Abstract
The diagnostic value of white matter hyperintensities (WMH) in different types of migraineare unknown. To evaluate the WMH pattern of different subtypes in migraine patients with no vascular risk factors. 92 migraine patients (73 females, mean age 34.6 ± 8.9; 61 episodic migraine, 31 chronic migraine, 36 migraine with aura, 56 migraine without aura) without vascular risk factors underwent brain MRI (3 T). We also included a matched healthy control group with no migraine (n = 24). The prevalence of WMH in different types of migraine was similar and ranged from 38.7 to 44.4%; the control group showed no WMH at all. Lesions were located within frontal, parietal and temporal lobes (in order of decreasing incidence) in juxtacortical and/or deep white matter. WMH appeared as round or slightly elongated foci with a median size of 2.5 mm [1.5; 3]. Total number, size and prevalence of WMH by lobes and white matter regions were similar between groups, and no interaction with age or sex was found. The number of lesions within the frontal lobe juxtacortical white matter correlated with the age of patients (r = 0.331, p = 0.001) and the duration since migraine onset (r = 0.264, p = 0.012). Patients with different migraine subtypes and without vascular risk factors are characterized by a similar pattern of WMH in the absence of subclinical infarctions or microbleedings. Therefore, WMH have no relevant prognostic value regarding the course of migraine and vascular complications. WMH pattern may be used to differentiate migraine as a primary disorder and other disorders with migraine-like headache and WMH.
Highlights
The diagnostic value of white matter hyperintensities (WMH) in different types of migraineare unknown
This question is of high importance, as WMH of vascular origin are a very common MRI sign of small vessels damage due to various reasons, and its severity is associated with cognitive impairment (CI), stroke and disability[17]
Differentiation of WMH as an MRI sign of migraine in the elderly population is difficult because the lesions are strongly associated with advanced age[38].The leading cause of WMH, i.e. small vessel disease (SVD) which is associated with age and vascular risk factors, has a prolonged subclinical c ourse[39]
Summary
The diagnostic value of white matter hyperintensities (WMH) in different types of migraineare unknown. The high incidence of WMH became one of the reasons to consider migraine as a risk factor for their d evelopment[9,11,13,14,15,16] and highlighted the problem of the diagnostic and prognostic value of WMH in different types of migraine This question is of high importance, as WMH of vascular origin are a very common MRI sign of small vessels damage due to various reasons, and its severity is associated with cognitive impairment (CI), stroke and disability[17]. Based on the association of MRI signs in migraine with small vessels damage[35] we used MRI standards for SVD d iagnostics[43] in WMH evaluation We assessed their localization according to white matter regions considering vascular territories[44], and size and shape of WMH45,46
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