目的:本研究的主要目的是评估偏头痛患者白质高信号(WMHs)的患病率,并比较成年男性和女性患者的发现。还分析了特定的症状和合并症,以确定它们是否与WMH患病率或偏头痛患者的性别有关。我们假设女性的WMHs患病率更高,经历更频繁和更严重的偏头痛,并且比男性更可能有与偏头痛相关的某些合并症。
背景:已提出偏头痛患者中WMHs的患病率增加,尽管基于人群的MRI研究的数据并未很好地支持这种关系。男性和女性之间大脑形态的差异具有研究意义,一般人群中女性的WMHs患病率较高。偏头痛患者相对于脑成像中WMHs数量的性别差异和各种合并症尚未得到充分研究。
方法:这是一项针对177名年龄在18岁及以上的偏头痛患者的横断面研究,这些患者于2000年1月1日至2017年1月1日在利哈伊谷弗莱明神经科学研究所的头痛中心就诊。从电子病历中提取患者的基线特征,包括人口统计,审查系统文件,和核磁共振成像的大脑成像。变量包括头痛严重程度,头部疼痛的频率,失眠,和合并症(焦虑,抑郁症,糖尿病,高脂血症,高血压,和颈部疼痛)也分析了与WMHs的存在的关联。
结果:发现女性的WMHs数量明显高于男性(中位数3[IQR:0-7]与0[IQR:0-3],p=0.023)。患有WMHs的患者比没有WMHs的患者更有可能患高血压(39.8%的WMHs患者与20.3%无WMHs,p=0.011),便秘(20.9%vs.8.3%,p=0.034),和睡眠障碍(55.7%vs.37.3%,p=0.022)。患有偏头痛的女性比男性更容易发生便秘(20.0%vs.2.9%,p=0.015)。没有研究偏头痛的特征(频率,严重程度,光环的存在)在性别之间是不同的,它们与WMHs的存在也没有显着关联。
结论:这项研究表明,女性偏头痛患者可能比男性偏头痛患者更容易发生WMHs和便秘。偏头痛的频率和严重程度在性别之间没有差异,它们与WMHs的存在也没有显着关联。这项研究的发现不支持偏头痛患者WMH发展的特定病因,这与一般人群的发现不同。需要进一步的研究。
OBJECTIVE: The primary objective of this study was to evaluate the prevalence of white matter hyperintensities (WMHs) in patients who experience migraine and compare findings between adult male and female patients. Specific symptoms and comorbidities also were analyzed to determine whether they were associated with WMH prevalence or the sex of patients with migraine. We hypothesized that females would have a higher prevalence of WMHs, experience more frequent and more severe migraine headaches, and be more likely to have certain comorbidities associated with migraine than males.
BACKGROUND: An increased prevalence of WMHs in patients with migraine has been proposed, although this relation is not well-supported by data from population-based MRI studies. The difference in brain morphology between males and females is of research interest, and females in the general population appear to have a higher prevalence of WMHs. Sex differences and various comorbidities in patients with migraine relative to the number of WMHs on brain imaging have not been fully investigated.
METHODS: This was a cross-sectional study of 177 patients aged 18 years and older with a diagnosis of migraine who were seen in the Lehigh Valley Fleming Neuroscience Institute\'s Headache Center between January 1, 2000, and January 1, 2017. Patients\' baseline characteristics were extracted from electronic medical records, including demographics,
review of systems documentation, and brain imaging from MRI. Variables including headache severity, frequency of head pain, insomnia, and comorbidities (anxiety, depression, diabetes, hyperlipidemia, hypertension, and neck pain) also were analyzed for associations with the presence of WMHs.
RESULTS: Females were found to have a significantly higher number of WMHs than males (median 3 [IQR: 0-7] vs. 0 [IQR: 0-3], p = 0.023). Patients with WMHs were significantly more likely than those without WMHs to have hypertension (39.8% of patients with WMHs vs. 20.3% without WMHs, p = 0.011), constipation (20.9% vs. 8.3%, p = 0.034), and sleep disorder (55.7% vs. 37.3%, p = 0.022). Females with migraine were significantly more likely to experience constipation than males (20.0% vs. 2.9%, p = 0.015). None of the migraine characteristics studied (frequency, severity, presence of aura) were different between sexes, nor were they significantly associated with the presence of WMHs.
CONCLUSIONS: This study suggests that females with migraine may be more likely to have WMHs and experience constipation than males with migraine. Migraine frequency and severity were not different between sexes, nor were they significantly associated with the presence of WMHs. The findings of this study do not support a specific etiology of WMH development in individuals with migraine that differs from findings in the general population. Further studies are warranted.