White matter hyperintensities in migraine: Clinical significance and central pulsatile hemodynamic correlates

Chun Yu Cheng, Hao Min Cheng, Shih Pin Chen, Chih Ping Chung, Yung Yang Lin, Han Hwa Hu, Chen Huan Chen, Shuu Jiun Wang

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: The role of central pulsatile hemodynamics in the pathogenesis of white matter hyperintensities in migraine patients has not been clarified. Methods: Sixty patients with migraine (20–50 years old; women, 68%) without overt vascular risk factors and 30 demographically-matched healthy controls were recruited prospectively. Cerebral white matter hyperintensities volume was determined by T1-weighted magnetic resonance imaging with CUBE-fluid-attenuated-inversion-recovery sequences. Central systolic blood pressure, carotid-femoral pulse wave velocity, and carotid augmentation index were measured by applanation tonometry. Carotid pulsatility index was derived from Doppler ultrasound carotid artery flow analysis. Results: Compared to the controls, the migraine patients had higher white matter hyperintensities frequency (odds ratio, 2.75; p = 0.04) and greater mean white matter hyperintensities volume (0.174 vs. 0.049, cm3, p = 0.04). Multivariable regression analysis showed that white matter hyperintensities volume in migraine patients was positively associated with central systolic blood pressure (p = 0.04) and carotid-femoral pulse wave velocity (p < 0.001), but negatively associated with carotid pulsatility index (p = 0.04) after controlling for potential confounding factors. The interaction effects observed indicated that the influence of carotid-femoral pulse wave velocity (p = 0.004) and central systolic blood pressure (p = 0.03) on white matter hyperintensities formation was greater for the lower-carotid pulsatility index subgroup of migraine patients. White matter hyperintensities volume in migraine patients increased with decreasing carotid pulsatility index and with increasing central systolic blood pressure or carotid-femoral pulse wave velocity. Conclusions: White matter hyperintensities are more common in patients with migraine than in healthy controls. Increased aortic stiffness or central systolic blood pressure in the presence of low intracranial artery resistance may predispose patients with migraine to white matter hyperintensities formation.

Original languageEnglish
Pages (from-to)1225-1236
Number of pages12
JournalCephalalgia
Volume38
Issue number7
DOIs
Publication statusPublished - Jun 1 2018

Fingerprint

Migraine Disorders
Hemodynamics
Blood Pressure
Pulse Wave Analysis
Thigh
White Matter
Sequence Inversion
Doppler Ultrasonography
Vascular Stiffness
Manometry
Carotid Arteries
Arteries
Odds Ratio
Regression Analysis
Magnetic Resonance Imaging

Keywords

  • aortic stiffness
  • augmentation index
  • carotid pulsatility index
  • central pulsatile hemodynamics
  • headache
  • migraine
  • pulse wave velocity
  • White matter hyperintensities
  • white matter lesions

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

White matter hyperintensities in migraine : Clinical significance and central pulsatile hemodynamic correlates. / Cheng, Chun Yu; Cheng, Hao Min; Chen, Shih Pin; Chung, Chih Ping; Lin, Yung Yang; Hu, Han Hwa; Chen, Chen Huan; Wang, Shuu Jiun.

In: Cephalalgia, Vol. 38, No. 7, 01.06.2018, p. 1225-1236.

Research output: Contribution to journalArticle

Cheng, CY, Cheng, HM, Chen, SP, Chung, CP, Lin, YY, Hu, HH, Chen, CH & Wang, SJ 2018, 'White matter hyperintensities in migraine: Clinical significance and central pulsatile hemodynamic correlates', Cephalalgia, vol. 38, no. 7, pp. 1225-1236. https://doi.org/10.1177/0333102417728751
Cheng, Chun Yu ; Cheng, Hao Min ; Chen, Shih Pin ; Chung, Chih Ping ; Lin, Yung Yang ; Hu, Han Hwa ; Chen, Chen Huan ; Wang, Shuu Jiun. / White matter hyperintensities in migraine : Clinical significance and central pulsatile hemodynamic correlates. In: Cephalalgia. 2018 ; Vol. 38, No. 7. pp. 1225-1236.
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AU - Cheng, Chun Yu

