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Migraine and structural abnormalities in the brain

Hougaard, Anders; Amin, Faisal Mohammad; Ashina, Messoud

Current Opinion in Neurology: June 2014 - Volume 27 - Issue 3 - p 309–314
doi: 10.1097/WCO.0000000000000086
HEADACHE: Edited by Manjit Matharu
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Purpose of review The aim is to provide an overview of recent studies of structural brain abnormalities in migraine and to discuss the potential clinical significance of their findings.

Recent findings Brain structure continues to be a topic of extensive research in migraine. Despite advances in neuroimaging techniques, it is not yet clear if migraine is associated with grey matter changes. Recent large population-based studies sustain the notion of increased prevalence of white matter abnormalities in migraine, and possibly of silent infarct-like lesions. The clinical relevance of this association is not clear. Structural changes are not related to cognitive decline, but a link to an increased risk of stroke, especially in patients with aura, cannot be ruled out.

Summary Migraine may be a risk factor for structural changes in the brain. It is not yet clear how factors such as migraine sub-type, attack frequency, and sex affects this association. Additional longitudinal studies are needed to address these issues. Brain structure changes in migraine could potentially serve as disease biomarkers or as a mean of identifying sub-groups of patients with specific therapeutic needs and prognoses.

Danish Headache Center and Department of Neurology, Glostrup Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark

Correspondence to Messoud Ashina, MD, PhD, DMSc, Danish Headache Center and Department of Neurology, Glostrup Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Ndr. Ringvej 67, Building 14, DK-2600 Glostrup, Denmark. Tel: +45 38 63 30 54; fax: +45 38 63 38 39; e-mail: ashina@dadlnet.dk

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