[Modern methods of neurovisualization and preventive treatment of migraine]

Area of Science:

• Neurology
• Radiology

Background:

• Migraine is a prevalent neurological disorder associated with significant disability.
• White matter changes on MRI are frequently observed in migraine patients, particularly those with frequent or chronic forms.
• The clinical significance and localization of these white matter lesions require further investigation.

Purpose of the Study:

• To investigate the prevalence and characteristics of white matter changes in migraine patients using MRI.
• To evaluate the efficacy of topiramate as a preventive treatment for frequent and chronic migraine.

Main Methods:

• Brain MRI was performed on 48 patients diagnosed with migraine.
• Twenty-three patients with frequent/chronic migraine received preventive treatment with topiramate (25-50 mg capsules) for 4-12 months.
• Migraine attack frequency and MIDAS (Migraine Disability Assessment) scores were assessed before and during treatment.

Main Results:

• MRI revealed white matter changes in 69% of patients, with 39% having multiple foci.
• Foci were more common in frontal areas and associated with frequent/chronic migraine without aura.
• Topiramate treatment led to a significant decrease in migraine frequency after 1 month and reduced MIDAS scores from 26.5 to 5.7 after 6 months.

Conclusions:

• White matter changes are common in migraine patients and may correlate with disease phenotype.
• Topiramate is an effective preventive treatment for frequent and chronic migraine, substantially reducing attack frequency and disability.