How can personalized medicine be used for patients with hemiplegic migraine?
Causal genes and gene variants have been discovered for hemiplegic migraine. A patient’s DNA can be tested to determine which type they have and which treatment will help.
“Well, I mentioned a little bit before about FHM [familial hemiplagic migraine] diagnosis. There are several disorders that we currently diagnose that all have similar symptoms. So they have movement-type disorders, some paralysis of part of the body, severe migraine, sometimes speech problems and sensory problems, also the headache and nausea. We now know that there are a number of genes that play a role in this, and if we can work out which gene it is in which person, these are causal genes, you can actually target the treatment to the right person. And I'll give an example:
“One of the FHM genes is a calcium channel gene and it has mutations at different parts of the gene that you find in different families with FHM, hemiplegic migraine. There's also other regions that cause a slightly different disorder called episodic ataxia, and then another region of the gene has something called spinocerebellar ataxia. Those three disorders have different treatments, and if you know which it is then you can target the treatment to them. There's also three hemiplegic migraine genes that we know. One's a calcium, one's an ATPase, and one's a sodium channel, and depending on which one it is, there's a different treatment that's in order for people to take.
“But not only that, it also defines, have we got a person with that or have we got a person with something else? Another disorder called CADASIL is a stroke like disorder, which has white-matter abnormalities in the brain, makes people very prone to stroke. Exactly the same symptoms. You can't tell looking at an individual whether it's going to be mutations in the FHM calcium channel gene or whether it's going to be, maybe, the notch-three gene, which causes CADASIL.
“Neurologists send us samples. They used to ask us to test one gene or the other, but now we know that, looking at the patient, you can't tell which to test. And so we would miss, and so since we've been able to go back, we can see that it's better to test all of them and then provide that advice back.“
Several types of disorders with similar symptoms of paralysis, severe migraine and speech problems are caused by different genes and have different treatments. Personalized medicine can treat these diseases by testing the patient’s DNA to determine which type they have so that the correct treatment can be used.
Professor Lyn Griffiths, PhD, BSc Hons
Director, Centre for Genomics & Personalised Health
Queensland University of Technology, Australia
Professor Lyn Griffiths is the executive director of the Institute of Health and Biomedical Innovation, the largest interdisciplinary research institute at Queensland University of Technology. An active and respected molecular geneticist with more than 28 years of experience studying human complex gene disorders, with specific expertise in human gene mapping and gene expression analysis in migraine, cardiovascular disease, and several types of cancer. Professor Griffiths leads the Genomics Research Centre, in which the main focus of research is the identification of genes involved in common human disorders and the translation of this research into new diagnostics and therapeutics.
Professor Griffiths’ own genetics research has appeared in more than 350 peer-reviewed international journals and led to diagnostic breakthroughs for several neurogenetic disorders, including familial migraine, ataxia, epilepsy, and hereditary stroke. A fellow of the Queensland Academy of Arts and Science, Professor Griffiths has also established several significant international collaborations with the Texas Biomedical Research Institute, Oxford University, University of Vienna, the Italian National Research Council, the MS ANZgene Consortium, and the International Migraine Genetics Consortium.