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Right-to-left shunt and subclinical ischemic brain lesions in Chinese migraineurs: a multicentre MRI study

Xiao-Han Jiang1, Si-Bo Wang1, Qian Tian2

  • 1Neuroscience Centre, Department of Neurology, The First Hospital of Jilin University, Changchun, China.

BMC Neurology
|February 16, 2018
PubMed
Abstract

Insights

Right-to-left shunt (RLS) is not linked to silent brain infarctions (SBI) or white matter hyperintensities (WMH) in migraine patients. However, a curtain pattern of RLS may increase the risk of SBI.

Area of Science:

  • Neurology
  • Cardiology
  • Radiology

Background:

  • Migraine is a known risk factor for subclinical brain ischemic lesions.
  • Right-to-left shunt (RLS) is more prevalent in individuals with migraine.

Purpose of the Study:

  • To investigate the association between RLS and subclinical ischemic brain lesions in migraineurs.
  • To determine if RLS grading correlates with the prevalence of silent brain infarctions (SBI) and white matter hyperintensities (WMH).

Main Methods:

  • A multicentre study included 334 migraineurs evaluated from June 2015 to August 2016.
  • Participants underwent contrast-enhanced transcranial Doppler, MRI, and completed questionnaires on demographics and vascular risk factors.
  • RLS was graded (0-III), and SBI and WMHs were assessed via MRI.

Main Results:

  • No significant differences in SBI or WMHs were found between migraineurs with and without RLS.
  • SBI and WMH prevalence did not increase with RLS grade.
  • Curtain pattern RLS (Grade III) was identified as a risk factor for SBI (OR=3.47, p=0.032).

Conclusions:

  • RLS, overall, is not associated with increased SBI or WMHs in migraineurs.
  • A curtain pattern of RLS may represent a risk factor for SBI in this population.
Keywords:
InfarctionMagnetic resonance imagingMigrainePatent foramen ovaleTranscranial Doppler ultrasonographyWhite matter

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