Migraines may be altering brain structure
New review of 19 previously published migraine studies shows that aura migraines increase the risk of brain lesions by 68%.
Thu, Aug 29, 2013 at 10:31 AM
Migraines are not just painful and debilitating. They could also, in some cases, be affecting your brain and increasing your risk of brain lesions and stroke.
This news — which is not as bad as it sounds — comes by way of a new review and meta-analysis of previously published migraine research. The study, conducted by scientists from the University of Copenhagen in Denmark and other institutions, was published Aug. 28 in the journal Neurology.
In this new meta-analysis, the authors looked at 19 previously published migraine studies, including 13 clinical studies and six population-based studies. They concentrated on studies that included MRI examinations, as they wanted to evaluate the association between migraines with aura (symptoms prior to the onset of the migraine) and migraine without aura on three types of brain abnormalities that could be detected by the brain scans: white matter abnormalities, lesions and volumetric changes of the brain.
The study found that people who suffered migraines with aura had a 68 percent increased risk of also suffering white matter brain lesions when compared with people who did not experience migraines. For those who suffered non-aura or "common" migraines, the increased risk was 34 percent. The authors do caution that more study is needed to determine the causality of the increased risk.
This increased risk isn't necessarily something that should create a panic. One of the study's co-authors, neurologist Richard B. Lipton of the Montefiore Headache Center in the Bronx, told the Los Angeles Times, "If you have migraine with aura and you have white-matter lesions, they’re probably not a cause of concern." What you should to, however, is adjust your lifestyle to reduce your accompanying risk factors for stroke. "If you have migraine with aura, certainly you shouldn't smoke," he said. He also suggested using the lowest possible hormone dosage for oral contraceptives and understanding your other risk factors for stroke, including diabetes or high cholesterol.
In their paper, the authors say that most migraine sufferers do not need to undergo an MRI to determine their risk factors. "Only patients with atypical headache, a recent change in headache pattern, other symptoms (such as seizures), or focal neurologic symptoms or signs are recommended for MRI of the brain," the paper says. If you do have an MRI and it shows white-matter abnormalities, the authors say that is not an immediate sign of concern. Those who show lesions should be more worried about their future risk of stroke.
Meanwhile, another study in Neurology, published on Aug. 23, found that women who experience chronic migraines showed an increased level of an amino acid called calcitonin gene-related peptide (CGRP) in their blood. CGRP helps transmit signs of pain to the brain; its presence, the authors write, could be a helpful biomarker in the diagnosis of chronic migraines.
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