Association of white matter hyperintensities with migraine features and prognosis

Xie, Hui; Zhang, Qiang; Huo, Kang; Li, Rui; Jian, Zhijie; Bian, Yitong; Li, Guoliang; Zhu, Dan; Zhang, Lihui; Yang, Jian; Luo, Gaoxing

doi:10.1186/s12883-018-1096-2

Cited by 23 publications

(42 citation statements)

References 37 publications

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“…About the limitations of this study, due to time constraints in the MRI acquisition process in a clinical setting, we acquired no T2 or T2-FLAIR MRI sequences that would be helpful to assess White Matter Hyperintensities (WMHs). Migraine has been associated with an increased risk for WMHs detected on MRI [64]; also pain in EM patients [65] and an unfavourable prognosis [66] were found to be associated with the occurrence of WMHs. Considering our correlation results in CM patients and the state of the art, the WMHs analysis would have been interesting in this study.…”

Section: Discussionmentioning

confidence: 99%

White matter changes in chronic and episodic migraine: a diffusion tensor imaging study

et al. 2020

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Background: White matter alterations have been observed in patients with migraine. However, no microstructural white matter alterations have been found particularly in episodic or chronic migraine patients, and there is limited research focused on the comparison between these two groups of migraine patients. Methods: Fifty-one healthy controls, 55 episodic migraine patients and 57 chronic migraine patients were recruited and underwent brain T1-weighted and diffusion-weighted MRI acquisition. Using Tract-Based Spatial Statistics (TBSS), fractional anisotropy, mean diffusivity, radial diffusivity and axial diffusivity were compared between the different groups. On the one hand, all migraine patients were compared against healthy controls. On the other hand, patients from each migraine group were compared between them and also against healthy controls. Correlation analysis between clinical features (duration of migraine in years, time from onset of chronic migraine in months, where applicable, and headache and migraine frequency, where applicable) and Diffusion Tensor Imaging measures was performed. Results: Fifty healthy controls, 54 episodic migraine and 56 chronic migraine patients were finally included in the analysis. Significant decreased axial diffusivity (p < .05 false discovery rate and by number of contrasts corrected) was found in chronic migraine compared to episodic migraine in 38 white matter regions from the Johns Hopkins University ICBM-DTI-81 White-Matter Atlas. Significant positive correlation was found between time from onset of chronic migraine and mean fractional anisotropy in the bilateral external capsule, and negative correlation between time from onset of chronic migraine and mean radial diffusivity in the bilateral external capsule. Conclusions: These findings suggest global white matter structural differences between episodic migraine and chronic migraine. Patients with chronic migraine could present axonal integrity impairment in the first months of chronic migraine with respect to episodic migraine patients. White matter changes after the onset of chronic migraine might reflect a set of maladaptive plastic changes.

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Section: Discussionmentioning

confidence: 99%

White matter changes in chronic and episodic migraine: a diffusion tensor imaging study

et al. 2020

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“…19 The white matter hyperintensities were classified based on the location as frontal, parietal, temporal, occipital, deep gray matter, and infratentorial region. 20,21 The axial images are used for the analysis of white matter hyperintensities and the structures at each cut were compared with neuroanatomy atlas as a reference to verify the location of interest on scans (https://radiopaedia.org/articles/brain). The size of the lesions was classified as <3 mm, 3-5 mm, ࣙ5-10 mm, and >10 mm in diameter.…”

Section: Mri Acquisitionmentioning

confidence: 99%

“…The size of the lesions was classified as <3 mm, 3-5 mm, ࣙ5-10 mm, and >10 mm in diameter. 21 In patients with multiple lesions, maximum diameter of the largest lesion was considered for analysis. The degree of white matter disease was assessed using the Scheltens visual rating scale.…”

