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Published on: June 2, 2014
Association of white matter hyperintensities with migraine phenotypes and response to treatment
Sherihan Rezk Ahmed1, Amr Abdel Monem Mohamed2, Haitham Hamdy Salem2
1Department of Neurology, Faculty of Medicine, Kafr el-Sheikh University, 12 Elgeish street, Kafr el-sheikh, 33511, Egypt. sherihanrezk2016@gmail.com.
Introduction:
White matter hyperintensities (WMHs) are frequently found in migraineurs. However, their clinical significance and correlation to different migraine phenotypes and treatment responses are not well defined. The study aimed to examine the association of WMHs with migraine clinical patterns and treatment response.
Aim Of Work:
We aimed to evaluate the association between WMHs and migraine phenotypes and explore the relationship of WMHs to treatment response.
Methods:
Our cross-sectional study formed of 500 migraineurs who sought treatment in Kafr el-sheik university hospital and underwent (3 T) MRI to evaluate WMHs. Different migraine phenotypes were compared between patients with and without WMHs. According to reduced headache pain intensity and frequency, these patients were divided into treatment responder and non-responder groups.
Results:
A total of 145 patients (29%) had WMHs. Patients with WMHs were significantly older, had a longer disease duration, and higher attack frequency. Patients who did not respond to acute and maintenance medications had a higher frequency of WMHs and high WMHs Scheltens score. Migraine with Aura and the presence of vomiting and dizziness were predictors for the development of WMHs.
Conclusion:
WMHs are more common in migraine with aura. It is more frequent in migraine associated with vomiting and dizziness. WMHs increased with advancing age and more severe disease burden. Poorer response to acute and prophylactic medications was found in patients with WMHs.
Insights
White matter hyperintensities (WMHs) are common in migraine patients, especially with aura, vomiting, or dizziness. These brain lesions are linked to poorer treatment response and increased disease severity.
Area of Science:
- Neurology
- Neuroimaging
- Migraine Research
Background:
- White matter hyperintensities (WMHs) are prevalent in migraineurs but their clinical significance remains unclear.
- The association of WMHs with specific migraine phenotypes and treatment outcomes requires further investigation.
Purpose of the Study:
- To evaluate the association between WMHs and various migraine phenotypes.
- To explore the relationship between WMHs and patient response to migraine treatments.
Main Methods:
- A cross-sectional study involving 500 migraineurs who underwent 3T MRI to assess WMHs.
- Comparison of migraine phenotypes between patients with and without WMHs.
- Classification of patients into treatment responder and non-responder groups based on symptom reduction.
Main Results:
- 29% of patients exhibited WMHs, correlating with older age, longer disease duration, and higher attack frequency.
- WMHs and higher Scheltens scores were more frequent in non-responders to acute and maintenance medications.
- Migraine with aura, vomiting, and dizziness were identified as predictors for WMH development.
Conclusions:
- WMHs are more common in migraine with aura, and associated with vomiting and dizziness.
- WMH prevalence increases with age and disease severity.
- Patients with WMHs demonstrated a poorer response to both acute and prophylactic migraine medications.
