Association between migraine and lacunar infarcts on MR image: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

ZHANG Yanan , CHEN Ning , TANG Li ,  HE Li

Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, P.R.China;

Corresponding author：

HE Li, Email: heli2003new@126.com

Keywords：

Migraine; Lacunar infarcts; Aura; Infratentorial lacunar infarcts; Meta-analysis; Systematic review; Cohort study; Cross-sectional study

DOI：

10.7507/1672-2531.202004162

Video：

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Objective To systematically review the association between migraine and lacunar infarcts on MR image.Methods PubMed, EMbase, The Cochrane Library, CNKI, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials, cohort studies and cross-sectional studies on the association between migraine and lacunar infarcts from inception to March 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by RevMan 5.3 software.Results A total of 5 studies involving 5 104 participants were included. The results of meta-analysis showed that: there were no significant associations of migraine (OR=0.93, 95%CI 0.78 to 1.12, P=0.470) and aura (OR=1.10, 95%CI 0.89 to 1.36, P=0.390) with lacunar infarcts on MR image. Subgroup analysis by age, presence or absence of aura showed no significant tendency.Conclusions There is no significant relationship between migraine and lacunar infarcts. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.

Citation： ZHANG Yanan, CHEN Ning, TANG Li, HE Li. Association between migraine and lacunar infarcts on MR image: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2021, 21(1): 55-60. doi: 10.7507/1672-2531.202004162 Copy

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2.	Cesar JM, García-Avello A, Vecino AM, et al. Increased levels of plasma Von Willebrand factor in migraine crisis. Acta Neurol Scand, 1995, 91(5): 412-413.
3.	Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition (beta version). Cephalalgia, 2013, 33(9): 629-808.
4.	Wardlaw JM, Smith EE, Biessels GJ, et al. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol, 2013, 12(8): 822-838.
5.	Scher AI, Gudmundsson LS, Sigurdsson S, et al. Migraine headache in middle age and late-life brain infarcts. JAMA, 2009, 301(24): 2563-2570.
6.	Cavestro C, Richetta L, L'episcopo MR, et al. Anatomical variants of the circle of Willis and brain lesions in migraineurs. Can J Neurol Sci, 2011, 38(3): 494-499.
7.	Palm-Meinders IH, Koppen H, Terwindt GM, et al. Structural brain changes in migraine. JAMA, 2012, 308(18): 1889-1897.
8.	Kruit MC, van Buchem MA, Hofman PA, et al. Migraine as a risk factor for subclinical brain lesions. JAMA, 2004, 291(4): 427-434.
9.	Tehrani KHN. An investigation of the prevalence of subclinical brain lesions in MRI images of migraine patients. Open Access Maced J Med Sci, 2018, 6(7): 1239-1243.
10.	Bayliss WM. On the origin from the spinal cord of the Vaso-Dilator fibres of the hind-limb, and on the nature of these fibres. J Physiol, 1901, 26(3-4): 173-209.
11.	Geppetti P, Rossi E, Chiarugi A, et al. Antidromic vasodilatation and the migraine mechanism. J Headache Pain, 2012, 13(2): 103-111.
12.	Lauritzen M. Pathophysiology of the migraine aura. The spreading depression theory. Brain, 1994, 117 (Pt 1): 199-210.
13.	Dreier JP, Woitzik J, Fabricius M, et al. Delayed ischaemic neurological deficits after subarachnoid haemorrhage are associated with clusters of spreading depolarizations. Brain, 2006, 129(Pt 12): 3224-3237.
14.	Somjen GG, Aitken PG, Czéh GL, et al. Mechanism of spreading depression: a review of recent findings and a hypothesis. Can J Physiol Pharmacol, 1992, 70(Suppl): S248-254.
15.	Malhotra R. Understanding migraine: potential role of neurogenic inflammation. Ann Indian Acad Neurol, 2016, 19(2): 175-182.
16.	Leo AAP. Pial circulation and spreading depression of activity in the cerebral cortex. J Neuro, 1944, 7(6): 391-396.
17.	Woods RP, Iacoboni M, Mazziotta JC. Brief report: bilateral spreading cerebral hypoperfusion during spontaneous migraine headache. N Engl J Med, 1994, 331(25): 1689-1692.
18.	Olesen J, Larsen B, Lauritzen M. Focal hyperemia followed by spreading oligemia and impaired activation of RCBF in classic migraine. Ann Neurol, 1981, 9(4): 344-352.
19.	Hadjikhani N, Sanchez Del Rio M, Wu O, et al. Mechanisms of migraine aura revealed by functional MRI in human visual cortex. Proc Natl Acad Sci USA, 2001, 98(8): 4687-4692.
20.	Holmberg L, Nilsson IM. Von Willebrand's disease. Eur J Haematol, 1992, 48(3): 127-141.
21.	Charidimou A, Pantoni L, Love S. The concept of sporadic cerebral small vessel disease: a road map on key definitions and current concepts. Int J Stroke, 2016, 11(1): 6-18.
22.	Pantoni L. Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol, 2010, 9(7): 689-701.
23.	Wardlaw JM, Smith C, Dichgans M. Mechanisms of sporadic cerebral small vessel disease: insights from neuroimaging. Lancet Neurol, 2013, 12(5): 483-497.
24.	Ducros A, Denier C, Joutel A, et al. The clinical spectrum of familial hemiplegic migraine associated with mutations in a neuronal calcium channel. N Engl J Med, 2001, 345(1): 17-24.
25.	Beausang-Linder M, Bill A. Cerebral circulation in acute arterial hypertension-protective effects of sympathetic nervous activity. Acta Physiol Scand, 1981, 111(2): 193-199.

