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White Matter Lesions in Migraine
Katharina Eikermann-Haerter1, Susie Y Huang2
1Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
The American Journal of Pathology
|February 26, 2021
Summary
Migraine is linked to white matter lesions (WMLs), even in healthy individuals. These lesions may stem from neuroinflammation and hypoperfusion during migraine attacks, impacting cognitive function.
Area of Science:
- Neurology
- Neuroscience
- Public Health
Background:
- Migraine is a prevalent neurological disorder, affecting millions globally.
- Migraine is an independent risk factor for subclinical focal deep white matter lesions (WMLs).
- WMLs are observed even in young, healthy individuals without cardiovascular risk factors.
Purpose of the Study:
- To explore the pathophysiology of migraine-related deep white matter lesions.
- To understand the mechanisms underlying WMLs in migraineurs.
- To highlight the public health significance of migraine and its neurological impact.
Main Methods:
- Review of existing literature on migraine and white matter lesions.
- Analysis of characteristic distribution of WMLs in migraine patients.
- Investigation of proposed pathophysiological mechanisms including ischemia and inflammation.
Main Results:
- WMLs are more common in migraine patients with aura and high attack frequency.
- Migraine-related WMLs differ in distribution from age-related WMLs, suggesting distinct mechanisms.
- Cerebral vulnerability to ischemia, blood-brain barrier disruption, and neuroinflammation are implicated.
Conclusions:
- Enhanced susceptibility to spreading depolarization may cause hypoperfusion and neuroinflammation during migraine.
- WMLs negatively impact physical and cognitive functions.
- Migraine is a significant contributor to neurological deficits in the general population.
