http://www.neurology.org/content/early/2013/08/28/WNL.0b013e3182a6cb32.abstract?sid=ec43234d-2f87-4dcd-befb-0adc9d400f17
A systematic review and meta-analysis
- Asma Bashir, MD,
- Richard B. Lipton, MD,
- Sait Ashina, MD and
- Messoud Ashina, MD, PhD
- Correspondence to Dr. M. Ashina: ashina@dadlnet.dk
-
10.1212/WNL.0b013e3182a6cb32Neurology
- Abstract
- Full Text (PDF)
- Also available:
- Data Supplement
Abstract
Objective: To evaluate the association between migraine without aura (MO) and migraine with aura (MA) and 3 types of structural brain abnormalities detected by MRI: white matter abnormalities (WMAs), infarct-like
lesions (ILLs), and volumetric changes in gray and white matter (GM, WM) regions.
Methods: PubMed as
well as the reference lists of identified studies and reviews were used
to identify potentially eligible studies
through January 2013. Candidate studies were
reviewed and eligible studies were abstracted. Pooled odds ratios (OR)
and 95%
confidence intervals (CI) were calculated for
WMAs and ILLs.
Results: Six
population-based and 13 clinic-based studies were identified. The
studies suggested that structural brain changes, including
WMAs, silent ILLs, and volumetric changes in GM
and WM regions, were more common in migraineurs than in control groups. The results were strongest for MA. The meta-analysis of WMAs showed an association for MA (OR
1.68; 95% CI 1.07–2.65; p = 0.03) but not for MO (OR 1.34; 95% CI 0.96–1.87; p = 0.08). The association of ILLs was greater for MA (OR 1.44; 95% CI 1.02–2.03; p = 0.04) than for MO, but no association was found for MA (p = 0.52) and MO (p = 0.08) compared to controls.
Conclusion: These data suggest that migraine
may be a risk factor for structural changes in the brain. Additional
longitudinal studies are needed to determine the differential
influence of migraine without and with aura, to better characterize the effects of attack frequency, and to assess longitudinal changes in brain
structure and function.
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