Iwasaki Akio, Suzuki Keisuke, Takekawa Hidehiro, Takashima Ryotaro, Suzuki Ayano, Suzuki Shiho, Hirata Koichi
Stroke Division, Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga-gun, Tochigi, 322-0293, Japan.
Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
J Headache Pain. 2017 Dec;18(1):3. doi: 10.1186/s10194-016-0714-x. Epub 2017 Jan 7.
There may be a link between right-to-left shunt (RLs) and brain white matter lesions (WMLs) in patients with migraine. In this study, we assessed the relationship between WMLs and RLs in Japanese migraine patients.
A total of 107 consecutive patients with migraine with (MA) and without aura (MWOA) were included in this study. Contrast transcranial Doppler ultrasound was used to detect RLs. WMLs were graded using brain magnetic resonance imaging based on well-established criteria.
The prevalence of RLs was significantly increased in the WMLs positive group (n = 24) compared with the WMLs negative group (n = 83) (75.0% vs. 47.0%, p = 0.015). In prevalence of WMLs between MA and MWOA patients, there were no statistical differences (p = 0.410). Logistic regression analysis adjusted by age and disease duration of migraine identified an RLs-positive status as the sole determinant for the presence of WMLs (OR = 6.15; 95% CI 1.82-20.8; p = 0.003) CONCLUSION: Our study suggests a possible link between RLs and WMLs in Japanese patients with migraine.
偏头痛患者的右向左分流（RLs）与脑白质病变（WMLs）之间可能存在关联。在本研究中，我们评估了日本偏头痛患者中WMLs与RLs之间的关系。
本研究共纳入107例连续性偏头痛患者，其中有先兆偏头痛（MA）患者和无先兆偏头痛（MWOA）患者。采用对比经颅多普勒超声检测RLs。基于既定标准，使用脑磁共振成像对WMLs进行分级。
与WMLs阴性组（n = 83）相比，WMLs阳性组（n = 24）中RLs的患病率显著增加（75.0%对47.0%，p = 0.015）。MA患者和MWOA患者之间WMLs的患病率无统计学差异（p = 0.410）。经偏头痛患者年龄和病程校正的逻辑回归分析确定，RLs阳性状态是WMLs存在的唯一决定因素（OR = 6.15；95%CI 1.82 - 20.8；p = 0.003）。结论：我们的研究表明，日本偏头痛患者中RLs与WMLs之间可能存在关联。
