Migraine Associated With Structural Brain Changes

Significant structural changes to the brain, including white matter abnormalities, infarct-like lesions, and changes in volume occur more frequently in patients who experience migraines than those who do not.

"Traditionally, migraine has been considered a benign disorder without long-term consequences for the brain," noted researchers at the Danish Headache Center at Glostrup Hospital in Copenhagen.

To evaluate the possible association between migraine and brain abnormalities, researchers conducted a meta-analysis of 6 population-based and 13 clinic-based studies including MRI results for patients with and without migraine from 1989 to 2013. 

White matter lesions were 68% more likely to occur in patients experiencing migraine with aura (MA) than those who did not experience migraine, and 34% more likely in those having migraine without aura (MW).

Infarct-like-lesions were 44% more likely in MA patients than MW patients, but results were not statistically significant when compared with those without migraine.

"It is unclear whether silent infarct-like lesions predispose to or are associated with development of clinical stroke," they wrote.

Of the 9 studies that measured brain volume, 7 indicated a reduction in grey matter density in those with migraine compared with those without, while 1 indicated increases in density. 

"Additional longitudinal studies are needed to determine the differential influence of migraine without and with aura, to better characterize the effects of attack frequency and to assess longitudinal changes in brain structure and function," they concluded.

–Michael Potts

Reference:

Bashir A, Lipton R, Ashina S, Ashina M. Migraine and structural changes in the brain [published online ahead of print August 28, 2013]. Neurology.doi: 10.1212/WNL.0b013e3182a6cb32