Inge Hester Palm-Meinders MD, Presenter: Nothing to Disclose

Hille Koppen MD, Abstract Co-Author: Nothing to Disclose

Lenore J. Launer, Abstract Co-Author: Nothing to Disclose

Gisela Terwindt MD, PhD, Abstract Co-Author: Nothing to Disclose

Junya Konishi, Abstract Co-Author: Nothing to Disclose

Mark A. Van Buchem MD, PhD, Abstract Co-Author: Research Consultant, Medis Medical Imaging Systems, Inc

Michel D. Ferrari MD, PhD, Abstract Co-Author: Nothing to Disclose

Mark C. Kruit MD, Abstract Co-Author: Nothing to Disclose

We previously reported that migraine is an independent risk factor for cerebellar infarcts and, among women, for high deep white matter lesion (DWML) load (Kruit MC, et al. JAMA 2004). As the risks increased with increasing attack frequency, we re-investigated the same population-based cohort (295 migraineurs; 140 controls) nine years later, to test for migraine-related progression of these brain lesions and to evaluate potential cognitive consequences.

Baseline and 9 yr follow-up brain MR images were acquired (same protocols/scanners) in 203/295 (69%) migraineurs and 83/140 (60%) controls, and analyzed for progression of volume and prevalence of WML (deep / periventricular) and cerebellar infarcts, blinded for diagnosis. MR results were controlled for age, hypertension, diabetes, low education, and correlated with findings from the cognitive test battery conducted in both time points.

We found > 1 new cerebellar infarct in n=10 (5%) migraineurs vs. none in controls (p=0.039) and, among women, a greater progression of DWML load (OR 2.1[1.1-4.2]) was found in migraineurs compared to controls. After adjustment for age and level of education, no association of cognitive functioning with migraine diagnosis and/or lesion load was found.

After 9 years, significantly more migraineurs than controls have developed new cerebellar infarcts. Among women, having migraine is an independent risk factor for the progression of DWML. Consequences for cognitive functioning of having these lesions could not be demonstrated.

Migraineurs are at risk of brain lesion progression and should be evaluated and treated for cardiovascular risk factors. More preventive / aggressive migraine treatment needs to be considered.

Palm-Meinders, I, Koppen, H, Launer, L, Terwindt, G, Konishi, J, Van Buchem, M, Ferrari, M, Kruit, M, Progression and Consequences of Brain Lesions in Migraine: The Population-based CAMERA-2 Nine Year Follow-up MRI Study.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9004033.html