White Matter Lesions Progression in Migraine with Aura: A Clinical and MRI Longitudinal Study

Dinia, Lavinia; Bonzano, Laura; Albano, Beatrice; Finocchi, Cinzia; Sette, Massimo Del; Saitta, Laura; Castellan, Lucio; Roccatagliata, Luca

doi:10.1111/j.1552-6569.2011.00643.x

Cited by 43 publications

(43 citation statements)

References 40 publications

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“…In CAMERA-1, 10 the authors examined the relationship between attack frequency and WMAs, and suggested that WMAs could arise due to the cumulative impact of repeated episodes of regional cerebral ischemia during a migraine attack. A longitudinal study from Italy, 31 which was not included in our summary tables because it lacked nonmigraine controls, suggested WMA progression in MA at follow-up MRI after about 33 months. The study reported a correlation of the number of new WMAs with attack frequency (p 5 0.03) and aura duration (p , 0.0001).…”

Section: Resultsmentioning

confidence: 99%

Migraine and structural changes in the brain

et al. 2013

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Objective: To evaluate the association between migraine without aura (MO) and migraine with aura (MA) and 3 types of structural brain abnormalities detected by MRI: white matter abnormalities (WMAs), infarct-like lesions (ILLs), and volumetric changes in gray and white matter (GM, WM) regions.Methods: PubMed as well as the reference lists of identified studies and reviews were used to identify potentially eligible studies through January 2013. Candidate studies were reviewed and eligible studies were abstracted. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated for WMAs and ILLs.Results: Six population-based and 13 clinic-based studies were identified. The studies suggested that structural brain changes, including WMAs, silent ILLs, and volumetric changes in GM and WM regions, were more common in migraineurs than in control groups. The results were strongest for MA. The meta-analysis of WMAs showed an association for MA (OR 1.68; 95% CI 1.07-2.65; p 5 0.03) but not for MO (OR 1.34; 95% CI 0.96-1.87; p 5 0.08). The association of ILLs was greater for MA (OR 1.44; 95% CI 1.02-2.03; p 5 0.04) than for MO, but no association was found for MA (p 5 0.52) and MO (p 5 0.08) compared to controls. Conclusion:These data suggest that migraine may be a risk factor for structural changes in the brain. Additional longitudinal studies are needed to determine the differential influence of migraine without and with aura, to better characterize the effects of attack frequency, and to assess longitudinal changes in brain structure and function. Neurology â 2013;81:1260-1268 GLOSSARY ACC 5 anterior cingulate cortex; CAMERA 5 Cerebral Abnormalities in Migraine, an Epidemiological Risk Analysis; CI 5 confidence interval; DTI 5 diffusion tensor imaging; GM 5 gray matter; ICHD 5 International Classification of Headache Disorders; IHL 5 infratentorial hyperintense lesion; ILL 5 infarct-like lesion; MA 5 migraine with aura; MO 5 migraine without aura; OR 5 odds ratio; PAG 5 periaqueductal gray; VBM 5 voxel-based morphometry; WM 5 white matter; WMA 5 white matter abnormality.

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Section: Resultsmentioning

confidence: 99%

Migraine and structural changes in the brain

et al. 2013

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“…Several studies showed migraine, especially migraine with aura to be a risk factor for WMLs [21, 22]. Additionally, the risk for ischemic stroke was reported to be higher in patients with migraine with aura than with migraine without aura [23].…”

Section: Discussionmentioning

confidence: 99%

The relationship between right-to-left shunt and brain white matter lesions in Japanese patients with migraine: a single center study

et al. 2017

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BackgroundThere may be a link between right-to-left shunt (RLs) and brain white matter lesions (WMLs) in patients with migraine. In this study, we assessed the relationship between WMLs and RLs in Japanese migraine patients.MethodsA total of 107 consecutive patients with migraine with (MA) and without aura (MWOA) were included in this study. Contrast transcranial Doppler ultrasound was used to detect RLs. WMLs were graded using brain magnetic resonance imaging based on well-established criteria.FindingsThe prevalence of RLs was significantly increased in the WMLs positive group (n = 24) compared with the WMLs negative group (n = 83) (75.0% vs. 47.0%, p = 0.015). In prevalence of WMLs between MA and MWOA patients, there were no statistical differences (p = 0.410). Logistic regression analysis adjusted by age and disease duration of migraine identified an RLs-positive status as the sole determinant for the presence of WMLs (OR = 6.15; 95% CI 1.82–20.8; p = 0.003)ConclusionOur study suggests a possible link between RLs and WMLs in Japanese patients with migraine.

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“…69 Hyperintensities in the white matter. 61,65,[70][71][72]77 Increased iron deposition in the periaqueductal grey, putamen, globus pallidus, and red nucleus. 70,[78][79][80]83 Increased stroke risk, especially in the posterior circulation.…”

Section: Modality Findingsmentioning

confidence: 99%

“…An important study recently conducted by Dinia and colleagues 77 used MRI to prospectively evaluate longitudinal changes in the white matter lesions in migraineurs with aura. The subjects were followed for a mean time of 33.2 months and were evaluated for cerebrovascular risk factors.…”

Section: 99mentioning

confidence: 99%

Structural and Functional Neuroimaging in Migraine: Insights From 3 Decades of Research

Lakhan

Avramut

Tepper³

2012

Headache

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Modern imaging methods provide unprecedented insights into brain structure, perfusion, metabolism, and neurochemistry, both during and between migraine attacks. Neuroimaging investigations conducted in recent decades bring us closer to uncovering migraine as a multifaceted, primarily central nervous system disorder. Three main categories of structural and functional brain changes are described in this review, corresponding to the migrainous aura, ictal headache, and interictal states. (Headache 2013;53:46-66)

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White Matter Lesions Progression in Migraine with Aura: A Clinical and MRI Longitudinal Study

Abstract: Our study demonstrates that in migraine with aura WMLs number can progress over time and suggests an association between aura features and WMLs progression. Studies with a higher number of patients are required to confirm these findings.

Cited by 43 publications

References 40 publications

Migraine and structural changes in the brain

Migraine and structural changes in the brain

The relationship between right-to-left shunt and brain white matter lesions in Japanese patients with migraine: a single center study

Structural and Functional Neuroimaging in Migraine: Insights From 3 Decades of Research

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