White matter hyperintensity in different migraine subtypes

Dobrynina, Larisa А.; Suslina, Anastasia D.; Губанова, М. В.; Белопасова, А. В.; Sergeeva, A. N.; Evers, Stefan; Gnedovskaya, E. V.; Кротенкова, М. В.

doi:10.1038/s41598-021-90341-0

Cited by 18 publications

(26 citation statements)

References 63 publications

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“…We found that WMHs were significantly higher in number in patients with migraine with aura. Our findings agree with Kurth et al, 2011;Bashir et al, 2013 andKruit et al, 2010 who showed that migraineurs with aura were at increased [11,16,19,25]. Our results are difficult to reconcile with some population-based studies, particularly the study by Gaist et al looking at migraine with aura patients.…”

Section: Discussionsupporting

confidence: 80%

Association of white matter hyperintensities with migraine phenotypes and response to treatment

et al. 2022

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Introduction White matter hyperintensities (WMHs) are frequently found in migraineurs. However, their clinical significance and correlation to different migraine phenotypes and treatment responses are not well defined. The study aimed to examine the association of WMHs with migraine clinical patterns and treatment response. Aim of work We aimed to evaluate the association between WMHs and migraine phenotypes and explore the relationship of WMHs to treatment response. Methods Our cross-sectional study formed of 500 migraineurs who sought treatment in Kafr el-sheik university hospital and underwent (3 T) MRI to evaluate WMHs. Different migraine phenotypes were compared between patients with and without WMHs. According to reduced headache pain intensity and frequency, these patients were divided into treatment responder and non-responder groups. Results A total of 145 patients (29%) had WMHs. Patients with WMHs were significantly older, had a longer disease duration, and higher attack frequency. Patients who did not respond to acute and maintenance medications had a higher frequency of WMHs and high WMHs Scheltens score. Migraine with Aura and the presence of vomiting and dizziness were predictors for the development of WMHs. Conclusion WMHs are more common in migraine with aura. It is more frequent in migraine associated with vomiting and dizziness. WMHs increased with advancing age and more severe disease burden. Poorer response to acute and prophylactic medications was found in patients with WMHs.

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Section: Discussionsupporting

confidence: 80%

Association of white matter hyperintensities with migraine phenotypes and response to treatment

et al. 2022

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“…Prevalence of WMHs was 20% in KD patients, which is four times higher than reported in healthy young adults with a similar age (Hopkins et al, 2006). In contrast, the prevalence of WMH in cases (migraine patients) was comparable to pediatric migraine patients (11 vs. 11%) (Eidlitz-Markus et al, 2013), but lower than reported in young adults with migraine (Dobrynina et al, 2021).…”

Section: Discussionmentioning

confidence: 72%

Brain white matter hyperintensities in Kawasaki disease: A case–control study

Laukka

Parkkola²,

Hirvonen³

et al. 2022

Front. Neurosci.

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BackgroundCerebrovascular involvement of Kawasaki disease (KD) is poorly studied. White matter hyperintensities (WMH) indicate cerebral small vessel disease and increase the risk for stroke.PurposeTo investigate whether childhood KD is associated with WMHs and other cerebrovascular findings later in adulthood.Materials and methodsIn this case-control study, patients diagnosed with KD (cases) at our tertiary hospital between 1978 and 1995 were invited to brain magnetic resonance (MRI) between 2016 and 2017. Migraine patients (controls) with available brain MRI were matched with cases (ratio 4:1) by age (±2 years) and sex. Two blinded neuroradiologists evaluated independently cerebrovascular findings from the brain MRI scans. Modified Scheltens' visual rating scale was used to evaluate WMH burden and the total WMH volume was measured using manual segmentation.ResultsMean age [years, (SD)] at the time of brain MRI was 33.3 (3.8) and 32.8 (4.0) for cases (n = 40) and controls (n = 160), respectively (P = 0.53). Mean follow-up time for cases was 29.5 years (4.3). Total volume of WMHs (median) was 0.26 cm3 (IQR 0.34) for cases and 0.065 cm3 (IQR 0.075) for controls, P = 0.039. Cases had higher total WMH burden (P = 0.003), deep WMH burden (P = 0.003), and more periventricular WMHs (prevalence 7.5 vs. 0%, P = 0.008) than controls. Cases had greater risk of having total Scheltens' score ≥2 vs. < 2 (odds ratio, 6.88; 95% CI: 1.84–25.72, P = 0.0041) and ≥3 vs. < 3 (odds ratio, 22.71; 95% CI: 2.57–200.53, P = 0.0049). Diabetes type 1/type 2, hypertension, smoking status or hypercholesterolemia were not risk factors for WMH burden, p > 0.1. Myocarditis at the acute phase of KD increased the risk for periventricular WMHs (P < 0.05). Three cases (7.5%) and three controls (1.9%) had lacune of presumed vascular origin (P = 0.0096).ConclusionHistory of KD could be associated with an increased WMH burden. More studies are needed to confirm our results.