1. Tietjen GE, Al-Qasmi MM, Athanas K, et al. Increased Von Willebrand factor in migraine. Neurology, 2001, 57(2): 334-336.
2. Cesar JM, García-Avello A, Vecino AM, et al. Increased levels of plasma Von Willebrand factor in migraine crisis. Acta Neurol Scand, 1995, 91(5): 412-413.
3. Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition (beta version). Cephalalgia, 2013, 33(9): 629-808.
4. Wardlaw JM, Smith EE, Biessels GJ, et al. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol, 2013, 12(8): 822-838.
5. Scher AI, Gudmundsson LS, Sigurdsson S, et al. Migraine headache in middle age and late-life brain infarcts. JAMA, 2009, 301(24): 2563-2570.
6. Cavestro C, Richetta L, L'episcopo MR, et al. Anatomical variants of the circle of Willis and brain lesions in migraineurs. Can J Neurol Sci, 2011, 38(3): 494-499.
7. Palm-Meinders IH, Koppen H, Terwindt GM, et al. Structural brain changes in migraine. JAMA, 2012, 308(18): 1889-1897.
8. Kruit MC, van Buchem MA, Hofman PA, et al. Migraine as a risk factor for subclinical brain lesions. JAMA, 2004, 291(4): 427-434.
9. Tehrani KHN. An investigation of the prevalence of subclinical brain lesions in MRI images of migraine patients. Open Access Maced J Med Sci, 2018, 6(7): 1239-1243.
10. Bayliss WM. On the origin from the spinal cord of the Vaso-Dilator fibres of the hind-limb, and on the nature of these fibres. J Physiol, 1901, 26(3-4): 173-209.
11. Geppetti P, Rossi E, Chiarugi A, et al. Antidromic vasodilatation and the migraine mechanism. J Headache Pain, 2012, 13(2): 103-111.
12. Lauritzen M. Pathophysiology of the migraine aura. The spreading depression theory. Brain, 1994, 117 (Pt 1): 199-210.
13. Dreier JP, Woitzik J, Fabricius M, et al. Delayed ischaemic neurological deficits after subarachnoid haemorrhage are associated with clusters of spreading depolarizations. Brain, 2006, 129(Pt 12): 3224-3237.
14. Somjen GG, Aitken PG, Czéh GL, et al. Mechanism of spreading depression: a review of recent findings and a hypothesis. Can J Physiol Pharmacol, 1992, 70(Suppl): S248-254.
15. Malhotra R. Understanding migraine: potential role of neurogenic inflammation. Ann Indian Acad Neurol, 2016, 19(2): 175-182.
16. Leo AAP. Pial circulation and spreading depression of activity in the cerebral cortex. J Neuro, 1944, 7(6): 391-396.
17. Woods RP, Iacoboni M, Mazziotta JC. Brief report: bilateral spreading cerebral hypoperfusion during spontaneous migraine headache. N Engl J Med, 1994, 331(25): 1689-1692.
18. Olesen J, Larsen B, Lauritzen M. Focal hyperemia followed by spreading oligemia and impaired activation of RCBF in classic migraine. Ann Neurol, 1981, 9(4): 344-352.
19. Hadjikhani N, Sanchez Del Rio M, Wu O, et al. Mechanisms of migraine aura revealed by functional MRI in human visual cortex. Proc Natl Acad Sci USA, 2001, 98(8): 4687-4692.
20. Holmberg L, Nilsson IM. Von Willebrand's disease. Eur J Haematol, 1992, 48(3): 127-141.
21. Charidimou A, Pantoni L, Love S. The concept of sporadic cerebral small vessel disease: a road map on key definitions and current concepts. Int J Stroke, 2016, 11(1): 6-18.
22. Pantoni L. Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol, 2010, 9(7): 689-701.
23. Wardlaw JM, Smith C, Dichgans M. Mechanisms of sporadic cerebral small vessel disease: insights from neuroimaging. Lancet Neurol, 2013, 12(5): 483-497.
24. Ducros A, Denier C, Joutel A, et al. The clinical spectrum of familial hemiplegic migraine associated with mutations in a neuronal calcium channel. N Engl J Med, 2001, 345(1): 17-24.
25. Beausang-Linder M, Bill A. Cerebral circulation in acute arterial hypertension-protective effects of sympathetic nervous activity. Acta Physiol Scand, 1981, 111(2): 193-199.

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