Eur opean Rev iew for Med ical and Pharmacol ogical Sci ences 2016; 20: 1032-1036 Characteristic analysis of white matter lesions in migraine patients with MRI
F. HU, Z.-W. QIAN
College of Health Information Technology and Management, Shanghai University of Medicine and Health Sciences, Shanghai, China
Abstract. – OBJECTIVE: The aim of this riplegia and migraine as the most severe chronicle study is to analyze the characteristics of white functional disorders. Clinically, the pathogenesis matter lesions in abnormal manifestations of of migraine is not clear, and there are several theo - magnetic resonance imaging (MRI) of patients with migraine, and its relationship with migraine. ries proposed, including vascular source theory, PATIENTS AND METHODS: 38 patients, diag - neuron theory, nerve vascular source theory and nosed with migraine were continuously selected so on 3. Currently, there are rare clinical specific as the observation group, while during the same imaging indicators and laboratory examination period, 30 healthy individuals were selected as methods, and magnetic resonance imaging (MRI) the control group. The differences of the fea - is the most frequently used technology in func - tures of MRI of two groups, the ratios of white matter lesions manifestations and the severity tional imaging, which has the advantages of high were compared. resolution, radiation less and no trauma. MRI is RESULTS: The manifestations of MRI in pa - sensitive to lesions in brain tissue and soft tissue, tients with migraine were mainly white matter le - can be quantitatively detected, and is more and sions. The accuracy rate was 86.7%, and the more widely applied clinically 4. With the wide de - sensibility was 92.3%. According to Wahlund velopment of MRI, the detection rate of white white matter lesions classifications, patients with migraine were mainly Level II and Level III matter lesions in patients with migraine is continu - (84.2%). It can be acquired from relevant analy - ously increasing, and relevant literature confirms ses that white matter lesions classifications and the close relationship between migraine and white the degrees of migraine were positively correlat - matter lesions 5. This research is designed to ana - ed ( p < 0.05). White matter lesions were mainly lyze the characteristics of white matter lesions in distributed in the frontal lobe (78.9%), limbic system (60.5%) and parietal lobe (28.9%). abnormal manifestations of MRI in patients with CONCLUSIONS: The MRI of migraine, the migraine, and its relationship with migraine. manifestations of white matter lesions were rela - tively sensitive. The higher the classification was linked with the degree of migraine. They Patients and Methods were mainly distributed in the frontal lobe, lim - bic system and parietal lobe. Patients Key Words: 38 patients with migraine in our hospital were Migraine, Magnetic resonance imaging, White continuously collected between February 2012 matter lesions. and February 2014 as the observation group. All patients confirm to the diagnostic criteria of mi - graine in head and face pain classification pro - Introduction posed by International Headache Society (HIS) in 2004 6. The patients with the histories of drug The migraine is a kind of headache disease that abuse and drug allergy, abnormal in growth and frequently appears clinically. Its occurrence rate is development, mental and communication disor - relatively high, which is about 34.3% -51.2% 1. Pa - ders, other headaches or refuse to participate in tients suffer a severe headache when the disease the research were excluded. There were 15 male occurs, the disease is protracted and is difficult to patients and 23 female patients, age range from be cured, and recurrent pains and sleep disorders 28 to 63 with the average age of (48.6 ± 7.5). 30 bring severe adverse effects to work and lives of individuals who were examined as healthy in our patients. WHO 2 has listed mental disorders, quad - hospital during the same period were selected as
1032 Corresponding Author: Fan Hu, MD; e-mail: [email protected] Characteristic analysis of white matter lesions in migraine patients with MRI the control group. There were 10 male patients graine degree classification method proposed by and 20 female patients, age range from 26 to 67 IHS in 1998 6 (Headache premonition, headache with the average age of (49.6 ± 7.4). This re - course of disease, headache occurrence frequen - search was approved by Ethics Committee of our cy, headache duration, headache severity, quality hospital and obtained informed consents from of sleep, the degrees of anxiety and depression patients and their families. were references). The patients with migraine were divided into 4 levels from 0 to 3, the higher Research Methods the level was more severe the headache was. MRI was carried out by 3.0T superconductive magnetic resonance scanner provided by Statistical Analysis Siemens AG. 8 channels phased array coils was Data are analyzed by SPSS 19.0 statistical adopted to carry out MRA examinations, FLAIR software (SPSS Inc., Chicago, IL, USA), mea - examinations, T1WI examinations and T2WI ex - surement data were represented by , and t-test aminations. The interlayer spacing was about 1.5 was adopted for comparison among groups. Enu - mm, and the thickness of the layer was about 5 meration data were represented by (%), X 2-test mm. The examinations were carried out by pro - was adopted for comparison among groups, X 2- fessional technicians from the Department of Im - test was adopted for the relevant analyses of mi - age, a blind method was carried out for all pa - graine classifications and white matter lesions tients, and the examination results were judged classifications. p < 0.05 was considered that the mutually by three technicians. The numbers of difference was of statistical significance. white matter lesions and their locations of pa - tients examined in two groups were completely recorded. Results
Observation Indexes Comparisons of Imaging Features of The characteristics, severity and distributions White Matter Lesions of white matter lesions on MRI in two groups White matter lesions were manifested on both were compared and the relevant analyses were sides of the brain cortex around the lateral ventri - carried out according to the classifications of mi - cle, centrum semiovale patchy or diffused mutual graine. According to literature of Wahlund 7, the fusion on MRI. T2 weighted imaging and FLAIR degrees of white matter lesions were divided into were high signals, T1 weighted imaging shows four levels. Level 0 represents no obvious white equal or low signals, the boundaries were explic - matter lesions, Level I represents the manifesta - it, and no space occupying effects (Figure 1). tion of partial leukoaraiosis, Level 2 represents MRI of patients with migraine was mainly mani - partial leukoaraiosis begin to fuse, and Level 3 fested as white matter lesions, there were 35 cas - represents leukoaraiosis is widely diffused and es (92.1%) detected in total, the accuracy rate converged, and U -fiber involvement was accom - was 86.7%, and the sensitivity was 92.3%. 5 pa - panied or not accompanied. According to mi - tients in control group manifest white matter le -
Figure 1. T1, T2 and FLAIR Scanning images of white matter lesions in the same layer of magnetic resonance imaging (T2 or FLAIR manifest high signals, while no low signal changes in T1).
