偏头痛患者右向左分流与白质病变的关系：一项单中心研究。

Relationship between right-to-left shunt and white matter lesions in patients with migraine: a single-center study.

作者信息

Liu Zhihong, Jiang Mingzhu, He Jing, Lin Yuchan, He Lou, Li Yan, Pan Qi, Wu Shan

机构信息

Department of Neurology, Xiuwen County People's Hospital, Guiyang, China.

Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China.

出版信息

Front Neurol. 2024 Aug 22;15:1419533. doi: 10.3389/fneur.2024.1419533. eCollection 2024.

DOI:10.3389/fneur.2024.1419533

PMID:39239401

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11374744/

Abstract

BACKGROUND

Migraine patients have an increased long-term risk of cardio and cerebrovascular events. However, whether these patients are more susceptible to white matter lesions (WMLs) remains debated. To explore this question, our study assessed the proportion of RLS in migraine patients and explored the association between right-to-left shunt (RLS) and WMLs.

METHODS

In this study, we included 998 migraine patients. Contrast transcranial doppler (c-TCD) was used to diagnose RLS and assess the extent of the shunt in RLS patients. Of the 998 patients, 505 underwent cranial magnetic resonance imaging (MRI) assessments. WMLs were classified into periventricular white matter lesions (pvWMLs) and deep white matter lesions (dWMLs).

RESULTS

Among the 998 migraine patients, 946 had migraine without aura (MO; mean age 36.68 ± 10.46 years; 80.5% female), and 52 had migraine with aura (MA; mean age 29.85 ± 8.59 years; 71.2% female). Compared with MO patients, MA patients had an earlier onset age (23.1 ± 7.97 vs. 28.44 ± 10.38 years, < 0. 001) and a shorter disease duration (6.76 vs. 8.34 years, = 0.024). The overall proportion of RLS patients was 41.9%, with a greater proportion of RLS patients in the MA group than in the MO group (55.8% vs. 41. 1%, = 0.037). The percentage of RLS-positive patients with no/small shunt was greater in the MO group than in the MA group (81.5% vs. 65.4%, = 0.004), whereas the percentage of RLS-positive patients with moderate/large shunt was greater in the MA group (34.6% vs. 18.5%, = 0.024). The proportion of RLS patients was lower in the WML-positive group ( = 173) than in the WML-negative group ( = 332), but the difference was not significant (40.5% vs. 45.8%, = 0.253).

CONCLUSION

This study revealed that 41.9% of migraine patients had RLS, and the proportion of RLS patients was 41. 1% in the MO group and 55.8% in the MA group. The rate of RLS positivity in migraine patients may not be related to the incidence of WMLs.

摘要

背景

偏头痛患者发生心脑血管事件的长期风险增加。然而，这些患者是否更容易发生白质病变（WMLs）仍存在争议。为探讨这一问题，我们的研究评估了偏头痛患者中右向左分流（RLS）的比例，并探讨了RLS与WMLs之间的关联。

方法

在本研究中，我们纳入了998例偏头痛患者。采用对比经颅多普勒（c-TCD）诊断RLS并评估RLS患者的分流程度。998例患者中，505例接受了头颅磁共振成像（MRI）评估。WMLs分为脑室周围白质病变（pvWMLs）和深部白质病变（dWMLs）。

结果

998例偏头痛患者中，946例为无先兆偏头痛（MO；平均年龄36.68±10.46岁；80.5%为女性），52例为有先兆偏头痛（MA；平均年龄29.85±8.59岁；71.2%为女性）。与MO患者相比，MA患者发病年龄更早（23.1±7.97岁 vs. 28.44±10.38岁，P<0.001），病程更短（6.76年 vs. 8.34年，P=0.024）。RLS患者的总体比例为41.9%，MA组RLS患者的比例高于MO组（55.8% vs. 41.1%，P=0.037）。MO组无分流/小分流RLS阳性患者的百分比高于MA组（81.5% vs. 65.4%，P=0.004），而中度/大分流RLS阳性患者的百分比在MA组更高（34.6% vs. 18.5%，P=0.024）。WML阳性组（n=173）中RLS患者的比例低于WML阴性组（n=332），但差异无统计学意义（40.5% vs. 45.8%，P=0.253）。