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“…One hypothesis is that vasoactive substances bypass the pulmonary circulation to directly enter the systemic circulation in patients with RLS, inducing migraine attacks and the aura symptoms ( 12 ). While some studies reported an association of RLS with migraine with aura ( 2 ), other studies showed no difference in the prevalence of RLS between migraine subtypes ( 10 , 11 ). Of the types of RLS, a patent foramen ovale (PFO) is the most common and is present in >25% of the healthy population ( 13 ), while other subtypes such as pulmonary arteriovenous malformations are rarer and associated with specific hereditary conditions ( 14 ).…”

Section: Introductionmentioning

confidence: 97%

“…There is recent interest in the relationship between migraine, aura status and RLS ( 1 , 10 , 11 ). One hypothesis is that vasoactive substances bypass the pulmonary circulation to directly enter the systemic circulation in patients with RLS, inducing migraine attacks and the aura symptoms ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Evaluating the relationship between right-to-left shunt and white matter hyperintensities in migraine patients: A systematic review and meta-analysis

Yeo

Goh²,

Tan³

et al. 2022

Front. Neurol.

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IntroductionWhite matter hyperintensities (WMHs) have been observed with greater frequency in patients with migraine and are thought to be associated with impaired cognition and function. The relationship between WMHs and right-to-left shunt (RLS) in migraine patients is unknown. We performed a systematic review to determine if there is an association between RLS and WMHs in patients with migraine.MethodsA systematic search of the literature was performed in PubMed and Embase using a suitable keyword search strategy from inception up to 16th June 2021. All studies that included patients with migraine and studied RLS and WMHs were included.ResultsA total of 8 non-randomized observational studies comprising 1125 patients with migraine were included; 576 had an RLS, compared to 549 patients with no RLS. The mean age of the study populations ranged from 28.4 to 43 years, while the average duration from migraine diagnosis ranged from 5.1 to 19 years. The proportion of female to male patients was consistently higher in all studies (60.0–94.4%). Amongst migraine patients with RLS, 338 patients (58.7%) had WMHs. In contrast, 256 (46.6%) of migraine patients without RLS had WMHs. RLS was significantly associated with the presence of WMHs in migraine patients (OR: 1.56, 95% CI: 1.05–2.34, p = 0.03).ConclusionIn migraine patients, RLS was significantly associated with the presence of WMHs. Longitudinal studies are warranted to establish RLS as a risk factor for WMHs in patients with migraine, and to establish the significance of these changes.

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White matter hyperintensity in different migraine subtypes

Cited by 18 publications

References 63 publications

Association of white matter hyperintensities with migraine phenotypes and response to treatment

Association of white matter hyperintensities with migraine phenotypes and response to treatment

Brain white matter hyperintensities in Kawasaki disease: A case–control study

Evaluating the relationship between right-to-left shunt and white matter hyperintensities in migraine patients: A systematic review and meta-analysis

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