Page 33 - Migraine, the heart and the brain

methods
Study Population and Procedures
The original participants of the CAMERA-1 study included 295 well characterized 2 individuals with migraine3 and 140 age and sex-matched controls who were
randomly selected from a community-based study of the general population.1 The
MRI scans were completed in 2000.4 All participants were invited to return for follow-
up scan in 2009. In 2000, the mean age of the sample was 48 years (SD, 7.8 years) and 71% were women (eTable 1, available at http://www.jama.com). The CAMERA-2 study, conducted in 2009, included a structured computer-guided telephone interview (programmed using Ishell software, World Health Organization), brain MRI, physical examination, and cognitive testing similar to the CAMERA-1 protocol. Participants were administered questionnaires to determine previous, current, and newly developed migraine attacks since 2000. The interview was structured so that participants could recount their history of migraine using personal benchmarks (eg, pregnancy) for when a different pattern started and stopped. These benchmarks were used to de ne periods. Information was collected on migraine prophylaxis and treatment. All non-imaging data were collected blinded to diagnosis and MRI ndings. To avoid introduction of false-positive differences due to upgraded MRI techniques, we used the same scanners and protocols that were used for CAMERA-1.4 The protocol was approved by the local medical ethics committees. All participants gave written informed consent.
Outcome Measures
Primary outcome measure of this study was change in number and volume of MRI- measured deep white matter hyperintensities in individuals with migraine vs controls during follow-up. In addition, progression of posterior circulation territory infarctlike lesions as well as infratentorial hyperintensities was evaluated.
Results of automatic segmentation of white matter lesions (QBrain 1.1 software) were, if necessary, corrected manually in a conservative manner by 1 rater, in anonymized baseline and follow-up scans separately, blinded for scan order and diagnosis. Reproducibility data include (random, n = 40 of participants reanalyzed): 1.0T-scanner: p, 0.999 (P < .001) and 1.5T-scanner: p, 0.963 (P < .001). Periventricular white matter hyperintensities were attached to the lateral ventricle; other supratentorial hyperintensities were deep white matter hyperintensities, which were calculated by number, total, and mean volume for each participant. Geographical
Structural Brain Changes in Migraine
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