PDF(Pubmed)
Abstract：
BACKGROUND: Cross-sectional and longitudinal studies have been conducted to investigate the association between migraine and any headache and white matter hyperintensities (WMH). However, studies are inconsistent regarding the strength of the association and its clinical significance. The aim of our study was to investigate the association between headache and its subtypes (migraine with aura (MigA+), migraine without aura (MigA-), non-migraine headache (nonMigHA)) and WMH and its course in the population-based 1000BRAINS study using state-of-the-art imaging techniques and migraine classification according to modified international classification of headache disorders.
METHODS: Data from 1062 participants (45% women, 60.9 ± 13.0 years) with ever or never headache (neverHA) and complete quantitative (WMH volume) and qualitative (Fazekas classification) WMH data at first imaging and after 3.7 ± 0.7 years (393 participants) were analyzed. The sex-specific association between headache and its subtypes and WMH volume and its change was evaluated by linear regression, between headache and its subtypes and Fazekas score high vs. low (2-3 vs. 0-1) by log-binomial regression, adjusted for confounders.
RESULTS: The lifetime prevalence of headache was 77.5% (10.5% MigA+, 26.9% MigA-, 40.1% nonMigHA). The median WMH volume was 4005 (IQR: 2454-6880) mm3 in women and 4812 (2842-8445) mm3 in men. Women with any headaches (all headache types combined) had a 1.23 [1.04; 1.45]-fold higher WMH volume than women who reported never having had a headache. There was no indication of higher Fazekas grading or more WMH progression in women with migraine or any headaches. Men with migraine or any headaches did not have more WMH or WMH progression compared to men without migraine or men who never had headache.
CONCLUSIONS: Our study demonstrated no increased occurrence or progression of WMH in participants with mgiraine. But, our results provide some evidence of greater WMH volume in women with headache of any type including migraine. The underlying pathomechanisms and the reasons why this was not shown in men are unclear and require further research.
METHODS: Data from 1062 participants (45% women, 60.9 ± 13.0 years) with ever or never headache (neverHA) and complete quantitative (WMH volume) and qualitative (Fazekas classification) WMH data at first imaging and after 3.7 ± 0.7 years (393 participants) were analyzed. The sex-specific association between headache and its subtypes and WMH volume and its change was evaluated by linear regression, between headache and its subtypes and Fazekas score high vs. low (2-3 vs. 0-1) by log-binomial regression, adjusted for confounders.
RESULTS: The lifetime prevalence of headache was 77.5% (10.5% MigA+, 26.9% MigA-, 40.1% nonMigHA). The median WMH volume was 4005 (IQR: 2454-6880) mm3 in women and 4812 (2842-8445) mm3 in men. Women with any headaches (all headache types combined) had a 1.23 [1.04; 1.45]-fold higher WMH volume than women who reported never having had a headache. There was no indication of higher Fazekas grading or more WMH progression in women with migraine or any headaches. Men with migraine or any headaches did not have more WMH or WMH progression compared to men without migraine or men who never had headache.
CONCLUSIONS: Our study demonstrated no increased occurrence or progression of WMH in participants with mgiraine. But, our results provide some evidence of greater WMH volume in women with headache of any type including migraine. The underlying pathomechanisms and the reasons why this was not shown in men are unclear and require further research.
摘要：
背景：已经进行了横断面和纵向研究，以研究偏头痛与任何头痛和白质高信号（WMH）之间的关系。然而,关于这种关联的强度及其临床意义的研究不一致.我们研究的目的是调查头痛与其亚型（先兆偏头痛（MigA），无先兆偏头痛（MigA-），非偏头痛（nonMigHA））和WMH及其病程在基于人群的1000BRAINS研究中，使用最先进的成像技术和根据改良的国际头痛疾病分类进行偏头痛分类。
方法：数据来自1062名参与者（45％的女性，60.9±13.0年），在首次成像和3.7±0.7年（393名参与者）后，分析了从未头痛（neverHA）和完整的定量（WMH体积）和定性（Fazekas分类）WMH数据。通过线性回归评估头痛及其亚型与WMH体积及其变化之间的性别特异性关联，在头痛及其亚型和Fazekas得分高与低（2-3vs.0-1)通过对数二项回归，针对混杂因素进行了调整。
结果：头痛的终生患病率为77.5％（MigA+，26.9%MigA-，40.1%非MigHA)。女性的WMH体积中位数为4005（IQR：2454-6880）mm3，男性为4812（2842-8445）mm3。有任何头痛的女性（所有头痛类型合并）的WMH体积比从未报告过头痛的女性高1.23[1.04;1.45]倍。在偏头痛或任何头痛的女性中，没有更高的Fazekas分级或更多的WMH进展的迹象。与没有偏头痛或从未头痛的男性相比，患有偏头痛或任何头痛的男性没有更多的WMH或WMH进展。
结论：我们的研究表明，在患有mgiraine的参与者中，WMH的发生率或进展没有增加。但是,我们的研究结果提供了一些证据,表明在包括偏头痛在内的任何类型头痛的女性患者中,WMH体积增加.潜在的病理机制以及男性未表现出这种现象的原因尚不清楚，需要进一步研究。
方法：数据来自1062名参与者（45％的女性，60.9±13.0年），在首次成像和3.7±0.7年（393名参与者）后，分析了从未头痛（neverHA）和完整的定量（WMH体积）和定性（Fazekas分类）WMH数据。通过线性回归评估头痛及其亚型与WMH体积及其变化之间的性别特异性关联，在头痛及其亚型和Fazekas得分高与低（2-3vs.0-1)通过对数二项回归，针对混杂因素进行了调整。
结果：头痛的终生患病率为77.5％（MigA+，26.9%MigA-，40.1%非MigHA)。女性的WMH体积中位数为4005（IQR：2454-6880）mm3，男性为4812（2842-8445）mm3。有任何头痛的女性（所有头痛类型合并）的WMH体积比从未报告过头痛的女性高1.23[1.04;1.45]倍。在偏头痛或任何头痛的女性中，没有更高的Fazekas分级或更多的WMH进展的迹象。与没有偏头痛或从未头痛的男性相比，患有偏头痛或任何头痛的男性没有更多的WMH或WMH进展。
结论：我们的研究表明，在患有mgiraine的参与者中，WMH的发生率或进展没有增加。但是,我们的研究结果提供了一些证据,表明在包括偏头痛在内的任何类型头痛的女性患者中,WMH体积增加.潜在的病理机制以及男性未表现出这种现象的原因尚不清楚，需要进一步研究。
