Relationship Between Cerebral White Matter Abnormalities In Magnetic Resonance Imaging And Clinical Factors In Patients With Migraine

Objectives: Migraine is a relatively common primary headache, which etiology and pathogenesis has not been fully clear. Recurring vasomotor dysfunction leads to abnormal terminal small artery blood flow in the brain, the cerebral vasospasm could sharply reduce the perforator artery blood flow, leading to cerebral white matter degeneration. Swartz recently reported that compared to patients without migraine, patients with migraine have a higher risk of white matter abnormalities in MRI, but the mechanism of white matter damage is not clear, which may be related to brain microvascular injury induced by recurrent attacks of migraine attacks. Li found the change of micro structure integrity in corpus callosum nerve fibers of patients with migraines applying DT-MRI(diffusion tensor magnetic resonance imaging) technology, and the integrity damage is more obvious with the increase of the course of the disease, headache frequency. Some studies have proved that the level of plasma HCY is higher than normal level in migraine patients, which possibly causes cerebral white matter damage through inducing superoxide, leading to vascular wall damage, promoting the production of large number of inflammatory factors, also through producing some free radicals, damaging vascular endothelial cells. Although there has been studies on relationship between migraine and clinical factors, the studies on the correlation of brain white matter lesions and clinical factors in the migraineurs which applied magnetic resonance imaging were less reported. According to this, the paper proceeds a preliminary research on the relationship between the white matter abnormalities on MRI and clinical relevant factors in patients with migraine.This study analyzes the relationship on the relationship between the brain white matter abnormalities(white matter lesions) on MRI and clinical relevant factors of patients with migraine and then discusses the clinical risk factors that causes cerebral white matter abnormalities, providing certain reference basis for the prevention, diagnosis and treatment of migraine.Methods:1 Clinical grouping98 patients who were diagnosed as migraine and accepted conventional MRI of the brain were selected and divided into cerebral white matter lesion group and cerebral white matter injury-free group according to the results of MRI.A detailed record of two groups of patients were made about their gender, age, history of hypertension, diabetes, coronary heart disease, history of smoking, drinking, family history, aura symptom, headache course, duration, frequency, severity, sleep quality, anxiety and depression, homocysteine levels and the relationship between the clinical factors and cerebral white matter lesions was studied by the single factor and multiple factors Logistic regression analysis.2 MRI3.0 T magnetic resonance checked all of the patients using the GE equipment(model w-750) by FLAIR, T1 WI and T2 WI. The slice thickness of all sequences is 5.0 mm and layer gap is 1.5 mm. Cerebral white matter lesion assessment: cerebral white matter lesions image displayed high signal on T2 or FLAIR, no low signal on T1.3 Determination of HCYFasting venous blood was extracted by 3 ml and serum HCY levels were determined using Japan Olympus AU2700 automatic biochemical analyzer and a complete set of original reagent, adopting cyclophorase, in strict accordance with the kit instructions.Results:1 Cases of each groupAccording to the results of the MRI,there are 31 cases with cerebral white matter lesion and 67 cases without cerebral white matter. The incidence of brain white matter lesion of migraine patients was 31.6%.2 Predilection site of cerebral white matter lesionThere are 64 focuses of cerebral white matter lesion, including frontal lobe lesions in 23(35.9%), parietal lobe lesions in 15(23.4%), basal ganglia region lesions in 13(20.3%), temporal and occipital lobe lesions in 9(14.1%), posterior circulation(brain stem and cerebellum) in 4(6.3%), frontal and parietal lobe lesions totally in 59.3%, and the predilection sites are frontal and parietal lobes.3 The comparsion of the two groupsThe two groups of patients have no significant difference in gender, age, history of hypertension, diabetes, coronary heart disease, history of smoking, drinking, headache duration, severity, sleep quality, anxiety score(P>0.05).The groups with cerebral white matter lesion and without cerebral white matter that have aura are 38.7% and 19.4% respectively, which has significant difference(P<0.05); the two groups that have a family history are 16.12% and 14.92% respectively, which has significant difference(P<0.05); the course of two groups are 8.3±3.5 years and 5.2±2.1 years, which has significant difference(P<0.05); the frequency of two groups are 4.7±2.3 times per month and 3.5±3.4 times per month respectively, which has significant difference(P<0.05); the depression scale scores of two groups are 19.7±4.4 and 16.7±3.5, which has significant difference(P<0.05); the HCY of two groups are(19.6±1.3) umol/L and(12.7±1.4) umol/L, which has significant difference(P<0.05).4 The multi-factor Logistic regression analysis resultsfamily history(OR = 0.928), the aura(OR = 2.314), headache course(OR = 1.524), the homocysteine(OR = 2.024) are independent risk factors for cerebral white matter lesion of migraine patients(P < 0.05).Conclusions:1 Brain white matter damage of migraine patients most locate in frontal and parietal lobe.2 The family history, aura, headache course, homocysteine levels are independent risk factors for cerebral white matter lesion in patients with migraine.