老年人偏头痛与大脑结构：鹿特丹研究。

Migraine and brain structure in the elderly: The Rotterdam Study.

机构信息

Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.

Department of Neurology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.

出版信息

Cephalalgia. 2024 Sep;44(9):3331024241266951. doi: 10.1177/03331024241266951.

DOI:10.1177/03331024241266951

PMID:39238475

Abstract

BACKGROUND

Recent studies suggested that persons with migraine might be at higher risk of structural brain changes, including cerebral small vessel disease and atrophy. However, findings in the literature are inconsistent, with variations observed in the direction, magnitude, and population characteristics of reported effects, and large-scale population-based evidence remains scarce. Hence, we investigated the association of migraine with structural brain changes in a middle-aged and elderly population.

METHODS

Within the population-based Rotterdam Study, lifetime history of migraine was assessed using a validated questionnaire between 2006 and 2011. Magnetic resonance imaging of the brain was performed in 4920 participants (median age 61.7 [IQR 45.5, 97.5] years, 55.4% female) to assess imaging markers of cerebral small vessel disease and brain atrophy. We used linear and logistic regression models to examine the cross-sectional association of migraine with brain volumes (total grey and white matter volumes in mL) and cerebral small vessel disease markers (white matter hyperintensity volume in mL, presence of lacunes and cerebral microbleeds). Adjustments were made for age, sex, intracranial volume and cardiovascular variables. Analyses were also stratified by sex and presence of aura.

RESULTS

The lifetime prevalence of migraine was 15.3% (752/4920). In multivariable adjusted regression models, we found no statistically significant differences between participants with and without migraine in terms of total brain volume (mean difference [MD]: 2.21 mL, 95% confidence interval [CI]: -0.38 ; 4.81), grey matter volume (MD: 0.38 mL, 95% CI: -1.98 ; 2.74), white matter volume (MD: 2.19 mL, 95% CI: -0.56 ; 4.93), log white matter hyperintensity volume (MD: -0.04 mL, 95% CI: -0.10 ; 0.02), presence of lacunes (odds ratio [OR]: 0.82, 95% CI: 0.58-1.15), and presence of cerebral microbleeds (OR: 0.95, 95% CI: 0.76-1.18).

CONCLUSION

In this study, we found that middle-aged and elderly participants with migraine were not more likely to have structural brain changes on magnetic resonance imaging.

摘要

背景

最近的研究表明，偏头痛患者可能存在更高的结构性脑改变风险，包括脑小血管疾病和萎缩。然而，文献中的研究结果并不一致，报告的效应的方向、程度和人群特征存在差异，并且缺乏大规模的基于人群的证据。因此，我们在中年和老年人群中研究了偏头痛与结构性脑改变的关系。

方法

在基于人群的鹿特丹研究中，使用经过验证的问卷在 2006 年至 2011 年间评估了偏头痛的终生病史。对 4920 名参与者（中位年龄 61.7[四分位距 45.5,97.5]岁，55.4%为女性）进行了脑部磁共振成像，以评估脑小血管疾病和脑萎缩的影像学标志物。我们使用线性和逻辑回归模型来检查偏头痛与脑容量（总灰质和白质体积，以毫升为单位）和脑小血管疾病标志物（白质高信号体积，以毫升为单位，腔隙和脑微出血的存在）之间的横断面关联。调整了年龄、性别、颅内体积和心血管变量。分析还按性别和先兆的存在进行分层。

结果

偏头痛的终生患病率为 15.3%（752/4920）。在多变量调整后的回归模型中，我们发现有偏头痛和无偏头痛的参与者之间在总脑容量（平均差异[MD]：2.21 毫升，95%置信区间[CI]：-0.38；4.81）、灰质容量（MD：0.38 毫升，95%CI：-1.98；2.74）、白质容量（MD：2.19 毫升，95%CI：-0.56；4.93）、log 白质高信号体积（MD：-0.04 毫升，95%CI：-0.10；0.02）、腔隙存在（比值比[OR]：0.82，95%CI：0.58-1.15）和脑微出血存在（OR：0.95，95%CI：0.76-1.18）方面没有统计学显著差异。