Characteristics and clinical correlates of white matter changes in brain magnetic resonance of migraine females (original) (raw)
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The Egyptian journal of neurology, psychiatry and neurosurgery, 2018
Migraine is a common disorder in general population. Presence of white matter hyperintensities (WMHs) in brain MRI of migraine patients was not studied clearly. Detection of the prevalence of white matter hyperintensities in migraine patients determines its correlation with migraine severity, type and duration. Cross sectional analytic study was conducted on migraine patients attending neurology clinic Suez Canal University Hospital. Sixty-five patients with migraine aged from 18 to 50 years were included. We excluded smokers and patients with hypertension, cardiac disease, diabetes mellitus, endocrine dysfunction, oncological and hematological diseases, infectious diseases, demyelinating disorders, and Alzheimer disease. Brain MRI and laboratory investigation was done for all patients. White matter hyperintensities were significant more frequent in migraine with aura than those without aura. According to MIGSEV scale, white matter hyperintensities were highly significantly more fre...
Migraine Is Associated With Magnetic Resonance Imaging White Matter Abnormalities
Archives of Neurology, 2004
Background: There is controversy as to whether migraine is associated with white matter abnormalities (WMAs) on magnetic resonance images. These abnormalities may be important as a risk factor for future stroke. Further, it is controversial whether any increased risk of WMAs is attributable to comorbidities such as vascular disease. Methods: A meta-analysis of published case-control studies was undertaken to address the relationship between migraine and magnetic resonance imaging WMAs. Seven studies were identified. Data from studies reporting the incidence of magnetic resonance imaging WMAs in those with migraine and appropriate control populations were used to calculate odds ratios for WMAs in migraine for each study. A stratified meta-analysis was performed using studies that did and did not exclude subjects with disease comorbidities. Results: The summary odds ratio shows that those with migraine are at increased risk for WMAs (odds ratio, 3.9 [95% confidence interval, 2.26-6.72]). The risk does not differ between studies that included subjects with comorbidities and those that did not. Conclusion: This meta-analysis demonstrates that subjects with migraine are at higher risk of having WMAs on magnetic resonance images than those without migraine. This increased risk is present even in younger individuals who do not have co-occurring cerebrovascular disease risk factors. Prospective studies are needed to determine whether the increased risk of stroke in migraine is mediated or foreshadowed by the presence of WMAs.
Migraine with aura white matter lesions: preliminary data on clinical aspects
Neurological Sciences, 2017
A few clinic-based magnetic resonance imaging studies report an increased risk of signal abnormalities in migraineurs brain's white matter, especially in migraine with aura subjects. A vascular genesis has been hypnotized and migraine with aura was considered an independent risk factor for stroke. Available data of magnetic resonance imaging alterations are often nonspecific and sometimes controversial. The aim of our study is to investigate migraine with aura patients with standardized brain magnetic resonance imaging to detect and to quantify the presence of white matter lesions and to analyze their relation with clinical data. We report preliminary data about first 90 subjects. We did not recognize any clinical aspect in close relationship with these alterations. The only clinical feature that seems to play a role in the presence of alterations is the age, and only in migraineurs women.
The Journal of Headache and Pain, 2011
Brain white matter hyperintensities are more prevalent in migraine patients than in the general population, but the pathogenesis and the risk factors of these hyperintensities are not fully elucidated. The authors analyzed the routine clinical data of 186 migraine patients who were referred to the Outpatient Headache between 2007 and 2009: 58 patients with white matter hyperintensities and 128 patients without white matter hyperintensities on 3 T MRI. Significant associations between the presence of white matter hyperintensities and longer disease duration (14.4 vs. 19.9 years, p = 0.004), higher headache frequency (4.1 vs. 5.5 attacks/month, p = 0.017), hyperhomocysteinemia (incidence of hyperintensity is 9/9 = 100%, p = 0.009) and thyroid gland dysfunction (incidence of hyperintensity is 8/14 = 57.1%, p = 0.038) were found. These data support the theory that both the disease duration and the attack frequency have a key role in the formation of migraine-related brain white matter hyperintensities, but the effects of comorbid diseases may also contribute to the development of the hyperintensities.
White matter MRI hyperintensities in a hundred and twenty-nine consecutive migraine patients
Cephalalgia, 1994
Riboflavin (Vit B 2 ) acts as a precursor for the coenzyme FAD and the prosthetic group FMN involved in the mitochondrial respiratory chain, and has proved effective in the treatment of some mitochondrial encephalomyopathies. To my knowledge, there is no role for riboflavin in the pathogenesis of migraine, and headache is not mentioned in the literature as a consequence of riboflavin deficiency. Schoenen et al., however, found a nearly 70% reduction of migraine severity after treatment with high doses, an effect comparable to that of aspirin. They attributed this effect to the improvement in mitochondrial energy metabolism brought about by riboflavin; indeed, there are no other known mechanisms of action (analgesia for instance) for riboflavin. This, admittedly, is an open pilot study, and we must await a controlled double-blind trial of riboflavin vs placebo. This caveat notwithstanding, the study, in my opinion, is truly interesting, for two principal reasons. If confirmed, it will further indicate the presence of metabolic defects in the brain of migraineurs, which can be partially corrected by riboflavin supplementation. The rationale which actually led to the trial was that migraineurs show impaired energy metabolism, in the form of decreased PCr levels, both during and in-between the migraine attack, as shown by phosphorous magnetic resonance spectroscopy studies of brain and muscle in patients with different forms of migraine (1-3). These studies, the first to disclose a metabolic abnormality intrinsic to the migraine brain, followed earlier suggestions of ours of migraine as a defect of oxidative metabolism, and represent the first steps towards the elucidation of the basic causative mechanism of migraine. Another reason for optimism is that we could have at our disposal a new drug devoid of substantial side effects, whose low cost would make it particularly suited to the needs of prophylactic treatment. We must wait hard scientific evidence, but some rewards could have already been provided by the interesting new insights into this puzzling disease afforded by magnetic resonance spectroscopy.