1033 F. Hu, Z.-W. Qian sions (16.7), the comparisons among groups with healthy individuals, the anterior cingulate show that the difference was of statistical signifi - white matter of patients with migraine reduces, cance ( p < 0.05). White matter lesions were signals were changed, which was linearly corre - mainly distributed in the frontal lobe (30 pa - lated to seizure frequency of migraine 10 . The re - tients, 78.9%), limbic system (23 patients, duction of white matter in the brain of patients 60.5%) and parietal lobe (11 patients, 28.9%) with migraine was closely related to the conduc - (Figures 2-3). tion of pain, the changes of white matter were triggered by the frequent introduction of pain, Analysis of Classified Correlations of and this kind of changes can be reversed in the Migraine and White Matter Lesions intermission of migraine 11 . The selective white There were 6 patients with Level I, 11 patients matter changes occurred in the brain of patients were with Level II and 21 patients were with with migraine were closely related to the degrees Level III in migraine. 2 patients with Level 0, 4 of disease attack and course of disease 12 , which patients with Level I, 15 patients with Level II provides scientific evidence for the theory that and 17 patients with Level III in white matter le - migraine is a kind of organic disease. sions. According to relevant analyses, it can be The morbidity of white matter lesions in acquired that the classifications of white matter healthy persons was between 10% and 15%, and lesions and the degrees of migraine were posi - gradually increases with the increase of age 13 . A tively correlated (r = 0.632 , p = 0.027). recent meta -analysis results showed that the risk of occurring white matter lesions in patients with migraine with aura was nearly twice of that of Discussion persons in the healthy control group (OR = 1.68 , 95% CI : 1.07-2.65) 11 . It was obtained from the Magnetic resonance was the most important research that MRI of patients with migraine was method in researching migraine in recent years, mainly manifested as white matter lesions, the which can be used to quantitatively analyze some detection rate was 92.1%, the accuracy rate was specific metabolic compounds 8. A large number 86.7%, and the sensitivity was 92.3%. White of researches verified that the MRI of the white matter lesions were mainly distributed in the matter of patients with migraine was manifested frontal lobe, limbic system and parietal lobe. as abnormal 9. Comparing patients with migraine This kind of distribution may be of evident rela -
Figure 2. White matter high signals of right frontal lobe, parietal lobe, left frontal lobe, temporal lobe juncture and inferior horn of lateral ventricle on magnetic resonance imaging FLAIR.
1034 Characteristic analysis of white matter lesions in migraine patients with MRI
Figure 3. White matter high signals of left radial coronary area single dot on MRI T2 and FLAIR. tionship with anatomical features of feeding ves - was the possibility of wallerian degeneration sels 14 . The blood supply of deep white matter of happens in the cerebral white matter of patients frontal lobe, limbic system and parietal lobe is with migraine, and it was closely related to dys - mainly carried out by the perforating artery. It is function of the cerebral cortex 18 . terminal arteriole with small pipe diameter, has few or even no collateral circulations, uses defin - itive zone which is 3 -10 mm from ventricle walls Conclusions as the watershed, and aforementioned structures determine that white matter in this area is subject MRI provides scientific statistical materials to the influence of ischemia and , therefore , lead for the diagnosis and treatment of patients with to demyelinating disease 15 . Some studies 16 have migraine, in terms of the technology itself, the shown that it is correlated with specific neuro - results may be different because of the differ - logical side effects of patients with migraine. ences of the number of samples and research ob - MRI examinations still need to be carried out to jects. Therefore, MRI of patients with migraine explore its causes, and the physiological mecha - should be further standardized to enhance the re - nism of MRI abnormalities still need to be fur - liability of research methods and to form re - ther illustrated. searches of relatively high comparability. MRI technology deals with multiple statistics and parameters, reacts to changes of extension in –––––––––––––––– –-– –– the imaging body through directions, and can ef - Conflict of Interest fectively display cerebral white matter fiber le - The Authors declare that there are no conflicts of interest. sions 17 . Repeated migraine could lower the cog - nitive function of patients to the utmost extent, and through MRI, cerebral white matter lesions References that were difficult to be discovered by other imaging examinations can be discovered. Some 1) MORGANTI LO, S ALMITO MC, D UARTE JA, B EZERRA KC, SIMÕES JC, G ANANÇA FF . Vestibular migraine: clini - scholars adopt MRI to carry out researches about cal and epidemiological aspects. Braz J Otorhino - the potential cerebral white matter lesions of pa - laryngol 2015 Oct 29. pii: S1808-8694(15)00181- tients with migraine, and they discover that there 0. Epub ahead of print.
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