High sensitivity C-reactive protein and cerebral white matter hyperintensities on magnetic resonance imaging in migraine patients

Abstract

BackgroundMigraine is a common headache disorder that may be associated with vascular disease and cerebral white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) scan. High sensitivity C-reactive protein (hs-CRP) is a marker of inflammation that may predict subclinical atherosclerosis. However, the relation between migraine, vascular risks, and WMHs is unknown. We evaluated hs-CRP levels and the relation between hs-CRP level and WMHs in adult migraine patients.MethodsThis case–control study included 432 subjects (216 migraine patients [without aura, 143 patients; with aura, 73 patients]; 216 healthy control subjects without migraine; age range 18–50 y). Migraine diagnosis was determined according to the International Classification of Headache Disorders II diagnostic criteria. The migraine patients and control subjects had no known vascular risk factors, inflammatory disease, or comorbid disease. The presence and number of WMHs on MRI scans were determined, and serum hs-CRP levels were measured by latex-enhanced immunoturbidimetry.ResultsMean hs-CRP level was significantly greater in migraine patients (1.94 ± 2.03 mg/L) than control subjects (0.82 ± 0.58 mg/L; P ≤ .0001). The mean number of WMHs per subject and the presence of WMHs was significantly greater in migraine patients (69 patients [31.9%]; 1.68 ± 3.12 mg/dL) than control subjects (21 subjects [9.7%]; 0.3 ± 1.3; P ≤ .001). However, there was no correlation between hs-CRP level and WMHs in migraine patients (r = 0.024; not significant). The presence of WMHs was increased 4.35-fold in migraine patients (odds ratio 4.35, P ≤ .001).ConclusionsHigh hs-CRP level may be a marker of the proinflammatory state in migraine patients. However, the absence of correlation between hs-CRP level and WMHs suggests that hs-CRP is not causally involved in the pathogenesis of WMHs in migraine patients. The WMHs were located mostly in the frontal lobe and subcortical area.

Migraine and peripheral inflammation

“…Consistent with previous reports, CRP levels were elevated in migraine patients in the present study [11,12].…”

Cognitive performance in young and middle-aged adults with migraine: Investigating the correlation with white matter hyperintensities and psychological symptoms

“…This could lead to cerebral ischemia caused by the effects on the cerebral blood flow [6]. On the contrary, inflammatory arteriopathy of the cranial vessels is associated with migraine attacks [23].…”

Does insomnia modify the association between C-reactive protein and migraine? The Tromsø Study 2015–2016

“…Most previous studies evaluating the association between CRP and migraine have been case-control studies with small sample sizes reporting inconsistent results. Some have reported significantly higher CRP values in migraine patients (8,12,13,19,(23)(24)(25)(26)(27), whereas others have not (7,10,15,16,20,21). Various results have also been found in population-based studies (9,11,14,29).…”