The diagnostic value of white matter hyperintensities (WMH) in different types of migraineare unknown. To evaluate the WMH pattern of different subtypes in migraine patients with no vascular risk factors. 92 migraine patients (73 females, mean age 34.6 ± 8.9; 61 episodic migraine, 31 chronic migraine, 36 migraine with aura, 56 migraine without aura) without vascular risk factors underwent brain MRI (3 T). We also included a matched healthy control group with no migraine (n = 24). The prevalence of WMH in different types of migraine was similar and ranged from 38.7 to 44.4%; the control group showed no WMH at all. Lesions were located within frontal, parietal and temporal lobes (in order of decreasing incidence) in juxtacortical and/or deep white matter. WMH appeared as round or slightly elongated foci with a median size of 2.5 mm [1.5; 3]. Total number, size and prevalence of WMH by lobes and white matter regions were similar between groups, and no interaction with age or sex was found. The number of lesions within the frontal lobe juxtacortical white matter correlated with the age of patients (r = 0.331, p = 0.001) and the duration since migraine onset (r = 0.264, p = 0.012). Patients with different migraine subtypes and without vascular risk factors are characterized by a similar pattern of WMH in the absence of subclinical infarctions or microbleedings. Therefore, WMH have no relevant prognostic value regarding the course of migraine and vascular complications. WMH pattern may be used to differentiate migraine as a primary disorder and other disorders with migraine-like headache and WMH.
Cerebral small vessel disease (SVD) is a major cause of cognitive impairment in elderly people. While most research focuses on the role of the classical vascular risk factors in SVD, a description of the psychophysiological mechanisms leading to the age-related brain damage may open new possibilities for prophylaxis. In the current study, we evaluated the associations between emotional abilities, interoception, and age-related vascular white matter degeneration. The work was influenced, first, by multiple studies recognizing alexithymia as a cardiovascular risk factor; second, by theories of emotions linking body's allostasis and emotional regulation; and third, by neuroimaging data highlighting the shared role of the insular cortex in interoceptive and emotional processing. In a sample of older female adults (N = 30), we performed the Mayer-Salovey-Caruso Emotional Intelligence Test, functional MRI using the heartbeat detection task, and evaluation of white matter microstructural integrity using diffusion weighted imaging. The ability to understand and analyze emotions-one of the four components of emotional intelligence-was found to be associated with higher interoception-related activation of the right anterior insula and preserved white matter microstructure. We interpret these results in light of the concept of Embodied Predictive Interoception Coding, which proposes that emotional processing, interoception, and allostasis (antecedent top-down regulation of the body's internal milieu) may rely on the shared neural mechanisms of predictive coding. The study demonstrates feasibility of the investigation of cerebrovascular diseases form a psychophysiological perspective and calls for future research.
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