Prevalence and clinical characteristics of white matter hyperintensities in Migraine: A meta-analysis

Zhang, Wenyuan; Cheng, Zicheng; Fu, Fangwang; Zhan, Zhenxiang

doi:10.1016/j.nicl.2023.103312

Cited by 10 publications

(4 citation statements)

References 61 publications

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“…It is important to note that, in our population, patients with and without WMHs had similar prevalence of aura. The association between aura and WMHs is controversial, as a meta-analysis of observational studies points toward an association, 28 while large studies did not find such a result. 10,29 According to preclinical evidence, the glymphatic outflow from the brain is impaired during episodes of cortical spreading depression, 5 which is the biological substrate of migraine aura and is a typical ictal phenomenon.…”

Section: Discussionmentioning

confidence: 99%

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White matter hyperintensities in migraine are not mediated by a dysfunction of the glymphatic system—A diffusion tensor imaging magnetic resonance imaging study

Ornello,

Bruno,

Frattale

et al. 2023

Headache

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ObjectiveWe assessed whether brain magnetic resonance imaging (MRI) markers of glymphatic function are altered in patients with migraine and brain white matter hyperintensities (WMHs).BackgroundThe glymphatic system is responsible for the outflow of waste products from the brain. An impaired glymphatic system has been associated with WMH; however, this impairment has not been shown in patients with migraine.MethodsThe present cross‐sectional study included consecutive patients with migraine from a single tertiary headache center. Glymphatic function was assessed by measuring the diffusion tensor imaging along the perivascular space (DTI‐ALPS) technique, resulting in an index value. WMHs were assessed and quantified by using the Scheltens semi‐quantitative score.ResultsWe included 147 patients (120 women [81.6%]) with a median (interquartile range [IQR]) age of 45 (36–50) years. In all, 74 (50.3%) patients had WMHs. The median (IQR) ALPS index was similar in patients with WMHs compared with those without, at 2.658 (2.332–3.199) versus 2.563 (2.222–3.050) (p = 0.344). The Scheltens score did not correlate with ALPS index (rho = 0.112, p = 0.268).ConclusionsOur results suggest that the presence of WMHs is not associated with an impairment in the glymphatic system in patients with migraine. Although negative and worthy of further confirmation, our finding has implications for the understanding of the nature of WMH in patients with migraine.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

White matter hyperintensities in migraine are not mediated by a dysfunction of the glymphatic system—A diffusion tensor imaging magnetic resonance imaging study

Ornello,

Bruno,

Frattale

et al. 2023

Headache

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“…While only the participant who was identified WMH (Scheltens visual rating scores > 0) will take the MRI scan again at the T 1 and T 2 . The prevalence of WMH in migraineurs ranged from 38 to 44% [ 15 ], we believe that we can include the enough cases for analysis. The associations between the changes of WMH and migraine features will be analyzed by the Mix model across T 0 , T 1 , and T 2 time point.…”

Section: Methodsmentioning

confidence: 99%

“…The pathophysiology of migraine attack is believed to be highly complex involving neuropathological, cerebrovascular and inflammatory mechanisms. A recent meta-analysis found a higher prevalence of white matter hyperintensity (WMHs) in migraineurs as compared to age-matched controls, which supported the involvement of changes in brain structure in the neuropathological of migraine [ 15 ]. Cerebrovascular mechanism also plays a role in the occurrence of migraine attacks.…”

Section: Introductionmentioning

confidence: 96%

Tai Chi for the prophylaxis of episodic migraine: protocol of a non-inferiority randomized controlled trial with mechanism exploration

Xie,

Liao,

Hui

et al. 2023

BMC Complement Med Ther

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Background Migraine is a complex neurovascular disorder with considerable clinical, social and economic issues. Tai chi has the potential to be an alternative prophylactic treatment for migraine with high safety since the adverse effects and limited efficacy of available medications. Aims The proposed study aims to compare the prophylaxis efficacy of 24-week Tai Chi training on migraine attacks with the standard prophylactic medication; and to explore the mechanism of Tai Chi in preventing migraine attacks by analyzing the associations between changes of migraine attacks and changes of neurovascular functions and inflammatory makers. Method This is a two-arm parallel non-inferiority randomized controlled trial. In total 220 Hong Kong Chinese women aged 18–65 years with diagnosis of episodic migraine will be recruited and randomized to either the Tai Chi training group or the standard prophylactic medication group with 1:1 ratio, and receive the 24 weeks of modified 33-short form Yang-style Tai Chi training and the standard prophylactic medications, respectively. A 24-week follow-up will be implemented for both groups. For efficacy examination, the primary outcome was the frequency of migraine attacks measured by the migraine diary; and for the mechanism exploration, the primary outcome was the volume and number of white matter hyperintensity (WMH) measured by magnetic resonance imaging (MRI). The measurements will be conducted at the baseline, 24th weeks, and 48th weeks. Linear mixed model will be adopted to comprehensively analyze the changes of variables within and between groups. Discussion Given the importance of reducing disease burden and financial cost of migraine attacks, the findings of this study will provide new insights regarding the role of Tai Chi in alleviating migraine burden and further shed light on the mechanism action of Tai Chi on preventing headache attacks. Trial registration ClinicalTrials.gov NCT05690737. Registered on January 28, 2023.

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Comparison of Syn T2-FLAIR and Syn DIR with conventional T2-FLAIR in displaying white matter hyperintensities in migraine patients

Liu,

Yu,

et al. 2024

Neuroradiology

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Prevalence and clinical characteristics of white matter hyperintensities in Migraine: A meta-analysis

Cited by 10 publications

References 61 publications

White matter hyperintensities in migraine are not mediated by a dysfunction of the glymphatic system—A diffusion tensor imaging magnetic resonance imaging study

White matter hyperintensities in migraine are not mediated by a dysfunction of the glymphatic system—A diffusion tensor imaging magnetic resonance imaging study

Tai Chi for the prophylaxis of episodic migraine: protocol of a non-inferiority randomized controlled trial with mechanism exploration

Comparison of Syn T2-FLAIR and Syn DIR with conventional T2-FLAIR in displaying white matter hyperintensities in migraine patients

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