Jul 2026· International journal of pathology· 0 citations
TL;DR
WMHs are common MRI findings in patients with migraine, particularly in older patients and those with chronic or long-standing disease, and may improve the interpretation of MRI findings and contribute to a better understanding of migraine-related brain changes.
Abstract
Background: Migraine is a common neurological disorder characterized by recurrent headaches that significantly affect quality of life and daily functioning. Brain magnetic resonance imaging (MRI) often demonstrates white matter hyperintensities (WMHs), but their clinical significance remains uncertain. Therefore, this study was conducted to determine the frequency and radiological characteristics of WMHs on MRI in patients with migraine.
Methods: This descriptive cross-sectional study was conducted at Pak Emirates Military Hospital, Rawalpindi. A total of 400 patients aged 18–60 years with migraine diagnosed according to the International Classification of Headache Disorders, 3rd edition (ICHD-3), were included through non-probability consecutive sampling. Brain MRI was performed using T2-weighted and fluid-attenuated inversion recovery (FLAIR) sequences. Associations were evaluated using the Chi-square test, and multivariable binary logistic regression analysis was performed to identify independent predictors of WMHs. Data were analyzed using SPSS version 28.
Results: WMHs were significantly more frequent in patients aged >40 years (p<0.001), those with chronic migraine (p=0.01), and those with a migraine duration >5 years (p=0.003). Binary logistic regression demonstrated that age >40 years, chronic migraine, and migraine duration >5 years were independent predictors of WMHs, whereas gender, migraine aura, hypertension, and diabetes mellitus were not independently associated.
Conclusion: WMHs are common MRI findings in patients with migraine, particularly in older patients and those with chronic or long-standing disease. Most lesions are small, mild, and predominantly involve the frontal and deep white matter. These findings may improve the interpretation of MRI findings and contribute to a better understanding of migraine-related brain changes.
White matter lesions were found in 35.5% of migraine patients, predominantly affecting frontal and cortical–subcortical regions, and age was the strongest predictor of lesion presence but did not correlate with lesion number.
N. Akkawi, Elkhansa Hassabo Mohamed, Marwa Suliman et al.· Frontiers in Neurology· 0 citations
Chronic musculoskeletal pain is a persistent condition that can reduce the quality of life and contribute to mental health disorders, leading to structural alterations in the central nervous system. On these grounds, the gray (GM) and white (WM) matter alterations in patients with non-specific chronic spinal pain (CSP) were examined using Magnetic Resonance Imaging (MRI), and explored their associations with clinical measures of mental health and quality of life. In this study, 60 controls (age 46.2 ± 11.8 years, 37 women) and 40 patients with CSP (age 49.5 ± 8.1 years, 31 women) were recruited. Before the MRI session, patients filled out multiple questionnaires and provided basic clinical information. The neuroimaging acquisition included a T1-weighted sequence, to extract the GM morphological features, and diffusion-weighted images (DWI) to calculate the WM diffusion parameters. The relationship of those measures with clinical variables was assessed with partial Spearman's correlation coefficients. Patients with non-specific CSP exhibited significantly reduced GM volume in several brain regions involved in pain processing and modulation. Regarding WM, patients showed increased mean and axial diffusivity in a few regions implicated in proprioception and the sensation of pain. Moreover, significant correlations between these measures and scores from clinical tests were found. In conclusion, MRI-based parameters from GM morphometry and diffusion descriptors allowed to detect structural alterations in the GM and WM of patients with CSP. These MRI-based descriptors were correlated with multiple clinical parameters that suggested a worsening of the patient's physical and mental health. PERSPECTIVE: This article assesses structural gray and white matter alterations of patients with non-specific chronic spinal pain and their relationship with clinical symptoms. Cerebellar and subcortical gray matter volume loss, and white matter altered diffusivity, were associated with reduced pain sensitivity, negative emotional and cognitive pain responses, and amplified pain experience.
Irene Guadilla, Álvaro Planchuelo-Gómez, R. Navarro-González et al.· Journal of Pain· 0 citations
White matter hyperintensities (WMHs) are common MRI findings and established markers of cerebral small-vessel disease associated with stroke, cognitive decline, and vascular risk factors. Several studies have suggested that individuals with migraine, particularly migraine with aura (MA), may have an increased burden of WMHs compared with individuals without migraine. Early population-based studies and meta-analyses reported a higher prevalence of WMHs in migraine, whereas more recent large neuroimaging cohorts have reported conflicting findings or no association. Differences in study design, migraine ascertainment, MRI acquisition parameters, WMH quantification methods, and adjustment for vascular risk factors complicate interpretation of the existing literature. An updated systematic review focusing on methodologically comparable population-based cohorts is therefore warranted.
