Recent evidence indicates a heightened risk of white matter hyperintensities (WMHs) in patients with migraine, visible as hyperintense brain foci on T2-weighted and fluid-attenuated inversion recovery MRI sequences. We aimed to evaluate the presence and location of WMHs and correlate them with clinical variables.
Retrospective design; selection of consecutive migraine patients from a public headache outpatient clinic, over 36 months. Demographic and clinical data collection included age, sex, comorbid medical history and migraine characterization. Patients with major central nervous system diseases, significant traumatic brain injury history, autoimmune diseases, HIV infection and/or uncontrolled vascular risk factors were excluded. Categorization of patients who underwent brain MRI into two groups based on WMHs presence. Statistical approach included chi-square tests for nominal variables, t-tests (confirmed with non-parametric tests) for numerical variables and binary logistic regression to identify independent predictors of WMHs.
A total of 1046 appointments reviewed, identifying 323 migraine patients, 127 of whom underwent brain MRI; 37 excluded, resulting in a final sample of 90 patients (majority female, mean age 37.8 years). Thirty-nine patients (43.3%) with WMHs and 51 patients (56.7%) without WMHs. The most susceptible areas for WMHs were the frontal lobe subcortical white matter, with bilateral predominance. There were no statistically significant differences between the two groups for each variable analyzed, including age and migraine characteristics. The logistic regression model was significant (χ²(2) = 6.19, p = 0.045, R² = 0.09), with age as a predictor for WMHs (p = 0.038).
Despite the reduced sample size and the monocentric nature of this study, WMHs seem common in migraine patients, particularly in those who are older, appearing more often in the frontal lobe subcortical white matter.