Section: Mri Acquisitionmentioning

confidence: 99%

White Matter Hyperintensities in Patients with Sporadic Hemiplegic Migraine

Nagarajan

Bollu

Sivaraman

et al. 2019

Journal of Neuroimaging

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To identify the differences in overall occurrence, location, and disease burden of white matter hyperintensities (WMH) in patients with sporadic hemiplegic migraine (SHM) and patients with migraine headaches. METHODS: We included patients who met diagnostic criteria proposed by the third International Classification of Headache Disorders (ICHD-3) for SHM and migraine headache. WMHs were identified using T2 fluid-attenuated inversion recovery axial sequence and classified based upon the location. The disease burden was assessed using Scheltens visual rating scale. RESULTS: Fifty patients met the diagnostic criteria for SHM and 100 patients for migraine headache. Patients in the study group were similar to the control group in terms of age (47.7 ± 12.2 years vs. 48.17 ± 9.7 years; P = .814) and gender (M: F; 14:36 vs. M: F 25:75; P = .693). WMH were found in 28 (56%) patients with SHM and 44 (44%) in patients with migraine headache. The proportion of patients with WMH was not different between the two groups (P = .166). On univariate analysis, the proportion of patients with WMH in parietal, occipital, and infratentorial regions was higher in patients with SHM. White matter burden determined by visual rating scale and proportion of patients with lesions ࣙ5 mm in diameter was also significantly higher in patients with SHM. On multivariate analysis, the WMH occurrence in the parietal lobe (P = .043) was found to be significantly higher in SHM. CONCLUSIONS: The WMH occurrence in patients with SHM is significantly more in the parietal lobe when compared to those with migraine headaches. WMH burden was also higher in patients with SHM, and larger white matter lesions occurred more frequently in these patients with SHM (compared to ordinary migraineurs).

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“…In patients with headache, genetic factors, migraine characteristics, and autonomic symptoms have been evaluated to predict treatment response to triptan and topiramate (26)(27)(28). In addition, white matter hyperintensity was found to predict migraine prognosis (29); however, the correlation and regression analysis between predictors and patient outcomes used in this previous study were insufficient. The present study used a linear SVMbased classification to distinguish between responders and nonresponders.…”

Section: Discussionmentioning

confidence: 84%

Baseline Brain Gray Matter Volume as a Predictor of Acupuncture Outcome in Treating Migraine

Yang

Liu

et al. 2020

Front. Neurol.

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Background: The present study aimed to investigate the use of imaging biomarkers to predict the outcome of acupuncture in patients with migraine without aura (MwoA). Methods: Forty-one patients with MwoA received 4 weeks of acupuncture treatment and two brain imaging sessions at the Beijing Traditional Chinese Medicine Hospital affiliated with Capital Medical University. Patients kept a headache diary for 4 weeks before treatment and during acupuncture treatment. Responders were defined as those with at least a 50% reduction in the number of migraine days. The machine learning method was used to distinguish responders from non-responders based on pre-treatment brain gray matter (GM) volume. Longitudinal changes in GM predictive regions were also analyzed. Results: After 4 weeks of acupuncture, 19 patients were classified as responders. Based on 10-fold cross-validation for the selection of GM features, the linear support vector machine produced a classification model with 73% sensitivity, 85% specificity, and 83% accuracy. The area under the receiver operating characteristic curve was 0.7871. This classification model included 10 GM areas that were mainly distributed in the frontal, temporal, parietal, precuneus, and cuneus gyri. The reduction in the number of migraine days was correlated with baseline GM volume in the cuneus, parietal, and frontal gyri in all patients. Moreover, the left cuneus showed a longitudinal increase in GM volume in responders. Conclusion: The results suggest that pre-treatment brain structure could be a novel predictor of the outcome of acupuncture in the treatment of MwoA. Imaging features could be a useful tool for the prediction of acupuncture efficacy, which would enable the development of a personalized medicine strategy.

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Association of white matter hyperintensities with migraine features and prognosis

Cited by 23 publications

References 37 publications

White matter changes in chronic and episodic migraine: a diffusion tensor imaging study

White matter changes in chronic and episodic migraine: a diffusion tensor imaging study

White Matter Hyperintensities in Patients with Sporadic Hemiplegic Migraine

Baseline Brain Gray Matter Volume as a Predictor of Acupuncture Outcome in Treating Migraine

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