Neurodiversity and Migraine: Is There a Link?

The link between migraine and neurodiversity isn’t clear, but neurodiverse people may be more likely to experience migraine. Here are the possible reasons.

Autism spectrum disorder (ASD) is a condition characterized, in part, by difficulty processing sensory information. Attention deficit hyperactivity disorder (ADHD) involves difficulty focusing on tasks. Migraine can make both sensory processing and focusing on a task almost impossible.

What’s more, ASD, ADHD, and migraine often occur together.

Could there be a link between these conditions? And is migraine a sign of neurodiversity? Read on for the latest research, plus first-hand accounts from real people.

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The link between migraine and neurodiversity

Research surrounding migraine and neurodiverse conditions like autism, ADHD, and sensory processing issues is limited — but emerging.

Migraine and Autism Spectrum Disorder

ASD and migraine are both conditions that affect the brain. However, a 2020 narrative review points out that little research exists on the link between the two despite the fact that they often occur together.

“They are both neurological and have complex impacts on the brain, including sensory processing,” explains Emily Treichler, PhD, LCP. “We know that autistic children are at higher risk of developing migraine than allistic (nonautistic) children, regardless of other risk factors for migraine.”

One 2021 study compared data from more than 18,000 autistic people and 18,000 peers without ASD. The study indicated that autistic people are more likely to develop migraine later in life.

A small 2019 study involving 105 autistic adults and 76 nonautistic participants indicated that people with ASD had a nearly 43% chance of also experiencing migraine compared to 20.7% of those without it.

The reason for the potential link is still being studied. However, there are theories about why the two may be connected.

“The answer is probably complex, and researchers are working toward developing a clearer understanding as to why migraine and autism tend to happen together,” says psychologist Gilly Kahn, PhD, who has ADHD.

Kahn notes these may include hormonal influences and over or underactivation of certain parts of the brain.

Other theories include:

• difficulties processing sensory information
• differences in sensitivity to pain
• dopamine levels, which can make it challenging to regulate emotions, pain, and focus
• lower levels of serotonin
• disruptions to the gut-brain axis
• disrupted function of the hypothalamus

“The hypothalamus can be thought of as an internal thermostat that produces hormones that control hunger, temperature, sleep, and mood,” Kahn explains. “With migraine, when our internal sense of balance or homeostasis is disrupted, this can bring on an attack.”

There’s also 2020 research suggesting both structural and functional alterations of the hypothalamus may be involved in ASD.

“The hypothalamus regulates hormones such as oxytocin, also popularly known as the love hormone, as it’s responsible for the positive feelings associated with social connection,” says Kahn. “In individuals with autism, oxytocin levels may be lower.”

Migraine and ADHD

An older 2011 study of more than 1,200 adults with and without ADHD indicated that 28.3% of people with ADHD experienced migraine compared to 19.2% of people without ADHD who had migraine. A larger 2018 study of 26,456 adults suggested a strong link between migraine and ADHD.

“There is a lot of overlap between ADHD and autism, so the link between ADHD and migraine is probably very similar to the link between autism and migraine,” Kahn says. “Both conditions involve significant difficulties with executive functioning, and both conditions involve sensory integration issues, though sensory issues are not part of the current diagnostic criteria for ADHD.”

CDC research published in 2020 indicates that 28% to 44% of autistic people have ADHD. However, research published in 2022 points to literature that suggests rates may be as high as 50% to 70%.

Migraine and sensory processing disorder

Unlike ASD and ADHD, sensory processing disorder is not in the DSM-5, a manual used to diagnose conditions.

“Instead, symptoms related to sensory processing difficulties are usually accounted for as a part of a person’s other mental health or physical health issues, including autism and ADHD,” says Treichler.

Migraine can involve sensory processing issues. However, migraine is not a sensory processing disorder. What’s the difference?

“Migraine, which consists of headache and other associated symptoms, can be triggered by sensory stimuli, but that stimulation leads to a series of neurovascular and chemical changes in the brain that activate pain pathways,” says Chantel Strachan, MD. “The pathophysiology leading to SPD is less well-known.”

According to the CDC, autistic people can be more or less sensitive to aspects of the environment, such as light, sound, textures, smells, and temperatures.

