Brain MRI white matter lesions in migraine patients: is there a relationship with antiphospholipid antibodies and coagulation parameters?

Abstract

Brain magnetic resonance imaging (MRI) studies in migraine patients have demonstrated lesions consisting of focal regions of increased signal intensity within the white matter. Antiphospholipid antibodies are known to have a role in many diseases including migraine. The aim of the present study was to ascertain the relationship between MRI-visualized cerebral focal hyperintense lesions and serum antiphospholipid antibody levels, as well as blood coagulation parameters in migraine patients. One hundred and two (77 females, 25 males, mean age 33.8 +/- 11.1) consecutive migraine patients and a control group of 94 (70 females, 24 males, mean age 33.2 +/- 10.8) healthy subjects were enrolled. All individuals underwent brain MRI. Complete blood examinations, autoantibodies, antiphospholipids antibodies including anticardiolipin and lupus anticoagulant (aCL, LAC), antithrombin III, Protein C and S serum levels were ascertained in the subjects who presented white matter lesions on MRI. Twenty-seven (26.4%) migraine patients and six (6.3%) healthy subjects in the control group showed focal regions of increased intensity signal within cerebral white matter (odds ratio 5.3, 95% CI: 1.98-16.36). In migraine patients with white matter lesions, antiphospholipid antibodies were not detected and serum levels of antithrombin III, and proteins C and S were normal. White matter lesions in migraine patients are fairly common. This finding is not associated with antiphospholipid antibodies or abnormal coagulation parameters. The significance of such lesions at present remains unclear.

Brain lesions and cerebral functional impairment in migraine patients

“…A number of pathophysiological mechanisms have been put forward including oligemia [18] and mitochondrial dysfunction [19], but there are no neuropathological data. They are not associated with arterial hypertension, hypercholesterolemia and diabetes mellitus [17], or the presence of antiphospholipid antibodies (anticardiolipin antibodies and lupus anticoagulans) or abnormal coagulation parameters, including antithrombin-III, Protein S or Protein C [20]. Several questions remain unanswered regarding these hyperintensities, including whether they accumulate over time in migraine patients (and whether the use of migraine prevention strategies would prevent their accumulation), whether their presence constitutes a risk for stroke in migraine patients (and whether stroke prophylaxis is indicated), and whether they have an impact on cognitive functioning in migraine patients [21].…”

Evaluation of Cerebellar and Cerebral Volume in Migraine with Aura: A Stereological Study

“…Migraine had been shown as a risk [49] or on the contrary as a protective factor [50] for the impairment of cortical brain function. A relation between migraine and cognitive dysfunction had also been suggested by MRI studies showing that WMLs were more apparent in migraine patients compared with controls [7,51]. A recent large, longitudinal population study investigated the effects of migraine on cognitive performance and on performance change over time.…”

Neurologic and Psychiatric Comorbidity in Migraine Patients

“…İzole veya multipl hiperintens BCL, serebral hemisferde unilateral veya bilateral olarak, frontal, pariyetal bölgelerde, sentrum semiovale ve periventriküler alanda saptanabilir. 13 Literatüre bakıldığında migren hastalarındaki BCL sıklığı %12 ile %46 arasında değişkenlik göstermektedir. 2,3,14 Bizim çalışmamızda migren olgularının %17,1'inde BCL tespit edilmiştir.…”