Precis Future Med.  2019 Dec;3(4):146-157. 10.23838/pfm.2019.00128.

White matter hyperintensities in migraine: a review

Affiliations
  • 1Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. mijilee.md@gmail.com
  • 2CHA University School of Medicine, Seongnam, Korea.

Abstract

Migraine is a neurological disorder characterized by recurrent spells of headache accompanied by brain symptoms such as nausea, vomiting, photophobia, and phonophobia. White matter hyperintensity (WMH) is the most frequent radiological abnormality observed in migraineurs. Older studies have reported that the prevalence of WMH is about 30% in migraineurs, while latest studies using advanced technology show that WMHs are present in about 70% of young (age <50 years), vascular risk factor-free patients with migraine. Population-based studies on elderlies reported conflicting results on the association between migraine and WMH, but deep WMHs were greater in studies of the younger population. Data are also conflicting on whether headache characteristics, migraine type, disease duration, or headache frequency are associated with WMH. Current evidence suggests that a greater deep WMH burden is associated with intracranial and extracranial vascular function. The clinical implication of WMH has not been well studied in relation to migraine, but it is generally not associated with cognitive dysfunction in patients with migraine. Current understanding of WMHs is limited; we herein suggest some tips for improvement in research methods that will bring a better understanding of both the pathophysiology and the consequence of WMH development in patients with migraine.

Keyword

Ischemia; Magnetic resonance imaging; Migraine with aura; Migraine without aura; Stroke; White matter

MeSH Terms

Brain
Headache
Humans
Hyperacusis
Ischemia
Magnetic Resonance Imaging
Migraine Disorders*
Migraine with Aura
Migraine without Aura
Nausea
Nervous System Diseases
Photophobia
Prevalence
Stroke
Vomiting
White Matter*
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