Migraine Tests: What Can I Expect From a DNA Test?
DNA testing to identify specific genes that may be associated with migraine may seem like something futuristic. However, we actually have the capability for it today.
Why is DNA testing conducted for migraine?
DNA testing today is usually done for one of three reasons:
- Because the doctor orders the test to look for and diagnose a specific migraine equivalent.
- For a patient who wants to order their own limited DNA results from companies that currently provide them for public use.
- Because a migraineur and their family members choose to participate in research to help pinpoint new genes associated with the disease.
Anyone can have their entire genome mapped, looking for specific issues they may be predisposed to develop. However, that process requires blood to be drawn and is typically available only to wealthy individuals because it is very involved and expensive. Today, we are talking about saliva testing and what it is like to go through the process itself.
Why would a doctor order a test?
Most DNA tests require specific information from the patient called a patient history.
A doctor ordering a test will only do so if they think there is a benefit to having the specific information and will ask you about your history and symptoms. This can be especially helpful if many members of a single family have similar symptoms that resemble the gene the doctor will test for. Because of the expense of these tests, there must be a very strong suspicion that the targeted gene will be found before the test is ordered. In this case, it is more often that a doctor is looking for something than looking to rule something out.
Why would a patient have their DNA profiled?
An individual looking to have their DNA profiled is often doing so because they want to be proactive in their health care. Having the knowledge that can lead to lifestyle changes and/or preparations is comforting and powerful for the majority of patients who choose to go this route. In this instance, the profile will look at many genes, not just those associated with migraine. The patient ends up with a very interesting list of conditions they may be predisposed to have — or not; conditions for which they may be a carrier; how they respond to specific medicines; and even their genetic hair and eye color or where their ancestors originated. Because the tests need to be specific, patients will fill out a detailed questionnaire about their lifestyle and medical and family history as they know it. Some patients may not be interested in learning about their status for specific conditions. You can ask to have particular results left out of your report.
DNA tests and genetic research
A family or person looking to participate in genetic research will also be asked to fill out a detailed questionnaire to help researchers look for commonalities and clues in the DNA. In some cases, it might be possible for a patient to receive their DNA information at a later time or copies of the study they are participating in. If the patient is interested in these things, asking before participation is key. However, many research projects will not give you the results of your DNA test, so prepare for that possibility.
How does the test work?
Patients are given a kit in a box. The kit will have specific instructions written in easy language, often with instructional illustrations. Most patients must refrain from eating or drinking for an hour or two before participation.
Inside the kit is a clear plastic tube with an attached cap.
The patient is asked to spit into the tube until the saliva reaches a fill line toward the top. When the tube is full, the patient closes the lid, which releases a liquid that mixes with the saliva in the tube. Gently inverting the tube a few times is usually required to mix it properly.
Sending it back for results
Once the saliva is in the tube and it has been securely closed, it will be put into a plastic bag from the kit and placed into a mailer, then sent to the company for testing.
In some instances, such as research trials, you may not receive any results.
Results from the company
If you are receiving results, it may take several weeks to receive them. Most companies offer your results online after setting up an account with them using the serial number from your kit. If so, you will receive an email notification when your results are ready and reviewed by a professional. If you have questions about your results, professionals are on staff and available to answer those questions, usually at no additional charge.
Results from a physician
Sometimes doctors have ordered your DNA tests, and you will likely receive your results during a consultation with them or a genetics counselor. Full explanations are given, and an opportunity to ask questions is a great time to educate yourself about your migraines and your genetic predispositions.
Understanding the results
Genetics are not a black and white science. Some conditions come with a single, very specific gene. However, most conditions have several markers associated with them. To function, many of those markers must be *turned on* by something. Just because you have a marker that indicates a predisposition for a condition doesn’t mean you will get it. Some markers seem to be protective of certain disorders/diseases.
Are you at an increased or decreased risk?
With this in mind, there is more of an art to reading the results for a full impression of a patient’s risk for an inherited condition. You will not usually be told, “You have this condition,” unless you also have the symptoms that go with it and other conditions have been ruled out first. You will be told that you may be at an increased or decreased risk for a condition, based only on the genes we can currently test for. Most companies who provide these tests are extremely good at explaining how to read your tests and will help you through the process.
When I had my DNA tested, I spent quite a while learning how to read the results before receiving mine online, even though I had a slight background in understanding basic genetic principles from my days of breeding Arabian show horses. That said, I could have much more easily contacted my assigned genetic counselor and had them all explained to me. I asked one question via email and was very satisfied with the quick and thorough response.
How does genetic testing impact lifestyle?
Genetic testing is not for everyone. Even consumer testing comes with the potential to learn the information you might not really want to know. The majority of people who choose genetic testing do not suffer increased anxiety as many physicians may fear, however, but instead use the information they’ve gained to change their lifestyles in ways that might influence their medical predispositions positively.
Where can you get tested?
There are many places where genetic testing is available. Where you go will depend largely on what information you are looking for.
For example, if you are testing for familial hemiplegic migraine for which there are specific genes identified, you will need to talk to your doctor and have your (blood or saliva) sample sent to one of these labs: GTR: Genetic Testing Registry. Mutations in the CACNA1A, ATP1A2, and SCN1A genes have been found to cause the three known types of familial hemiplegic migraine.
If you want to order your own testing, there are a few companies who offer it including 23andMe.
Disclosures: I have no financial or other interest in the companies or products mentioned.
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