title: The relationship between right-to-left shunt and brain white matter lesions in Japanese patients with migraine: a single center study.
abstract: BACKGROUND
  There may be a link between right-to-left shunt (RLs) and brain white matter lesions (WMLs) in patients with migraine. In this study, we assessed the relationship between WMLs and RLs in Japanese migraine patients.
  
  
  METHODS
  A total of 107 consecutive patients with migraine with (MA) and without aura (MWOA) were included in this study. Contrast transcranial Doppler ultrasound was used to detect RLs. WMLs were graded using brain magnetic resonance imaging based on well-established criteria.
  
  
  RESULTS
  The prevalence of RLs was significantly increased in the WMLs positive group (n = 24) compared with the WMLs negative group (n = 83) (75.0% vs. 47.0%, p = 0.015). In prevalence of WMLs between MA and MWOA patients, there were no statistical differences (p = 0.410). Logistic regression analysis adjusted by age and disease duration of migraine identified an RLs-positive status as the sole determinant for the presence of WMLs (OR = 6.15; 95% CI 1.82-20.8; p = 0.003) CONCLUSION: Our study suggests a possible link between RLs and WMLs in Japanese patients with migraine.
authors.affiliation: Stroke Division, Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga-gun, Tochigi, 322-0293, Japan. a.iwasaki.n@gmail.com.
authors.forename: Akio
authors.initials: A
authors.lastname: Iwasaki
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Stroke Division, Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga-gun, Tochigi, 322-0293, Japan.|Center of Medical Ultrasonics, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Takekawa
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Ryotaro
authors.initials: R
authors.lastname: Takashima
authors.affiliation: Stroke Division, Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga-gun, Tochigi, 322-0293, Japan.
authors.forename: Ayano
authors.initials: A
authors.lastname: Suzuki
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Shiho
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D054092:Foramen Ovale, Patent / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D007564:Japan; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015995:Prevalence; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*; D066127:White Matter / Q000000981:diagnostic imaging*
keywords: Brain white matter lesions; Migraine; Patent foramen ovale; Pulmonary arteriovenous malformations; Right-to-left shunt; Transcranial ultrasonography