Correlation between migraine and cerebral small vessel disease: A case-control study

Area of Science:

• Neurology
• Neuroimaging
• Vascular Neurology

Background:

• Microcirculatory pathology is a proposed mechanism in migraine pathophysiology.
• Cerebral small vessel disease (CSVD) markers have been studied in elderly migraineurs, but comprehensive analyses in younger populations are lacking.
• Previous studies on migraine and CSVD have been limited by focusing on specific imaging features and potential confounding factors.

Purpose of the Study:

• To investigate the association between migraine and various imaging markers of CSVD in young adults.
• To identify risk factors for CSVD-related image abnormalities in migraineurs.
• To provide a comprehensive MRI assessment of CSVD in young migraineurs, including less-studied features like cerebral microbleeds (CMBs) and Virchow-Robin spaces (VRSs).

Main Methods:

• A case-control study involving episodic young migraineurs, tension-type headache (TTH) patients, and healthy controls.
• Assessment of distinct microvascular damage imaging features and baseline characteristics.
• Multivariate linear regression analysis to determine risk factors for image abnormalities in migraineurs.

Main Results:

• The study included 48 migraineurs, 32 TTH patients, and 49 healthy controls (median age 32 years, 58.7% female).
• Migraineurs showed significant differences in Scheltens score and white matter hyperintensities (WMHs) volume compared to controls. Both migraineurs and TTH patients had different numbers of Virchow-Robin spaces (VRSs) compared to controls.
• No lacunar infarct-like lesions (ILLs) or cerebral microbleeds (CMBs) were detected. Age, education level, attack duration, and attack frequency were identified as independent risk factors for WMHs. Migraine aura, attack frequency, and education level correlated with VRSs.

Conclusions:

• Migraine is associated with white matter hyperintensities (WMHs) and Virchow-Robin spaces (VRSs).
• Risk factors for CSVD image abnormalities in migraineurs include aura, attack duration, attack frequency, age, and education level.
• The findings offer new insights into the pathophysiology of migraine and TTH, suggesting potential targets for early management of visual brain damage in migraine.