR 1.85, 95% CI 0.45–7.68) amongst participants with previous intracranial infection compared with the surrounding population. Conclusions: This study challenges the existence of chronic post‐bacterial meningitis headache and does not indicate the presence of other long‐term headaches induced by intracranial infection.     

Clinical progress in headache]

In Western communities, 15 to 20% of the general population experiences migraine headaches. In Japan, 3 to 9% of the population experience migraine headaches. Quality of life in headache patients is impaired. The International Headache Society (IHS) published the new headache classification in 1988. Chronic daily headache (CDH) is a common problem in headache clinics. Recently, the problems in classifying CDH have been discussed. CDH is not easily classified within the IHS criteria. For migraine attacks, triptans are effective. The genetic analysis in migraine is progressing. Point mutations in the P/Q-type Ca2+ channel alpha 1 subunit gene in familial hemiplegic migraine and in Notch 3 gene in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), have been identified. Although CADASIL patients in Europe often show migraine headache, migraine attacks are less common in Japanese CADASIL patients.     

Atrial septal defects as a risk factor for migraine: a case-control study

To determine the magnitude of the association between atrial septal defect (ASD) and migraine. We evaluated 101 subjects submitted to transesophageal echocardiography (TEE). They have been asked about headache. Migraine diagnosis was established according the criteria of the International Headache Society (IHS). The subjects were match in cases (ASD carrier) and controls (without ASD). We analyzed the occurrence of migraine, of aura and the frequency of crises in the last month by chi-square test. We matched 34 cases and controls: 82.4% female, the mean age, in years was 38.7 (+/-11.24) and 38.9 (+/-11.17)). Migraine occurred in 79.4% of the cases and in 55.9% of the controls (OR = 4.3) CI = 95% (1.04-8.8), (p = 0.038). Aura occurred in 65.1% (cases) and 40% (controls). It was observed more than three migraine crises in the last month in 76.7% of the cases and 60% of the controls (OR = 1.56) (p = 0.2) (95% CI, 0.6 to 7.6). ASD is a risk factor to migraine with aura in the sample studied. ASD apparently increase the frequency of migraine crises.     

The co-occurrence of headache and musculoskeletal symptoms amongst 51 050 adults in Norway

We have evaluated the association between headache and musculoskeletal symptoms in a large cross‐sectional population‐based study. Between 1995 and 1997, all 92 566 adults in Nord‐Trøndelag County in Norway were invited to participate in a health survey. A total of 51 050 (55%) responded to questions concerning headache and musculoskeletal symptoms. Both migraine and non‐migrainous headache were strongly associated with musculoskeletal symptoms. However, frequency of headache had a higher impact than headache diagnosis on this association. Thus, the prevalence of chronic headache (headache >14 days/month) was more than four times higher (OR = 4.6; 95% CI 4.0–5.3) in the group of individuals with musculoskeletal symptoms than in those without. Individuals with neck pain were more likely to suffer from headache as compared with those with musculoskeletal symptoms in other restricted areas. In conclusion, there was a strong association between chronic headache and musculoskeletal symptoms, which may have implications for the choice of treatment.     

Prevalence and Impact of Migraine and Tension-Type Headache in Korea

Background and Purpose

The epidemiology and impact of headache disorders are only partially documented for Asian countries. We investigated the prevalence and impact of migraine and tension-type headache - which are the two most common primary headache disorders - in a Korean population.

Methods

A stratified random population sample of Koreans older than 19 years was selected and evaluated using a 29-item, semistructured interview. The questionnaire was designed to classify headache types according to the criteria of the International Classification of Headache Disorders, second edition, including migraine and tension-type headache. The questionnaire also included items on basic demographics such as age, gender, geographical region, education level, and income, and the impact of headache on the participant.

Results

Among the 1507 participants, the 1-year prevalence of all types of headaches was 61.4% (69.9% in women and 52.8% in men). The overall prevalence rates of migraine and tension-type headaches were 6.1% (9.2% in women and 2.9% in men) and 30.8% (29.3% in women and 32.2% in men), respectively. The prevalence of migraine peaked at the age of 40-49 years in women and 19-29 years in men. In contrast to migraine, the prevalence of tension-type headache was not influenced by either age or gender. Among individuals with migraine and tension-type headache, 31.5% and 7% reported being substantially or severely impacted by headache, respectively (Headache Impact Test score ≥56). Overall, 13.4% of all headache sufferers reported being either substantially or severely impacted by headache.

Conclusions

The 1-year prevalence rates of migraine and tension-type headache in the studied Korean population were 6.1% and 30.8%, respectively. One-third of migraineurs and some individuals with tension-type headache reported being either substantially or severely impacted by headache.     

Familial migraine with and without aura: clinical characteristics and co-occurrence

Migraine with aura (MwA) and migraine without aura (MwoA) are the two common forms of migraine. Many migraine patients suffer from both kinds of attacks. In a questionnaire-based study using the current International Headache Society (IHS) criteria we determined the clinical characteristics and occurrence of MwA + MwoA in 1000 migraine patients belonging to 210 Finnish migraine families. Nine hundred and six patients were able to indicate whether they suffered from MwA (but not MwoA), migraine aura without headache (migraine equivalent) (but not MwA) or MwA and MwoA. Of these patients, 3.2% had experienced MwoA, 11.1% MwA, 40.6% MwA + MwoA, 23.5% MwoA and 20.3% MwA-like symptoms not meeting the IHS criteria. The high prevalence of MwA attacks in the families studied supports the belief that aura has a strong hereditary component. The MwA + MwoA patients had significantly more severe attacks, more typical headache and more prodromal symptoms than the MwA and MwoA subjects. Therefore, it is possible that there is a continuum with pure MwA at the neural and pure MwoA at the headache end of the spectrum, and MwA + MwoA lying in between the two. The MwA + MwoA patients would thus be liable to both types of migraine, making their attacks more characteristic and more severe. This would also explain why the co-occurrence of MwA and MwoA is more common in the clinic compared with population based epidemiological studies. These findings have consequences for future research on liability genes for migraine.     

The prevalence of migraine in university students: a systematic review and meta‐analysis

Our aim was to determine the prevalence of migraine amongst university students. Migraine is highly prevalent amongst university students, but the exact frequency remains inconsistent between studies. PubMed, Embase and Google Scholar databases were used to identify studies dealing with the prevalence of migraine amongst university students published between 1 January 1988 and 31 August 2014. The pooled migraine prevalence was calculated using DerSimonian and Laird's random‐effects model. Heterogeneity of the results was investigated using subgroup analysis and the trend of migraine prevalence according to the publication year and sample size was determined by cumulative analysis. Data were combined from 56 independent studies, analysing a total of 34 904 students. The pooled migraine prevalence was 16.1% [95% confidence interval (CI) 13.6%–18.9%]: 11.3% (95% CI 8.8%–14.4%) amongst male students and 21.7% (95% CI 18.0%–25.8%) amongst female students. Subgroup analysis revealed that diagnostic criteria (P < 0.0001) and gender distribution (P = 0.004) significantly affected migraine prevalence. Cumulative analysis found that the 95% CI became narrower with ascending publication year and sample size. Many studies agree that migraine is highly prevalent amongst university students, but diverse methodologies lead to substantial heterogeneity in the results. It is shown that gender and diagnostic criteria significantly influence the migraine prevalence and may partially explain the heterogeneity between studies.