Enrico B Arkink1, Inge H Palm-Meinders1, Hille Koppen1, Julien Milles1, Baldur van Lew1, Lenore J Launer1, Paul A M Hofman1, Gisela M Terwindt1, Mark A van Buchem1, Michel D Ferrari1, Mark C Kruit2. 1. From the Departments of Radiology (E.B.A., I.H.P.-M., J.M., B.v.L., M.A.v.B., M.C.K.) and Neurology (H.K.) and Laboratory for Clinical and Experimental Image Processing, Department of Radiology (J.M., B.v.L.), Leiden University Medical Center; Department of Neurology (H.K., G.M.T., M.D.F.), Haga Hospital, The Hague, the Netherlands; Laboratory of Epidemiology and Population Sciences (L.J.L.), National Institute on Aging, Bethesda, MD; and Department of Radiology (P.A.M.H.), Maastricht University Medical Center, the Netherlands. 2. From the Departments of Radiology (E.B.A., I.H.P.-M., J.M., B.v.L., M.A.v.B., M.C.K.) and Neurology (H.K.) and Laboratory for Clinical and Experimental Image Processing, Department of Radiology (J.M., B.v.L.), Leiden University Medical Center; Department of Neurology (H.K., G.M.T., M.D.F.), Haga Hospital, The Hague, the Netherlands; Laboratory of Epidemiology and Population Sciences (L.J.L.), National Institute on Aging, Bethesda, MD; and Department of Radiology (P.A.M.H.), Maastricht University Medical Center, the Netherlands. m.c.kruit@lumc.nl.
Abstract
OBJECTIVE: We used magnetization transfer imaging to assess white matter tissue integrity in migraine, to explore whether white matter microstructure was more diffusely affected beyond visible white matter hyperintensities (WMHs), and to explore whether focal invisible microstructural changes precede visible focal WMHs in migraineurs. METHODS: We included 137 migraineurs (79 with aura, 58 without aura) and 74 controls from the Cerebral Abnormalities in Migraine, an Epidemiological Risk Analysis (CAMERA) study, a longitudinal population-based study on structural brain lesions in migraine patients, who were scanned at baseline and at a 9-year follow-up. To assess microstructural brain tissue integrity, baseline magnetization transfer ratio (MTR) values were calculated for whole brain white matter. Baseline MTR values were determined for areas of normal-appearing white matter (NAWM) that had progressed into MRI-detectable WMHs at follow-up and compared to MTR values of contralateral NAWM. RESULTS: MTR values for whole brain white matter did not differ between migraineurs and controls. In migraineurs, but not in controls, NAWM that later progressed to WMHs at follow-up had lower mean MTR (mean [SD] 0.354 [0.009] vs 0.356 [0.008], p = 0.047) at baseline as compared to contralateral white matter. CONCLUSIONS: We did not find evidence for widespread microstructural white matter changes in migraineurs compared to controls. However, our findings suggest that a gradual or stepwise process might be responsible for evolution of focal invisible microstructural changes into focal migraine-related visible WMHs.
OBJECTIVE: We used magnetization transfer imaging to assess white matter tissue integrity in migraine, to explore whether white matter microstructure was more diffusely affected beyond visible white matter hyperintensities (WMHs), and to explore whether focal invisible microstructural changes precede visible focal WMHs in migraineurs. METHODS: We included 137 migraineurs (79 with aura, 58 without aura) and 74 controls from the Cerebral Abnormalities in Migraine, an Epidemiological Risk Analysis (CAMERA) study, a longitudinal population-based study on structural brain lesions in migrainepatients, who were scanned at baseline and at a 9-year follow-up. To assess microstructural brain tissue integrity, baseline magnetization transfer ratio (MTR) values were calculated for whole brain white matter. Baseline MTR values were determined for areas of normal-appearing white matter (NAWM) that had progressed into MRI-detectable WMHs at follow-up and compared to MTR values of contralateral NAWM. RESULTS: MTR values for whole brain white matter did not differ between migraineurs and controls. In migraineurs, but not in controls, NAWM that later progressed to WMHs at follow-up had lower mean MTR (mean [SD] 0.354 [0.009] vs 0.356 [0.008], p = 0.047) at baseline as compared to contralateral white matter. CONCLUSIONS: We did not find evidence for widespread microstructural white matter changes in migraineurs compared to controls. However, our findings suggest that a gradual or stepwise process might be responsible for evolution of focal invisible microstructural changes into focal migraine-related visible WMHs.
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