Page 136 - Migraine, the heart and the brain

Chapter 7
Supplemental methods
MRI
We acquired 48 contiguous 3-mm axial slices ( eld of view 22 cm; matrix, 190-205 x 256) using combined proton density and T2-weighted fast spin-echo (repetition time/ echo time, 3000/14-85 for Magnetom Harmony and 3000/27-120 for ACS-NT) and fluid-attenuated inversion-recovery (FLAIR; repetition time/echo time/inversion time 8000/105/2000 for Magnetom Harmony and 8000/100/2000 for ACS-NT) sequences to cover the whole brain. (Silent) ischaemic lesions were de ned as non-mass parenchymal defects with a vascular distribution and iso-intense to cerebrospinal fluid signal on all sequences (Bokura et al., 1998; Kruit et al., 2004). Infratentorial lesions were evaluated as hyperintense on T2- and proton-density-weighted and not hypo-intense on FLAIR images. Location and vascular territory of new and pre-existing infarct-like lesions were analyzed by two neuroradiologists, blinded for diagnosis (κ=0.87, p<0.001). Detailed cerebellar topography of found infarct-like lesions was provided using cerebellar territories described by Ye (2010). All sequences of baseline and follow-up scans were presented side-by-side (angulation-corrected and position- linked).
Cerebellar tests
The Purdue pegboard (Lafayette instrument company, model 32020) is made of a board with two vertical lines penetrated at equal distances with 25 holes (Supplementary gure 1A) (Loras et al., 2013). In the rst part of the test participants are given 30 seconds to place as many pins (i.e. pegs) in the right-hand column of holes as possible. Pins may only be placed with the right hand and must be inserted in order. In the second part, this process is repeated using the left hand and column. In the third part, participants have 30 seconds to place pins into both columns at the same time; they must use the right hand for the right column and the left hand for the left column. In the nal part of the test, called the assembly test, the participant must pick up a pin and insert it into a hole with the right hand and then pick up a washer and place it over the pin with the left hand. Subsequently, participants must pick up a collar with the right hand and place it over the pin on top of the washer, and then place a nal washer on top of the collar with the left hand. Participants should complete as many assemblies as possible within 60 seconds. The primary endpoint of the pegboard test was the number of assemblies during the assembly task (Table 2). Secondary outcome measures were number of placed pegs during tasks 1, 2 and 3,
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