Headache, migraine, and structural brain lesions and function: Population based epidemiology of vascular ageing-MRI study
BMJ. 2011-01-18; 342(jan18 2): c7357-c7357
DOI: 10.1136/bmj.c7357
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1. BMJ. 2011 Jan 18;342:c7357. doi: 10.1136/bmj.c7357.
Headache, migraine, and structural brain lesions and function: population based
Epidemiology of Vascular Ageing-MRI study.
Kurth T(1), Mohamed S, Maillard P, Zhu YC, Chabriat H, Mazoyer B, Bousser MG,
Dufouil C, Tzourio C.
Author information:
(1)INSERM Unit 708–Neuroepidemiology, Paris, France.
OBJECTIVE: To evaluate the association of overall and specific headaches with
volume of white matter hyperintensities, brain infarcts, and cognition.
DESIGN: Population based, cross sectional study.
SETTING: Epidemiology of Vascular Ageing study, Nantes, France.
PARTICIPANTS: 780 participants (mean age 69, 58.5% women) with detailed headache
assessment.
MAIN OUTCOME MEASURES: Brain scans were evaluated for volume of white matter
hyperintensities (by fully automated imaging processing) and for classification
of infarcts (by visual reading with a standardised assessment grid). Cognitive
function was assessed by a battery of tests including the mini-mental state
examination.
RESULTS: 163 (20.9%) participants reported a history of severe headache and 116
had migraine, of whom 17 (14.7%) reported aura symptoms. An association was found
between any history of severe headache and increasing volume of white matter
hyperintensities. The adjusted odds ratio of being in the highest third for total
volume of white matter hyperintensities was 2.0 (95% confidence interval 1.3 to
3.1, P for trend 0.002) for participants with any history of severe headache when
compared with participants without severe headache being in the lowest third. The
association pattern was similar for all headache types. Migraine with aura was
the only headache type strongly associated with volume of deep white matter
hyperintensities (highest third odds ratio 12.4, 1.6 to 99.4, P for trend 0.005)
and with brain infarcts (3.4, 1.2 to 9.3). The location of infarcts was
predominantly outside the cerebellum and brain stem. Evidence was lacking for
cognitive impairment for any headache type with or without brain lesions.
CONCLUSIONS: In this population based study, any history of severe headache was
associated with an increased volume of white matter hyperintensities. Migraine
with aura was the only headache type associated with brain infarcts. Evidence
that headache of any type by itself or in combination with brain lesions was
associated with cognitive impairment was lacking.
PMCID: PMC3022913
PMID: 21245119 [Indexed for MEDLINE]