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- Title
A retrospective review of sex differences of white matter hyperintensities in brain MRI of patients with migraine.
- Authors
Su, Ye; Tay, Victoria Q.; Singh, Satinderpal; Leary, Megan C.; Koss, Vitaliy; Kincaid, Hope M.; Yacoub, Hussam A.; Castaldo, John
- Abstract
Objectives: The primary objective of this study was to evaluate the prevalence of white matter hyperintensities (WMHs) in patients who experience migraine and compare findings between adult male and female patients. Specific symptoms and comorbidities also were analyzed to determine whether they were associated with WMH prevalence or the sex of patients with migraine. We hypothesized that females would have a higher prevalence of WMHs, experience more frequent and more severe migraine headaches, and be more likely to have certain comorbidities associated with migraine than males. Background: An increased prevalence of WMHs in patients with migraine has been proposed, although this relation is not well‐supported by data from population‐based MRI studies. The difference in brain morphology between males and females is of research interest, and females in the general population appear to have a higher prevalence of WMHs. Sex differences and various comorbidities in patients with migraine relative to the number of WMHs on brain imaging have not been fully investigated. Methods: This was a cross‐sectional study of 177 patients aged 18 years and older with a diagnosis of migraine who were seen in the Lehigh Valley Fleming Neuroscience Institute's Headache Center between January 1, 2000, and January 1, 2017. Patients' baseline characteristics were extracted from electronic medical records, including demographics, review of systems documentation, and brain imaging from MRI. Variables including headache severity, frequency of head pain, insomnia, and comorbidities (anxiety, depression, diabetes, hyperlipidemia, hypertension, and neck pain) also were analyzed for associations with the presence of WMHs. Results: Females were found to have a significantly higher number of WMHs than males (median 3 [IQR: 0–7] vs. 0 [IQR: 0–3], p = 0.023). Patients with WMHs were significantly more likely than those without WMHs to have hypertension (39.8% of patients with WMHs vs. 20.3% without WMHs, p = 0.011), constipation (20.9% vs. 8.3%, p = 0.034), and sleep disorder (55.7% vs. 37.3%, p = 0.022). Females with migraine were significantly more likely to experience constipation than males (20.0% vs. 2.9%, p = 0.015). None of the migraine characteristics studied (frequency, severity, presence of aura) were different between sexes, nor were they significantly associated with the presence of WMHs. Conclusion: This study suggests that females with migraine may be more likely to have WMHs and experience constipation than males with migraine. Migraine frequency and severity were not different between sexes, nor were they significantly associated with the presence of WMHs. The findings of this study do not support a specific etiology of WMH development in individuals with migraine that differs from findings in the general population. Further studies are warranted. Plain Language Summary: We evaluated brain scans of adults with migraine to assess for problems in their white matter, which is a type of brain tissue. We also explored whether patient sex, migraine features like severity or frequency, or co‐existing health conditions were related to white matter problems. While more females than males with migraine had abnormal white matter, our findings did not support any specific cause for this, so more studies are needed on this topic.
- Subjects
CROSS-sectional method; BRAIN; SEX distribution; HYPERTENSION; MAGNETIC resonance imaging; RETROSPECTIVE studies; DESCRIPTIVE statistics; SEVERITY of illness index; WHITE matter (Nerve tissue); MIGRAINE; COMORBIDITY; SLEEP disorders; CONSTIPATION
- Publication
Headache: The Journal of Head & Face Pain, 2024, Vol 64, Issue 6, p612
- ISSN
0017-8748
- Publication type
Article
- DOI
10.1111/head.14714