Yasuda Takashi, Kodera Yuka, Iijima Kazuyuki, Mizuma Atsushi, Tokuoka Kentaro, Okuma Hirohisa, Takizawa Shunya, Kitagawa Yasuhisa, Nogawa Shigeru
Department of Neurology, Tokai University Hachioji Hospital, 1838 Ishikawamachi, Hachioji, Tokyo 192-0032, Japan.
Tokai J Exp Clin Med. 2016 Sep 20;41(3):156-62.
Cerebral white matter lesions (WMLs) have been frequently observed on MRI in patients with migraine. We investigated characteristics of WMLs in migraine and tried to determine the relationship between its causal mechanism and arteriosclerosis.
A head MRI was performed in juvenile migraine patients. The distributions of deep and periventricular WMLs were separately studied in the anterior and posterior circulation. Grading was conducted according to the Fazekas classification. Arteriosclerotic risk factors were identified, and their effects on WMLs were investigated.
WMLs were observed in 85 (40.5%) of 210 patients in our hospital. This is significantly higher than the 10 (19.2%) of 63 patients in the control group (p < 0.01). WMLs were significantly observed on the anterior territory of the deep white matter (p < 0.01) and the posterior territory of the periventricular white matter (p < 0.05). Multivariable analysis revealed that the occurrence of WMLs was not related to arteriosclerotic risk factors, while migraine (p < 0.01) and aging (p < 0.05) were significant risk factors.
While migraine was a risk factor of WMLs, its relationship with arteriosclerotic factors was weak. Accordingly, a mechanism other than arteriosclerosis may be involved.
偏头痛患者的脑部磁共振成像（MRI）常可见脑白质病变（WMLs）。我们研究了偏头痛患者WMLs的特征，并试图确定其发病机制与动脉硬化之间的关系。
对青少年偏头痛患者进行头部MRI检查。分别研究前循环和后循环中深部和脑室周围WMLs的分布情况。根据 Fazekas 分级法进行分级。确定动脉硬化危险因素，并研究其对WMLs的影响。
我院210例患者中有85例（40.5%）观察到WMLs。这显著高于对照组63例患者中的10例（19.2%）（p < 0.01）。在深部白质的前区（p < 0.01）和脑室周围白质的后区（p < 0.05）显著观察到WMLs。多变量分析显示，WMLs的发生与动脉硬化危险因素无关，而偏头痛（p < 0.01）和年龄增长（p < 0.05）是显著的危险因素。
虽然偏头痛是WMLs的一个危险因素，但其与动脉硬化因素的关系较弱。因此，可能涉及除动脉硬化以外的其他机制。
