Risk factors of migraine with white matter lesion

Li Xiaoqing; Wang Wei; Bi Qi

doi:10.3760/cma.j.issn.1673-4777.2017.10.020

Abstract：Objective To investigate the relation among migraine,patent foramen ovale(PFO) and white matter lesion(WML);to analyze risk factors of migraine-related WML.Methods From January 2014 to December 2015,126 migraine patients were enrolled from Department of Neurology of Capital Medical University,Beijing Anzhen Hospital as observation group;153 patients without migraine were enrolled as control group.WML was examined by brain magnetic resonance imaging in all patients.Migraine patients had transesophageal echocardiography and contrast-enhanced transcranial Doppler ultrasonography to diagnose PFO and right-to-left shunt(RLS).Severity of migraine was evaluated by the Headache Impact Test-6 (HIT-6).Risk factors of WML in migraine patients were analyzed.Results The incidence of WML in observation group was significantly higher than that in control group[26.2％ (33/126) vs 10.5％ (16/153)] (P ＜ 0.05).The observation group was divided into WML group(33 cases) and non-WML group(93 cases).There were significant differences of age,migraine with aura,course of migraine,duration of headache,score of HIT-6,PFO,persistent RLS,severe RLS(grade 3-4) between WML group and non-WML group[(38 ±6) years vs (34 ±6)years,36.4％ (12/33) vs 22.6％ (21/93),(8.2 ±3.6) years vs (5.3 ± 2.7) years,(6.3 ± 1.3) h/time vs (4.4 ± 1.2) h/time,(68.5 ± 2.4) points vs (63.2 ±5.1)points,57.6％ (19/33) vs 29.0％ (27/93),45.5％ (15/33) vs 15.0％ (14/93),12.1％ (4/33) vs 9.7％ (9/93),36.4％ (12/33) vs 6.5％ (6/93)] (P ＜ 0.05).Logistic regression analysis demonstrated that migraine with aura,course of migraine,PFO and grade 4 RLS were independent risk factors of migraine-related WML(P ＜ 0.05).Conclusions Migraine patients have high risk of WML.Migraine with aura,long course of disease,PFO and severe RLS are independent risk factors of WML in patients with migraine.