White matter hyperintensities and headache: A population-based imaging study (HUNT MRI).

Area of Science:

• Neurology
• Neuroimaging
• Epidemiology

Background:

• White matter hyperintensities (WMH) are common findings on MRI, often associated with aging and cerebrovascular disease.
• The relationship between WMH and specific headache types, particularly in the general population, requires further elucidation.

Purpose of the Study:

• To investigate the association between the burden of white matter hyperintensities and different headache classifications.
• To explore the link between WMH and the evolution of headache over time.

Main Methods:

• Utilized MRI data from the Nord-Trøndelag Health Study (HUNT MRI) to assess white matter hyperintensities using Fazekas and Scheltens scales, and volumetric methods.
• Categorized participants into headache groups (headache-free, tension-type headache, migraine, unclassified headache) and longitudinal headache evolution groups (stable headache-free, past headache, new onset headache, persistent headache) based on validated questionnaires.
• Employed adjusted multivariate regression models to compare WMH burden across headache groups.

Main Results:

• Individuals with tension-type headache showed a significantly higher likelihood of extensive white matter hyperintensities compared to headache-free individuals (OR 2.46, 95% CI 1.44-4.20 on Scheltens scale).
• New onset headache was also associated with an increased likelihood of extensive white matter hyperintensities (OR 2.24, 95% CI 1.13-4.44 on Scheltens scale).
• No significant association was found between migraine or unclassified headache and extensive white matter hyperintensities.

Conclusions:

• The presence of tension-type headache and the development of new-onset headache in middle age are linked to a greater burden of white matter hyperintensities.
• These findings remained consistent across all applied methods for assessing white matter hyperintensities.
• The observed association warrants consideration in the development of future therapeutic strategies targeting white matter hyperintensities.