Cerebral distribution of white matter lesions in migraine with aura patients
Cephalalgia, 2010
Objective: The objective of the study was to compare the cerebral distribution of white matter lesions (WMLs) between migraine patients with different aura symptoms. Methods: Migraine with aura (MA) patients were consecutively enrolled as part of the Shunt-Associated Migraine (SAM) study. According to clinical symptoms, aura was classified as motor, aphasic, sensory, visual or vertebrobasilar. Standard and FLAIR (fluid attenuated inversion recovery) T2-weighted MRI sequences were inspected for WMLs by three independent raters blinded to clinical data. WMLs were assessed in the periventricular areas (PV-WMLs) with the Fazekas scale and in the deep white matter (D-WMLs) with the Schelten's scale. Interobserver agreement was good to excellent ( k = 0.64 to 0.96, p < .0001). Results: One hundred and eighty-five patients (77% women) were included. Aura symptoms were classified as visual in 172 (99%) patients, sensory in 76 (42%), aphasic in 54 (30%), motor in 39 (21%) and vertebro...
2021
Background: Migraine is associated with magnetic resonance imaging (MRI) changes as white matter hyper intensities (WMHI), which is interpreted as ischemic in origin, the clinical significance & pathophysiology of these lesions are not well understood. The aim of study: to investigate these lesions and to find the relationships to the character of the headache and the effect on the response to treatment. Methods: a prospective, analytical study was conducted in Mosul city on 100 adult patients who were attending the neurological clinic, all fulfilled the migraine diagnostic criteria according to the Headache Classification Committee of the International Headache Society (IHS), the patients' demographics and the clinical characteristics of the headache were evaluated, all patients were examined by MRI, given treatment and followed up for three months. Results: average age was 35.04 years, with the highest prevalence noted at 29-38 years, of all patients 36% were having WMHI in MRI (positive group),while 64% were having normal MRI study (negative group),the average headache frequency was 5.69 attacks /month, average severity was (3.6) according to GAMS (Global assessment of migraine severity), average disability was 14.29 according to migraine Disability Assessment Questionnaire (MIDAS), the average duration was 10.63 hours, the mean frequency, severity, disability and duration were all significantly higher in the positive group, compared to the negative groups, and all are significantly reduced after treatment, however (91.3%), of improved cases (n=23) were from the negative group. Conclusion: migraine is associated with WMHI. Patients with WMHI showed a higher frequency, severity, disability as well as longer duration of the headache and a less favorable response to treatment.
Cardiovascular risk factors and white matter hyperintensities in migraine without aura patients
Ağrı - The Journal of The Turkish Society of Algology, 2017
White matter hyperintensities (WMHs) are observed in patients with migraine with aura (MWA) and without aura (MWO), but there are a limited number of studies regarding patients with MWA. In this study, we aimed to investigate the cardiovascular risk factors which may play a role in the development of WMHs in patients with MWO. Methods: This observational, analytical, case-control study was conducted between June 2016 and January 2017. It included 21 patients with MWO who had WMHs on brain MRI and 19 patients with MWO who tested normal on MRI (control group) at the Neurology Department Outpatient Polyclinic, Ankara Training and Research Hospital. The patients' data (history, family history, neurological examination findings, echocardiography findings, and cerebral MRI findings) were retrospectively reviewed. Results: Age, gender, body mass index, blood lipid level, migraine duration, localization of headache, average number of headache per month, medication for headache attack, and echocardiography findings were similar between the two groups. (p>0.05). Conclusion: In this study, we did not find any association between cardiovascular risk factors and WMHs development in patients with MWO. The association of risk factors other than cardiovascular risk factors (genetic factors and oxidative stress) with the development of WMHs in patients with MWO should also be studied in future.
Brain morphologic abnormalities in migraine patients: an observational study
The Journal of Headache and Pain
Background Migraine is a common neurological disorder characterized by a complex physiopathology. We assessed brain morphologic differences in migraine and the possible pathogenetic mechanism underlying this disease. Methods We analyzed brain morphologic images of migraine patients, 14 with aura (MwA) [the mean (SD) age was 42.36 (2.95) years (range, 37–47)] and 14 without aura (MwoA) [the mean (SD) age was 43.5 (3.25) years (range, 39–50)] during episodic attack compared with health subjects balanced (HS) [the mean (SD) age was 42.5 (5.17) years (range, 34–51)]. All subjects underwent a Magnetic Resonance Imaging (MRI) examination with a scanner operating at 3.0 T and voxel based morphometry (VBM) approach was used to examine the gray matter volume (GMV). The statistical analysis to compare clinicl characteristics was performed using unpaired t-test an one-way Anova. Results: Total cerebral GMV showed a significant difference between MwA and HS (p = 0.02), and between MwoA and HS (...