A Meilán1, D Larrosa2, C Ramón2, E Cernuda-Morollón2, P Martínez-Camblor3, A Saiz1, E Santamarta1, S Pérez-Pereda4, J Pascual4. 1. Service of Radiology, University Hospital Central de Asturias, Oviedo, Spain. 2. Service of Neurology, University Hospital Central de Asturias, Oviedo, Spain. 3. Geisel School of Medicine at Dartmouth, Hanover, NH, USA. 4. Service of Neurology, University Hospital Marqués de Valdecilla, University of Cantabria and IDIVAL, Santander, Spain.
Abstract
BACKGROUND AND PURPOSE: It has been suggested that silent infarctions (SIs) and hyperintense white matter lesions (WMLs) are related to migraine frequency. We studied their prevalence and anatomical distribution in patients with chronic migraine (CM). METHODS: A total of 96 women with CM [mean age 43 (range 16-65) years] and 29 women with episodic migraine (EM) [mean age 36 (range 16-58) years] underwent 1.5-T magnetic resonance imaging following the CAMERA protocol. The number, size and location of SIs and deep WMLs were recorded and a modified Fazekas scale was applied to assess periventricular WMLs. RESULTS: White matter lesions were found in 59 (61.5%) women with CM and 17 (58.6%) women with EM (odds ratio, 1.13; 95% confidence intervals, 0.48-2.62; P = 0.784). The majority (63% CM and 71% EM) were small deep WMLs. Exclusive periventricular WMLs were exceptional. Of the 739 WMLs seen in patients with CM, 734 (99.3%) were hemispheric and mostly frontal (81%). Posterior fossa WMLs were seen in only five (5.2%) women with CM (always in the pons) and two (6.9%) women with EM. Age >45 years was the only vascular risk factor associated with a higher WML number (median: 0 < 45 years and 3 > 45 years; P = 0.004). We found seven SIs in six women with CM (6.3%). CONCLUSIONS: As compared with the expected prevalence at this age, this study confirms that the prevalence of WMLs, in most cases small, deep and frontal, was increased in CM and EM. However, our results do not support an association of WMLs or SIs with a higher frequency of attacks, but with the presence of vascular risk factors and mainly age >45 years.
BACKGROUND AND PURPOSE: It has been suggested that silent infarctions (SIs) and hyperintense white matter lesions (WMLs) are related to migraine frequency. We studied their prevalence and anatomical distribution in patients with chronic migraine (CM). METHODS: A total of 96 women with CM [mean age 43 (range 16-65) years] and 29 women with episodic migraine (EM) [mean age 36 (range 16-58) years] underwent 1.5-T magnetic resonance imaging following the CAMERA protocol. The number, size and location of SIs and deep WMLs were recorded and a modified Fazekas scale was applied to assess periventricular WMLs. RESULTS:White matter lesions were found in 59 (61.5%) women with CM and 17 (58.6%) women with EM (odds ratio, 1.13; 95% confidence intervals, 0.48-2.62; P = 0.784). The majority (63% CM and 71% EM) were small deep WMLs. Exclusive periventricular WMLs were exceptional. Of the 739 WMLs seen in patients with CM, 734 (99.3%) were hemispheric and mostly frontal (81%). Posterior fossa WMLs were seen in only five (5.2%) women with CM (always in the pons) and two (6.9%) women with EM. Age >45 years was the only vascular risk factor associated with a higher WML number (median: 0 < 45 years and 3 > 45 years; P = 0.004). We found seven SIs in six women with CM (6.3%). CONCLUSIONS: As compared with the expected prevalence at this age, this study confirms that the prevalence of WMLs, in most cases small, deep and frontal, was increased in CM and EM. However, our results do not support an association of WMLs or SIs with a higher frequency of attacks, but with the presence of vascular risk factors and mainly age >45 years.
Authors: Nicoletta Brunelli; Claudia Altamura; Carlo A Mallio; Gianguido Lo Vullo; Marilena Marcosano; Marcel Bach-Pages; Bruno Beomonte Zobel; Carlo Cosimo Quattrocchi; Fabrizio Vernieri Journal: Int J Environ Res Public Health Date: 2022-07-14 Impact factor: 4.614