AU - Cheng, Hao Min

AU - Chen, Shih Pin

AU - Chung, Chih Ping

AU - Lin, Yung Yang

AU - Hu, Han Hwa

AU - Chen, Chen Huan

AU - Wang, Shuu Jiun

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N2 - Background: The role of central pulsatile hemodynamics in the pathogenesis of white matter hyperintensities in migraine patients has not been clarified. Methods: Sixty patients with migraine (20–50 years old; women, 68%) without overt vascular risk factors and 30 demographically-matched healthy controls were recruited prospectively. Cerebral white matter hyperintensities volume was determined by T1-weighted magnetic resonance imaging with CUBE-fluid-attenuated-inversion-recovery sequences. Central systolic blood pressure, carotid-femoral pulse wave velocity, and carotid augmentation index were measured by applanation tonometry. Carotid pulsatility index was derived from Doppler ultrasound carotid artery flow analysis. Results: Compared to the controls, the migraine patients had higher white matter hyperintensities frequency (odds ratio, 2.75; p = 0.04) and greater mean white matter hyperintensities volume (0.174 vs. 0.049, cm3, p = 0.04). Multivariable regression analysis showed that white matter hyperintensities volume in migraine patients was positively associated with central systolic blood pressure (p = 0.04) and carotid-femoral pulse wave velocity (p < 0.001), but negatively associated with carotid pulsatility index (p = 0.04) after controlling for potential confounding factors. The interaction effects observed indicated that the influence of carotid-femoral pulse wave velocity (p = 0.004) and central systolic blood pressure (p = 0.03) on white matter hyperintensities formation was greater for the lower-carotid pulsatility index subgroup of migraine patients. White matter hyperintensities volume in migraine patients increased with decreasing carotid pulsatility index and with increasing central systolic blood pressure or carotid-femoral pulse wave velocity. Conclusions: White matter hyperintensities are more common in patients with migraine than in healthy controls. Increased aortic stiffness or central systolic blood pressure in the presence of low intracranial artery resistance may predispose patients with migraine to white matter hyperintensities formation.

AB - Background: The role of central pulsatile hemodynamics in the pathogenesis of white matter hyperintensities in migraine patients has not been clarified. Methods: Sixty patients with migraine (20–50 years old; women, 68%) without overt vascular risk factors and 30 demographically-matched healthy controls were recruited prospectively. Cerebral white matter hyperintensities volume was determined by T1-weighted magnetic resonance imaging with CUBE-fluid-attenuated-inversion-recovery sequences. Central systolic blood pressure, carotid-femoral pulse wave velocity, and carotid augmentation index were measured by applanation tonometry. Carotid pulsatility index was derived from Doppler ultrasound carotid artery flow analysis. Results: Compared to the controls, the migraine patients had higher white matter hyperintensities frequency (odds ratio, 2.75; p = 0.04) and greater mean white matter hyperintensities volume (0.174 vs. 0.049, cm3, p = 0.04). Multivariable regression analysis showed that white matter hyperintensities volume in migraine patients was positively associated with central systolic blood pressure (p = 0.04) and carotid-femoral pulse wave velocity (p < 0.001), but negatively associated with carotid pulsatility index (p = 0.04) after controlling for potential confounding factors. The interaction effects observed indicated that the influence of carotid-femoral pulse wave velocity (p = 0.004) and central systolic blood pressure (p = 0.03) on white matter hyperintensities formation was greater for the lower-carotid pulsatility index subgroup of migraine patients. White matter hyperintensities volume in migraine patients increased with decreasing carotid pulsatility index and with increasing central systolic blood pressure or carotid-femoral pulse wave velocity. Conclusions: White matter hyperintensities are more common in patients with migraine than in healthy controls. Increased aortic stiffness or central systolic blood pressure in the presence of low intracranial artery resistance may predispose patients with migraine to white matter hyperintensities formation.

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KW - headache

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KW - pulse wave velocity

KW - White matter hyperintensities

KW - white matter lesions

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