title: Attack frequency and disease duration as indicators for brain damage in migraine.
abstract: OBJECTIVE
  The aim of this study was to pinpoint predilection sites of brain damage in migraine by quantitatively identifying morphometric and diffusion differences in migraineurs, compared with control subjects, and to assess whether migraine attack frequency and attack history are indicators for brain abnormalities in migraineurs.
  
  
  BACKGROUND
  Previous clinical neuroimaging investigations introduced the concept of migraine as a progressive brain disease. They reported an increased risk of white matter hyperintensities (WMH) with increasing attack frequency in migraineurs.
  
  
  METHODS
  We investigated 28 patients with migraine, using high-resolution T1- and diffusion-weighted magnetic resonance imaging and optimized voxel-based morphometry to localize gray and WM density, and fractional anisotropy and apparent diffusion coefficient differences.
  
  
  RESULTS
  We identified predilection sites of brain abnormalities in migraineurs in the frontal lobes, brainstem, and the cerebellum, and we show that both attack frequency and disease duration are indicators for brain damage in migraine.
  
  
  CONCLUSIONS
  Our findings report an unbiased quantitative whole brain assessment of morphological abnormalities in migraine. This might help to identify indicators for migraine as a possibly progressive brain disease. In order to reveal the causes and consequences of brain damage in migraine, further neuroimaging studies have to investigate quantitative brain changes in a longitudinal design.
authors.affiliation: Department of Radiology, Leiden Universtity Medical Centre, Leiden, The Netherlands.
authors.forename: Nicole
authors.initials: N
authors.lastname: Schmitz
authors.forename: Faiza
authors.initials: F
authors.lastname: Admiraal-Behloul
authors.forename: Enrico B
authors.initials: EB
authors.lastname: Arkink
authors.forename: Mark C
authors.initials: MC
authors.lastname: Kruit
authors.forename: Guus G
authors.initials: GG
authors.lastname: Schoonman
authors.forename: Michel D
authors.initials: MD
authors.lastname: Ferrari
authors.forename: Mark A
authors.initials: MA
authors.lastname: van Buchem
mesh_terms: D000328:Adult; D000368:Aged; D001925:Brain Damage, Chronic / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D006305:Health Status Indicators; D006801:Humans; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications* / Q000191:economics / Q000473:pathology*; D013997:Time Factors; D055815:Young Adult