Page 45 - Migraine, the heart and the brain

Table 3. Risk of Deep White Matter and Infratentorial Hyperintensities in Women by Migraine Statusa
Structural Brain Changes in Migraine
Deep white matter hyperintensities Progression, No. (%)b
OR (95% Cl)
High progression, No. (%)c
OR (95% Cl)
High increase in number, No. (%)d
OR (95% Cl)
Infratentorial hyperintensities Prevalence, No. (%)
OR (95% Cl)
Progression, No. (%)b
OR (95% Cl)
Controls (n = 57)
33 (60)e
1 [Reference] 5 (9) e
1 [Reference] 5(9) e
1 [Reference] 2(4)
1 [Reference] 1 (2)
1 [Reference]
Migraine (n = 145)
112 (77)
2.1 (1.0-4.1)f 33 (23)
2.3 (0.8-6.4) 43 (30)
3.5 (1.3-9.6)f 30 (21)
6.5 (1.5-28.3)f 21 (15)
7.7 (1.0-59.5)
P Value
.04 .12 .01
.01 .05
Migraine Without Aura ( n = 64)
53 (83)
2.9 (1.2-6.7)f 19 (30)
3.3 (1.1-9.9)f 25 (39)
5.3 (1.8-15.4)f 18 (28)
9.6 (2.1-44.1)f 13 (20)
11.5 (1.4-92.9)f
Migraine With Aura
(n = 81)
59 (73)
1.7 (0.8-3.5) 14(17)
1.6 (0.5-5.0) 18 (22)
2.4 (0.8-7.0) 12(15)
4.4 (0.9-20.5) 8(10)
5.0 (0.6-41.7)
PValue
2
.23 .12 .04
.07 .10
Abbreviation: OR, odds ratio.
a OR (95% CI) are adjusted for age, education, hypertension, and diabetes.
b Progression is de ned as an increase in volume after 9 years (delta between follow-up and baseline > 0.01 mL); progression of infratentorial hyperintensities is de ned as an increase in size, number, or both.
c High progression is de ned as the upper 20th percentile of progression distribution.
d High increase in number of lesions is de ned as 10 or more new lesions, which reflects the upper 20th percentile of the distribution of lesions count.
e For analyses of deep white matter hyperintensity progression, 2 women in the control group were excluded (leaving n = 55), because of missing baseline volumes due to software failures during lesion segmentations. Visual comparison revealed no progression between baseline and follow-up for these 2 women.
f Compared with controls: P < .05
Infarcts and Infarctlike Lesions
None of the infarctlike lesions present at baseline had disappeared. No signi cant association of migraine with new posterior circulation territory infarctlike lesions existed between groups (migraine group, 5% vs control group, 0%; P = .07; Table 2). Among participants in the migraine group, 18 (8.9%) with posterior circulation territory infarctlike lesions had a less favorable cardiovascular risk pro le than the 185 participants (91.1%) without it. Those with infarctlike lesions were older (mean age, 62 vs 57 years; P = .006); had higher prevalences of clinically diagnosed stroke (22% vs 3%; P < .001) or hypertension (67% vs 33%; P = .005), and were more likely taking statins (39% vs 17%; P = .03) or platelet inhibitors (33% vs 6%; P < .001). There was no difference between groups for new non–posterior circulation territory infarctlike
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