Migraine and structural changes in the brain: A systematic review and meta-analysis

TY - JOUR

T1 - Migraine and structural changes in the brain

T2 - A systematic review and meta-analysis

AU - Bashir, Asma

AU - Lipton, Richard B

AU - Ashina, Sait

AU - Ashina, Messoud

PY - 2013/10/1

Y1 - 2013/10/1

N2 - 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, includingWMAs, silent ILLs, and volumetric changes in GM andWM 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 1.07-2.6 p 5 0.03) but not for MO (OR 1.34 95% CI 0.96-1.87 p 5 0.08). The association of ILLs was greater for MA (OR 1.44 95% CI 1.02-2.03 p 5 0.04) than for MO, but no association was found for MA (p 5 0.52) and MO (p 5 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.

AB - 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, includingWMAs, silent ILLs, and volumetric changes in GM andWM 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 1.07-2.6 p 5 0.03) but not for MO (OR 1.34 95% CI 0.96-1.87 p 5 0.08). The association of ILLs was greater for MA (OR 1.44 95% CI 1.02-2.03 p 5 0.04) than for MO, but no association was found for MA (p 5 0.52) and MO (p 5 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.

U2 - 10.1212/WNL.0b013e3182a6cb32

DO - 10.1212/WNL.0b013e3182a6cb32

M3 - Journal article

C2 - 23986301

SN - 0028-3878

VL - 81

SP - 1260

EP - 1268

JO - Neurology

JF - Neurology

IS - 14

ER -