title: White matter lesion burden in migraine with aura may be associated with reduced cerebral blood flow.
abstract: Objective The objective of this study was to determine whether white matter hyperintensities (WMHs) in subjects with migraine are related to alterations in resting cerebral blood flow (CBF). Methods Migraine with aura (MWA), migraine without aura (MwoA), and control subjects were enrolled in a 1:1:1 ratio. WMH load was scored based on fluid-attenuated inversion recovery/T2-weighted magnetic resonance imaging (MRI) using a previously established semi-quantitative scale. Global and regional CBFs were quantified using arterial spin labelled perfusion MRI. Integrity of the circle of Willis was assessed with magnetic resonance angiography (MRA). Results A total of 170 subjects were enrolled (54 controls, 56 MWA, and 60 MwoA). There was no significant difference in subjects with ≥1 WMH across groups (22% controls, 29% MWA, 35% MwoA; p = NS). Similarly, high WMH load was not significantly different across groups (16.7% controls, 21.4% MWA, 25.0% MwoA; p = NS). High WMH load was strongly associated with increasing age (odds ratio: 1.08 per year, 95% confidence interval: 1.02-1.13, p = 0.01). Resting CBF was similar across groups, but was significantly higher in women. In MWA subjects with high WMH load, CBF was substantially lower ( p = 0.03). No association between WMH load and CBF was seen in control or MwoA subjects. Conclusions WHMs in MWA may be related to alterations in resting CBF.
authors.affiliation: 1 Department of Medical Imaging, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Quan
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: 2 Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Ritobrato
authors.initials: R
authors.lastname: Datta
authors.affiliation: 2 Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Detre
authors.affiliation: 2 Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Brett
authors.initials: B
authors.lastname: Cucchiara
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology*; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D020325:Migraine with Aura / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011446:Prospective Studies; D066127:White Matter / Q000000981:diagnostic imaging* / Q000503:physiopathology
keywords: Migraine; cerebral blood flow; white matter lesions