Abstract：
BACKGROUND: Microcirculatory pathology is one of the pathophysiological theories of migraine, which may present as visually subclinical lesions. Image markers of cerebral small vessel disease (CSVD) have been investigated in elderly migraineurs. However, past studies looked at only part of image features, and the conclusions may have been hindered by confounding factors. The relationship between migraine and CSVD signs needs reliable demonstrations.
METHODS: We conducted a case-control study by recruiting episodic young migraineurs from a tertiary headache centre, with tension-type headache (TTH) and healthy controls. Distinct image features of microvascular damage and baseline characteristics across groups were assessed, and multivariate linear regression was performed to evaluate the risk factors for image abnormalities in migraineurs.
RESULTS: Forty-eight migraineurs, 32 TTHs and 49 healthy controls were included. The median age was 32 year-old. 58.7% of the participants were female. The Scheltens score and volume of white matter hyperintensities (WMHs) in migraineurs, and the number of Virchow-Robin spaces (VRSs) in both migraineurs and TTHs were different from those in normal controls. No lacunar infarct-like lesions (ILLs) or cerebral microbleeds (CMBs) were found. Age, education level (high level: β = -2.23, lobar WMHs), attack duration (long duration: β = 3.81, lobar WMHs) and attack frequency were independent risk factors for Scheltens score and volume of WMH in migraineurs. Migraine aura (β = -2.389), attack frequency and education level were correlated with the number of VRSs.
CONCLUSIONS: Migraine was associated with WMHs and VRSs. Aura, attack duration, attack frequency, age and education level were risk factors for image abnormalities of CVSD in migraineurs.
CONCLUSIONS: This study provides a novel and comprehensive landscape of CSVD MRI features in young migraineurs, and it fills the blank of CMBs and VRSs which received less attention, with more persuasive, more reliable and stronger evidence of the association between CSVD and migraine. Our results also imply some new feature of TTH and the possible pathophysiology of the migraine course as well as new clues for the early management of migraine in terms of visual brain damage.
METHODS: We conducted a case-control study by recruiting episodic young migraineurs from a tertiary headache centre, with tension-type headache (TTH) and healthy controls. Distinct image features of microvascular damage and baseline characteristics across groups were assessed, and multivariate linear regression was performed to evaluate the risk factors for image abnormalities in migraineurs.
RESULTS: Forty-eight migraineurs, 32 TTHs and 49 healthy controls were included. The median age was 32 year-old. 58.7% of the participants were female. The Scheltens score and volume of white matter hyperintensities (WMHs) in migraineurs, and the number of Virchow-Robin spaces (VRSs) in both migraineurs and TTHs were different from those in normal controls. No lacunar infarct-like lesions (ILLs) or cerebral microbleeds (CMBs) were found. Age, education level (high level: β = -2.23, lobar WMHs), attack duration (long duration: β = 3.81, lobar WMHs) and attack frequency were independent risk factors for Scheltens score and volume of WMH in migraineurs. Migraine aura (β = -2.389), attack frequency and education level were correlated with the number of VRSs.
CONCLUSIONS: Migraine was associated with WMHs and VRSs. Aura, attack duration, attack frequency, age and education level were risk factors for image abnormalities of CVSD in migraineurs.
CONCLUSIONS: This study provides a novel and comprehensive landscape of CSVD MRI features in young migraineurs, and it fills the blank of CMBs and VRSs which received less attention, with more persuasive, more reliable and stronger evidence of the association between CSVD and migraine. Our results also imply some new feature of TTH and the possible pathophysiology of the migraine course as well as new clues for the early management of migraine in terms of visual brain damage.
摘要：
背景：微循环病理学是偏头痛的病理生理学理论之一，可能表现为视觉上的亚临床病变。已在老年偏头痛患者中研究了脑小血管病（CSVD）的图像标记。然而,过去的研究只关注图像特征的一部分，结论可能受到混杂因素的阻碍。偏头痛和CSVD体征之间的关系需要可靠的证明。
方法：我们进行了一项病例对照研究，从三级头痛中心招募偶发的年轻偏头痛患者，紧张型头痛（TTH）和健康对照。评估各组微血管损伤的不同图像特征和基线特征，采用多元线性回归分析评估偏头痛患者影像异常的危险因素.
结果：48名偏头痛患者，包括32名TTH和49名健康对照。中位年龄为32岁。58.7%的参与者是女性。偏头痛患者的Scheltens得分和白质高强度（WMHs）的体积，偏头痛患者和TTH的Virchow-Robin空间（VRS）数量与正常对照组不同。未发现腔隙性梗塞样病变（ILLs）或脑微出血（CMBs）。年龄,教育水平(高水平：β=-2.23，大叶WMHs)，发作持续时间（持续时间长：β=3.81，叶WMHs）和发作频率是偏头痛患者Scheltens评分和WMH量的独立危险因素。偏头痛先兆（β=-2.389），发作频率和受教育程度与VRS数量相关。
结论：偏头痛与WMHs和VRSs相关。Aura,攻击持续时间,攻击频率,年龄和文化程度是偏头痛患者CVSD影像异常的危险因素。
结论：这项研究为年轻偏头痛患者的CSVDMRI特征提供了一个新颖而全面的图景，它填补了CMB和VRS受到较少关注的空白，更有说服力，CSVD和偏头痛之间的相关性更可靠和更有力的证据。我们的结果还暗示了TTH的一些新特征和偏头痛病程的可能病理生理学，以及从视觉脑损伤方面早期治疗偏头痛的新线索。
方法：我们进行了一项病例对照研究，从三级头痛中心招募偶发的年轻偏头痛患者，紧张型头痛（TTH）和健康对照。评估各组微血管损伤的不同图像特征和基线特征，采用多元线性回归分析评估偏头痛患者影像异常的危险因素.
结果：48名偏头痛患者，包括32名TTH和49名健康对照。中位年龄为32岁。58.7%的参与者是女性。偏头痛患者的Scheltens得分和白质高强度（WMHs）的体积，偏头痛患者和TTH的Virchow-Robin空间（VRS）数量与正常对照组不同。未发现腔隙性梗塞样病变（ILLs）或脑微出血（CMBs）。年龄,教育水平(高水平：β=-2.23，大叶WMHs)，发作持续时间（持续时间长：β=3.81，叶WMHs）和发作频率是偏头痛患者Scheltens评分和WMH量的独立危险因素。偏头痛先兆（β=-2.389），发作频率和受教育程度与VRS数量相关。
结论：偏头痛与WMHs和VRSs相关。Aura,攻击持续时间,攻击频率,年龄和文化程度是偏头痛患者CVSD影像异常的危险因素。
结论：这项研究为年轻偏头痛患者的CSVDMRI特征提供了一个新颖而全面的图景，它填补了CMB和VRS受到较少关注的空白，更有说服力，CSVD和偏头痛之间的相关性更可靠和更有力的证据。我们的结果还暗示了TTH的一些新特征和偏头痛病程的可能病理生理学，以及从视觉脑损伤方面早期治疗偏头痛的新线索。
