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Frequency of magnetic resonance imaging abnormalities in patients with migraine
B S Cooney1, R I Grossman, R E Farber
1Department of Radiology, University of Pennsylvania, Philadelphia, USA.
Background:
The frequency of magnetic resonance imaging (MRI) abnormalities in patients with migraine has been reported at 12% to 46%. We examined a series of patients to determine the frequency of MRI abnormalities, and any relationship of frequency with patient age, sex, migraine type, duration of symptoms, and other medical conditions.
Methods:
Magnetic resonance imaging findings were reviewed retrospectively with respect to presence of focal white matter hyperintensities in 185 consecutive patients. Patients had been diagnosed with migraine by a neurologist. All images had been interpreted by a neuroradiologist. Clinical information was obtained by chart review.
Results:
Sixteen percent had focal white matter abnormalities. Among patients less than 50 years old, and without other medical problems such as hypertension, atherosclerotic heart disease, diabetes mellitus, autoimmune disorder or demyelinating disease, only 6% had white matter abnormalities. Increased frequency of white matter abnormalities was associated with age and medical risk factors, but not with sex, migraine subtype, or duration of migraine symptoms.
Conclusion:
The observed frequency of MRI abnormalities in our series is lower than has been previously reported. In many cases, these abnormalities may be unrelated to migraine. When such changes are discovered in a patient with migraine, other etiologies should be considered.
Insights
Magnetic resonance imaging (MRI) abnormalities are less common in migraine patients than previously thought. White matter abnormalities are linked to age and other medical conditions, not migraine itself.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Magnetic resonance imaging (MRI) abnormalities in migraine patients are reported with variable frequencies (12%-46%).
- Previous studies have not consistently determined the relationship between MRI findings and patient demographics or comorbidities.
Purpose of the Study:
- To determine the frequency of MRI abnormalities in migraine patients.
- To investigate the association of MRI abnormalities with age, sex, migraine type, symptom duration, and coexisting medical conditions.
Main Methods:
- Retrospective review of magnetic resonance imaging (MRI) findings in 185 consecutive migraine patients.
- Analysis focused on the presence of focal white matter hyperintensities.
- Clinical data were gathered through chart review.
Main Results:
- Sixteen percent of patients exhibited focal white matter abnormalities.
- In patients under 50 without significant medical comorbidities, the abnormality rate was only 6%.
- Increased frequency of white matter abnormalities correlated with patient age and medical risk factors, but not sex, migraine subtype, or symptom duration.
Conclusions:
- The observed frequency of MRI abnormalities in this migraine cohort is lower than previously reported.
- Many detected MRI abnormalities may be incidental and unrelated to migraine.
- Alternative etiologies should be considered when MRI changes are found in migraine patients.