title: Migraine with aura and risk of silent brain infarcts and white matter hyperintensities: an MRI study.
abstract: A small number of population-based studies reported an association between migraine with aura and risk of silent brain infarcts and white matter hyperintensities in females. We investigated these relations in a population-based sample of female twins. We contacted female twins ages 30-60 years identified through the population-based Danish Twin Registry. Based on questionnaire responses, twins were invited to participate in a telephone-based interview conducted by physicians. Headache diagnoses were established according to the International Headache Society criteria. Cases with migraine with aura, their co-twins, and unrelated migraine-free twins (controls) were invited to a brain magnetic resonance imaging scan performed at a single centre. Brain scans were assessed for the presence of infarcts, and white matter hyperintensities (visual rating scales and volumetric analyses) blinded to headache diagnoses. Comparisons were based on 172 cases, 34 co-twins, and 139 control subjects. Compared with control subjects, cases did not differ with regard to frequency of silent brain infarcts (four cases versus one control), periventricular white matter hyperintensity scores [adjusted mean difference (95% confidence interval): -0.1 (-0.5 to 0.2)] or deep white matter hyperintensity scores [adjusted mean difference (95% confidence interval): 0.1 (-0.8 to 1.1)] assessed by Scheltens' scale. Cases had a slightly higher total white matter hyperintensity volume compared with controls [adjusted mean difference (95% confidence interval): 0.17 (-0.08 to 0.41) cm(3)] and a similar difference was present in analyses restricted to twin pairs discordant for migraine with aura [adjusted mean difference 0.21 (-0.20 to 0.63)], but these differences did not reach statistical significance. We found no evidence of an association between silent brain infarcts, white matter hyperintensities, and migraine with aura.
authors.affiliation: 1 Department of Neurology, Odense University Hospital, Denmark, Odense, Denmark 2 Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark dgaist@health.sdu.dk.
authors.forename: David
authors.initials: D
authors.lastname: Gaist
authors.affiliation: 3 Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark.
authors.forename: Ellen
authors.initials: E
authors.lastname: Garde
authors.affiliation: 1 Department of Neurology, Odense University Hospital, Denmark, Odense, Denmark 2 Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: Blaabjerg
authors.affiliation: 1 Department of Neurology, Odense University Hospital, Denmark, Odense, Denmark 2 Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
authors.forename: Helle H
authors.initials: HH
authors.lastname: Nielsen
authors.affiliation: 1 Department of Neurology, Odense University Hospital, Denmark, Odense, Denmark 2 Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Krøigård
authors.affiliation: 1 Department of Neurology, Odense University Hospital, Denmark, Odense, Denmark.
authors.forename: Kamilla
authors.initials: K
authors.lastname: Østergaard
authors.affiliation: 1 Department of Neurology, Odense University Hospital, Denmark, Odense, Denmark.
authors.forename: Harald S
authors.initials: HS
authors.lastname: Møller
authors.affiliation: 4 Epidemiology, Biostatistics and Biodemography, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
authors.forename: Jacob
authors.initials: J
authors.lastname: Hjelmborg
authors.affiliation: 3 Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark 5 Department of Radiology, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark.
authors.forename: Camilla G
authors.initials: CG
authors.lastname: Madsen
authors.affiliation: 3 Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark.
authors.forename: Pernille
authors.initials: P
authors.lastname: Iversen
authors.affiliation: 2 Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark 6 The Danish Twin Registry, Epidemiology, Biostatistics and Biodemography, Institute of Public Health, University of Southern Denmark, Odense, Denmark 7 Odense Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark.
authors.forename: Kirsten O
authors.initials: KO
authors.lastname: Kyvik
authors.affiliation: 3 Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark 8 Department of Neurology, Copenhagen University Hospital Bispebjerg, Denmark.
authors.forename: Hartwig R
authors.initials: HR
authors.lastname: Siebner
authors.affiliation: 9 Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
authors.forename: Messoud
authors.initials: M
authors.lastname: Ashina
mesh_terms: D000328:Adult; D020520:Brain Infarction / Q000000981:diagnostic imaging* / Q000209:etiology*; D003718:Denmark; D004200:Diseases in Twins; D005260:Female; D006801:Humans; D056784:Leukoencephalopathies / Q000000981:diagnostic imaging* / Q000209:etiology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D020325:Migraine with Aura / Q000150:complications* / Q000000981:diagnostic imaging*
keywords: cerebral infarction; cerebral ischaemia; headache: imaging; migraine; migraine with aura