These sensory processing issues are also present in people with migraine, though likely for different reasons.

Treichler adds that people can have sensory processing issues without migraine and vice versa.

Overlapping symptoms in ASD, ADHD, and migraine

Migraine and neurodiverse conditions like autism and ADHD may share common symptoms, including:

• sensory processing issues
• distraction
• irritability
• anxiety
• sleep issues
• gastrointestinal (GI) issues like vomiting, nausea, and diarrhea

A small 2014 study of 81 autistic children ages 7 to 17 years old indicated increased sensory sensitivity and anxiety in participants with migraine compared to those without it.

This 2021 systemic review suggests a link between migraine and anxiety. A 2018 report notes that anxiety is common in youth with autism, and research from 2021 points out that it’s also common in people with ADHD.

Research published in 2020 pointed to literature suggesting a link between an altered gut-brain axis and autism and migraine. However, the author reports that the mechanism of the gut-brain axis disruption in people with migraine is less understood.

Differences in the gut-brain axis may contribute to GI discomfort in autistic people and disorders like inflammatory bowel disease in people with migraine, but more research is needed.

A 2020 review indicated that sleep disturbances and daytime drowsiness are common in people with ADHD. A 2022 study suggested a link between poor sleep and the chances of developing a migraine.

How to manage co-occurring symptoms

There may be a gap in knowledge about the links between neurodiversity and migraine, but those experiencing both can take steps to treat, manage, and prevent symptoms.

Identify triggers

“Having an understanding of clear triggers … allows for an individual to modify or avoid certain behaviors that are associated with symptom onset,” Strachan says.

This can involve limiting screen time, staying hydrated, or avoiding certain foods.

“For those with unavoidable triggers like menses or barometric pressure changes, tracking and preparing for the onset of symptoms can also be helpful,” Strachan says. Keeping a log of migraine and its associated symptoms in real time can greatly help recall events during provider visits.”

Strachan says these logs can be handy for people with ADHD, who may need help focusing and with recall, and autistic individuals who are less verbal in communication.

Create a treatment plan

It’s a good idea to work with a neurologist to develop a customized treatment plan and ensure you don’t have other brain health or general health conditions.

“Working with a neurologist can also be helpful in ruling out other less common and potentially life threatening explanations for migraine symptoms,” Treichler says.

Break things down into small tasks and lists

Migraine can derail your to-do list. Additionally, people with ADHD may need to take some extra steps to remember information and stay on task.

“For some with ADHD, creating small to-do lists and reminders are helpful for limiting triggers,” Strachan says.

Kahn says small tasks help her and the people she works with who have ADHD and migraine.

Get support with communication

People with ADHD or migraine may have trouble remembering things and staying organized, and some autistic people may be nonverbal.

In these cases, it may help to have a support person, like a loved one or patient advocate, to take notes or manage appointments.

Communication devices, visual diagrams, or written communication may also be helpful.

Frequently asked questions

Get the answers to commonly asked questions about migraine and neurodiversity.

Is migraine a neurodiverse condition?

Currently, migraine is not considered a neurodiverse condition. Migraine is a neurologic disorder. Neurodiverse conditions like autism and ADHD are considered developmental.

However, there is symptom overlap, such as increased anxiety and sensory sensitivity, between migraine and neurodiverse conditions.

Is there a link between ADHD and migraine?

More research is needed, but migraine and ADHD may be linked. Research suggests an increased prevalence of migraine in people with ADHD.

Is migraine aura associated with autism?

Research is still emerging. However, an older 2013 review indicated that migraine with aura and autism can both occur in infancy and can have long-term impacts on development.

Moreover, autism and migraine aura share common diagnostic criteria like sensory disturbances.

Are migraine and autism neurological conditions?

Migraine is a neurological condition, while autism is neurodevelopmental. However, some research suggests that autistic people are more likely to experience migraine.

Symptoms of both conditions vary, but sensory processing issues and increased anxiety commonly occur in each.

Takeaway

Neurodiverse conditions like autism and ADHD are common, just like migraine.

Some research indicates that people who are neurodiverse are more likely to develop migraine, but more research is needed to confirm the links.

Still, there does seem to be an overlap between the symptoms and experiences of people with these conditions.