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Abstract
Objective: To evaluate the association between migraine without aura (MO) and migraine with aura (MA) and 3 types of structural brain abnormalities detected by MRI: white matter abnormalities (WMAs), infarct-like lesions (ILLs), and volumetric changes in gray and white matter (GM, WM) regions.
Methods: PubMed as well as the reference lists of identified studies and reviews were used to identify potentially eligible studies through January 2013. Candidate studies were reviewed and eligible studies were abstracted. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated for WMAs and ILLs.
Results: Six population-based and 13 clinic-based studies were identified. The studies suggested that structural brain changes, including WMAs, silent ILLs, and volumetric changes in GM and WM regions, were more common in migraineurs than in control groups. The results were strongest for MA. The meta-analysis of WMAs showed an association for MA (OR 1.68; 95% CI 1.07–2.65; p = 0.03) but not for MO (OR 1.34; 95% CI 0.96–1.87; p = 0.08). The association of ILLs was greater for MA (OR 1.44; 95% CI 1.02–2.03; p = 0.04) than for MO, but no association was found for MA (p = 0.52) and MO (p = 0.08) compared to controls.
Conclusion: These data suggest that migraine may be a risk factor for structural changes in the brain. Additional longitudinal studies are needed to determine the differential influence of migraine without and with aura, to better characterize the effects of attack frequency, and to assess longitudinal changes in brain structure and function.
GLOSSARY
- ACC=
- anterior cingulate cortex;
- CAMERA=
- Cerebral Abnormalities in Migraine, an Epidemiological Risk Analysis;
- CI=
- confidence interval;
- DTI=
- diffusion tensor imaging;
- GM=
- gray matter;
- ICHD=
- International Classification of Headache Disorders;
- IHL=
- infratentorial hyperintense lesion;
- ILL=
- infarct-like lesion;
- MA=
- migraine with aura;
- MO=
- migraine without aura;
- OR=
- odds ratio;
- PAG=
- periaqueductal gray;
- VBM=
- voxel-based morphometry;
- WM=
- white matter;
- WMA=
- white matter abnormality
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at www.neurology.org
- Received January 9, 2013.
- Accepted in final form July 1, 2013.
- © 2013 American Academy of Neurology
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