title: High sensitivity C-reactive protein and cerebral white matter hyperintensities on magnetic resonance imaging in migraine patients.
abstract: BACKGROUND
  Migraine is a common headache disorder that may be associated with vascular disease and cerebral white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) scan. High sensitivity C-reactive protein (hs-CRP) is a marker of inflammation that may predict subclinical atherosclerosis. However, the relation between migraine, vascular risks, and WMHs is unknown. We evaluated hs-CRP levels and the relation between hs-CRP level and WMHs in adult migraine patients.
  
  
  METHODS
  This case-control study included 432 subjects (216 migraine patients [without aura, 143 patients; with aura, 73 patients]; 216 healthy control subjects without migraine; age range 18-50 y). Migraine diagnosis was determined according to the International Classification of Headache Disorders II diagnostic criteria. The migraine patients and control subjects had no known vascular risk factors, inflammatory disease, or comorbid disease. The presence and number of WMHs on MRI scans were determined, and serum hs-CRP levels were measured by latex-enhanced immunoturbidimetry.
  
  
  RESULTS
  Mean hs-CRP level was significantly greater in migraine patients (1.94 ± 2.03 mg/L) than control subjects (0.82 ± 0.58 mg/L; P ≤ .0001). The mean number of WMHs per subject and the presence of WMHs was significantly greater in migraine patients (69 patients [31.9%]; 1.68 ± 3.12 mg/dL) than control subjects (21 subjects [9.7%]; 0.3 ± 1.3; P ≤ .001). However, there was no correlation between hs-CRP level and WMHs in migraine patients (r = 0.024; not significant). The presence of WMHs was increased 4.35-fold in migraine patients (odds ratio 4.35, P ≤ .001).
  
  
  CONCLUSIONS
  High hs-CRP level may be a marker of the proinflammatory state in migraine patients. However, the absence of correlation between hs-CRP level and WMHs suggests that hs-CRP is not causally involved in the pathogenesis of WMHs in migraine patients. The WMHs were located mostly in the frontal lobe and subcortical area.
authors.affiliation: Department of Neurology, Baskent University, Saray Mah, Yunusemre cad, No. 1, Alanya-Antalya, 07400, Ankara, Turkey. yilmazaynur@yahoo.com.
authors.forename: Aynur Yilmaz
authors.initials: AY
authors.lastname: Avci
authors.affiliation: Department of Radiology, Baskent University, Ankara, Turkey. hlakadamyali@gmail.com.
authors.forename: Hatice
authors.initials: H
authors.lastname: Lakadamyali
authors.affiliation: Department of Biochemistry, Baskent University, Ankara, Turkey. serapsivarana@gmail.com.
authors.forename: Serap
authors.initials: S
authors.lastname: Arikan
authors.affiliation: Department of Neurology, Baskent University, Saray Mah, Yunusemre cad, No. 1, Alanya-Antalya, 07400, Ankara, Turkey. ulkusibelbenli@hotmail.com.
authors.forename: Ulku Sibel
authors.initials: US
authors.lastname: Benli
authors.affiliation: Department of Neurology, Baskent University, Saray Mah, Yunusemre cad, No. 1, Alanya-Antalya, 07400, Ankara, Turkey. munirekilinc@gmail.com.
authors.forename: Munire
authors.initials: M
authors.lastname: Kilinc
mesh_terms: D000293:Adolescent; D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020325:Migraine with Aura / Q000097:blood* / Q000473:pathology*; D020326:Migraine without Aura / Q000097:blood* / Q000473:pathology*; D066127:White Matter / Q000473:pathology*; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein
keywords: Headache; Inflammation; Pathophysiology; Vascular disease