The primary objective of this systematic review and meta-analysis is to determine whether adults with migraine have a higher prevalence or burden of WMHs on MRI than non-migraine controls. Secondary objectives include evaluating associations according to migraine subtype (MA vs. migraine without aura and episodic vs. chronic migraine), sex, WMH location, age, and MRI acquisition or WMH quantification methods, as well as examining longitudinal WMH progression where available. We will include population-based cross-sectional or longitudinal cohort studies of adults undergoing brain MRI with sequences suitable for WMH detection. Migraine exposure may be defined using International Classification of Headache Disorders criteria, structured interviews, validated questionnaires, physician diagnosis, or ICD codes. Controls must originate from the same source population. Searches will be conducted in PubMed/MEDLINE, EMBASE, Web of Science, and Scopus. Study selection, data extraction, and risk-of-bias assessment will be performed independently by two reviewers using Covidence, and risk of bias will be evaluated using the ROBINS-E tool. Because WMH burden is reported using heterogeneous metrics across studies, the primary synthesis will use a precision-weighted direction-of-effect approach, in which each study contributes the direction of the association, weighted by statistical precision. Where sufficiently comparable outcomes are available, random-effects meta-analysis will be performed. Sensitivity analyses will explore the influence of diagnostic criteria, MRI field strength, and confounder adjustment. This review will provide an updated and methodologically rigorous synthesis of the evidence on the association between migraine and WMHs.
C. Gollion, Chia-Chun Chiang, Mi-Ji Lee et al.· Cephalalgia Reports· 0 citations
Background: The cerebral venous system comprises both superficial and deep veins, which contain nearly 70% of the brain’s blood volume and play a crucial role in maintaining normal cerebral perfusion.
Subject and methods: A retrospective study was conducted at Rizgary Teaching Hospital from January 1st, 2025, to November 1st, 2025. A convenient sample of 100 patients' MRI reports was reviewed. The first section of the questionnaire included gender, age, and indications for Magnetic Resonance Imaging. Signs and symptoms such as headache, headache with vertigo, seizure, headache and vomiting, dizziness, altered sensorium, and forgetfulness were documented. Categorical data was tested with the Chi-square test, and numerical data with the t-test. A P-value ≤0.05 was considered significant.
Results: The prevalence of females presenting with headaches was higher than that of males, at 75% compared to 67.5%. Headache and vomiting were more common in males (25%) than in females (15%). No statistically significant difference was reported between gender and the TS symmetrical and asymmetrical variation. The prevalence of asymmetry was 85% in males compared to 81.7% in females. The prevalence of left hypoplastic transfer sinus was higher than that of the right hypoplastic transfer sinus. The highest predictive value (96%) for diagnosing the laterality of the dominant TS was reported by gSSS inclination, with an interobserver reliability of 0.82. SSS flow-void laterality had the second-highest reliability for determining TS dominance, at 92%.
Conclusion and recommendation: Several anatomical features visible on MRI can predict TS dominance laterality. Right TS dominance is indicated by a gSSS that slopes downward to the right, with the SSS flow void positioned to the right of the more prominent, rightward angulation of the posterior falx, and a more inferiorly located left occipital lobe. The orientation of the gSSS to the right or left is strongly associated with and highly predictive of right- and left-sided TS dominance laterality.
Maryam Hatem Rmaidh, A. Farooq· Adolescência e Saúde· 0 citations
Patients with WMH exhibit alterations in EEG microstate features that are significantly correlated with WMH burden and cognitive function, and classification models based on these microstate features show promise for practical application in WMH-related dementia.
Kai-Yan Feng, Jia-Xin Cai, Jian-Ming Lei et al.· Frontiers in Neuroscience· 0 citations
Background
Recent studies have explored the link between white matter hyperintensity (WMH) and gait disorders; however, inconsistent results have arisen due to varied populations and sample sizes. We aimed to examine the relationship between WMH severity and gait in patients with cerebral small vessel disease (CSVD).
Methods
We included 335 patients with CSVD with independent walking ability hospitalized at the Department of Neurology, Tianjin Huanhu Hospital, from August 1, 2018, to May 17, 2021. WMH was graded using the Fazekas scale on magnetic resonance imaging. Patients were categorized into the mild and moderate-to-severe WMH groups. A wearable gait analysis system was employed to evaluate the impact of WMH severity on patients' walking ability.
Results
Patients in the moderate-to-severe WMH group exhibited slower gait speed, shorter length stride, and reduced foot strike and toe-off angles compared to those in the mild WMH group, all with significant differences (p < 0.05). Analysis of gait parameter symmetry and variability showed significant increases in the moderate-to-severe WMH group. Multivariate logistic regression analysis identified toe-off angle, swing phase coefficient of variation, and age as independent risk factors for WMH-induced gait impairment.
Conclusion
The severity of white matter lesions affects the gait of patients with small vessel disease, including spatiotemporal and kinematic parameters, symmetry, and variability. With increasing age, the severity of white matter lesions increases, resulting in a reduced toe-off angle and greater swing variability, leading to decreased stability.
Yajing Wang, Zhizhong Zhu, Jiao-Jiao Zhao et al.· Frontiers in Neurology· 0 citations
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