Migraine and structural changes in the brain: a systematic review and meta-analysis

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This study evaluated the association between migraine without aura (MO) and migraine with aura (MA) and 3 types of structural brain abnormalities detected by MRI: white matter abnormalities (WMAs), infarct-like lesions (ILLs), and volumetric changes in gray and white matter (GM, WM) regions. In this systematic review, the results showed that six population-based and 13 clinic-based studies were identified. The studies suggested that structural brain changes, including WMAs, silent ILLs, and volumetric changes in GM and WM regions, were more common in migraineurs than in control groups. The results were strongest for MA. The meta-analysis of WMAs showed an association for MA (OR 1.68; 95% CI 1.07-2.65; p = 0.03) but not for MO (OR 1.34; 95% CI 0.96- 1.87; p = 0.08). The association of ILLs was greater for MA (OR 1.44; 95% CI 1.02-2.03; p = 0.04) than for MO, but no association was found for MA (p = 0.52) and MO (p = 0.08) compared to controls. The authors conclude that the data suggest that migraine may be a risk factor for structural changes in the brain. They argue additional longitudinal studies are needed to determine the differential influence of MO and MA. Neurology. 2013 August. PMID: 23986301

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