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Tuesday, September 3, 2013

Do Migraines Permanently Alter the Brain?

Migraines were once considered a benign disorder without long-term consequences for the brain. But a new review, published online ahead of print in the Aug. 28 edition of Neurology, set out to investigate this postulation. In the study, Asma Bashir, MD, from the University of Copenhagen in Denmark, and colleagues found that migraines are a risk factor for permanent changes in the brain.

            Using a PubMed search, the authors identified six population-based studies and 13 clinic-based studies of MRI abnormalities in migraineurs (with aura and without). Dr. Bashir and colleagues looked at three types of structural brain abnormalities on MRI — white matter abnormalities (WMAs), infarct-like lesions (ILLs), and volumetric changes in gray and white matter (GM, WM) regions.

The meta-analysis of WMAs showed an association for migraine with aura (OR 1.68; 95% CI 1.07–2.65; p = 0.03) but not for migraine without aura (OR 1.34; 95% CI 0.96–1.87; p = 0.08). ILLs were more prevalent individuals with migraine with aura (OR 1.44; 95% CI 1.02–2.03; p = 0.04) than for migraine without aura, but no association was found for migraine without aura (p = 0.52) and MO (p = 0.08) compared to controls. According to the data, migraine is a risk factor for WMAs, ILLs, and volumetric changes in the brain. These associations were strongest for individuals with migraine with aura. 

More longitudinal studies are necessary 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,” the authors concluded.

See our past coverage of migraine and brain changes in Neurology Today: