Migraine Linked to Brain Lesions
Damage Worse With More Frequent, More Severe Migraines
Jan. 27, 2004 -- Severe migraine headaches may cause long-term damage to the brain, a new study suggests.
The findings may change the way we think about migraines, say study researchers Mark C. Kruit, MD, of Leiden University, Netherlands, and Lenore J. Launer, PhD, chief of the neuroepidemiology section at the U.S. National Institute on Aging.
"This is not just a headache we are talking about," Launer tells WebMD. "These findings could change the basic way of seeing migraine from an episodic disorder to something that is more chronic -- where something happens in your brain as a result of the attacks."
"The findings of this study will change the common perception that migraine only is a 'trivial problem' with only transient symptoms, into [seeing] that migraine may be a chronic-progressive disorder that may cause permanent changes in the brain," Kruit tells WebMD.
The findings, reported in the Jan. 28 issue of The Journal of the American Medical Association, don't spell doom for people with migraines. But they do suggest that people who suffer severe headaches should see a doctor -- and get effective treatment as soon as possible.
Brain Scans Show Lesions
One problem with migraine studies is that they often look only at patients seen in clinics. Yet as many as half of real-world migraine sufferers don't ever see a doctor. To get a sense of real-world migraine, Kruit's team went out and recruited Dutch adults age 20 to 60. Those who seemed to have migraines, based on a screening questionnaire, underwent further testing.
Eventually, the researchers came up with 161 people who had migraine with visual or sensory symptoms known as aura, 131 people who had migraine without aura, and 140 people without migraine. All of these people then underwent a 25-minute brain scan with a highly sensitive MRI device. The scans were able to detect very small lesions in the brain.
Unexpectedly, about 38% of the people without migraines had tiny brain lesions.
"Based on that, one could argue that having only a few incidental small lesions is quite normal," Kruit says. "However, we calculated a total volume of lesions for each subject and determined a level of 'high deep white matter lesions load.' In analyzing this group vs. the rest, we found female migraine patients to be at twofold increased risk. Having a small number of incidental small lesions might be not that abnormal, but larger numbers of larger lesions at a younger age is what makes our finding in migraine-women remarkable and significant."
Women with migraines -- but not men with migraines -- were more likely to have these brain lesions. The more frequent their migraines, and the more they had migraine with aura, the more likely they were to have brain lesions.