Enrico B Arkink1, Gisela M Terwindt2, Anton J M de Craen2, Junya Konishi2, Jeroen van der Grond2, Mark A van Buchem2, Michel D Ferrari2, Mark C Kruit2. 1. From the Departments of Radiology (E.B.A., J.K., J.v.d.G., M.A.v.B., M.C.K.), Neurology (G.M.T., M.D.F.), and Gerontology and Geriatrics (A.J.M.d.C.), Leiden University Medical Center, Leiden, The Netherlands. e.b.arkink@lumc.nl. 2. From the Departments of Radiology (E.B.A., J.K., J.v.d.G., M.A.v.B., M.C.K.), Neurology (G.M.T., M.D.F.), and Gerontology and Geriatrics (A.J.M.d.C.), Leiden University Medical Center, Leiden, The Netherlands.
Abstract
BACKGROUND AND PURPOSE: Migraine is a risk factor for clinical stroke and for subclinical white matter hyperintensities and infratentorial infarcts. These subclinical lesions are linked to small-vessel pathology. Cerebral microbleeds (CMBs) are another biomarker of small-vessel disease but have not yet been studied in migraine. METHODS: Identification of CMBs in 63 migraineurs (25 with aura/35 without aura/3 unknown aura status) and 359 controls (aged, 73-85 years) from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) magnetic resonance imaging study. We assessed the modifying role of migraine in the co-occurrence of CMBs, infarcts, and white matter hyperintensity-load. RESULTS: Infratentorial microbleeds were more prevalent in migraine without aura patients than controls (14% versus 4%). Prevalence of other CMBs, infarcts, and white matter hyperintensities did not differ between groups. Migraineurs with CMBs had more often infarcts than controls with CMBs (65% versus 43%). In comparison with controls with infarcts, migraineurs with infarcts had more commonly CMBs (55% versus 30%). CONCLUSIONS: Migraine, notably without aura, is associated with infratentorial CMBs at older age. CMBs and infarcts co-occur more often in migraine than in controls. This supports the hypothesis of small-vessel involvement in migraine pathophysiology.
BACKGROUND AND PURPOSE:Migraine is a risk factor for clinical stroke and for subclinical white matter hyperintensities and infratentorial infarcts. These subclinical lesions are linked to small-vessel pathology. Cerebral microbleeds (CMBs) are another biomarker of small-vessel disease but have not yet been studied in migraine. METHODS: Identification of CMBs in 63 migraineurs (25 with aura/35 without aura/3 unknown aura status) and 359 controls (aged, 73-85 years) from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) magnetic resonance imaging study. We assessed the modifying role of migraine in the co-occurrence of CMBs, infarcts, and white matter hyperintensity-load. RESULTS: Infratentorial microbleeds were more prevalent in migraine without aurapatients than controls (14% versus 4%). Prevalence of other CMBs, infarcts, and white matter hyperintensities did not differ between groups. Migraineurs with CMBs had more often infarcts than controls with CMBs (65% versus 43%). In comparison with controls with infarcts, migraineurs with infarcts had more commonly CMBs (55% versus 30%). CONCLUSIONS:Migraine, notably without aura, is associated with infratentorial CMBs at older age. CMBs and infarcts co-occur more often in migraine than in controls. This supports the hypothesis of small-vessel involvement in migraine pathophysiology.