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.
Abstract
Introduction Migraine is ranked as the third most common and second most disabling neurological disorder worldwide. Neuroimaging studies demonstrate higher white matter lesion (WML) prevalence in migraineurs, with a meta-analysis reporting a 44% pooled prevalence. In the UAE, migraine affects 18.2% of healthcare professionals, but WML prevalence remains unstudied. This study investigates WML prevalence and clinical correlates in UAE migraine patients. Methods This retrospective study included 313 migraine patients aged 10–50 years who underwent brain MRI at HMS Mirdif Hospital (2022–2025). MRI scans (3T, T2/FLAIR) were assessed by three trained doctors supervised by a radiologist. Demographic, clinical, and MRI data were collected from electronic records. Non-parametric tests and binary logistic regression were used (p < 0.05). Results A total of 313 migraine patients (median age 32 years, 73.8% female) were included. White matter lesions were identified in 35.5% (n = 111), with a median of 4 lesions (IQR: 2–10). Lesions were predominantly frontal (86.5%), bilateral (70.3%), and cortical–subcortical (94.6%). Age was the only significant predictor of WML presence (OR = 1.038, p = 0.003), but did not correlate with lesion number among affected patients. Conclusion This study found white matter lesions in 35.5% of migraine patients, predominantly affecting frontal and cortical–subcortical regions. Age was the strongest predictor of lesion presence but did not correlate with lesion number. Why WMLs develop in some patients but not others remain unclear. The retrospective single-center design, potential selection bias, limited generalizability, and lack of an age- and sex-matched control group warrant cautious interpretation and underscore the need for prospective studies.
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.
Aqeela, K. Nawaz, Sania Saeed et al.· International journal of pat...· 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
Abstract Introduction Migraine is a common neurological disorder with attacks lasting 4–72 h. Although duration is a key diagnostic criterion, the clinical and demographic factors associated with its variability are not well defined. Identifying temporal phenotypes may improve diagnostic accuracy and inform individualized management. Methods In this cross-sectional observational study, we evaluated 694 patients fulfilling ICHD-3 migraine criteria. Patients were categorized by attack duration into short (4–12 h), medium (13–24 h), and long (>24 h) groups. Sociodemographic features, migraine characteristics, associated symptoms, and disability measures were compared across groups. Multinomial logistic regression was performed using the short-duration group as the reference category to identify variables independently associated with medium- and long-duration attacks. Results Of 694 participants (84% female; mean age 36.66 ± 12.20 years), 33.3% (n = 231) experienced short, 28.2% (n = 196) medium, and 38.5% (n = 267) long attacks. Long-duration attacks were associated with older age (39.98 ± 11.36 vs. 34.09 ± 12.62 years, p < 0.001), higher female ratio (89.1% vs. 78.8%, p = 0.007), and lower educational level (p = 0.008). Patients with prolonged attacks had higher allodynia scores (median ASC 6 vs. 4, p < 0.001), greater pain intensity (VAS 9 vs. 8, p < 0.001), and more frequent nausea and vomiting (p = 0.002). Illness duration was the longest in the long-attack group (median 120 vs. 60 months, p < 0.001). Other clinical characteristics, including aura, localization, and chronic migraine rates, showed no significant differences. In multivariable analysis, older age and higher pain intensity remained independently associated with long-duration attacks, while lower educational level and higher pain intensity were independently associated with medium-duration attacks. Conclusion Migraine attack duration is associated with distinct demographic and clinical characteristics independent of attack frequency. In multivariable analysis, older age and higher pain intensity remained independently associated with long-duration attacks, while lower educational level and higher pain intensity were independently associated with medium-duration attacks. These findings suggest that attack duration could represent a meaningful clinical phenotype; therefore, frequency-based classification approaches might overlook patients with infrequent but prolonged and disabling attacks.
T. Okluoğlu, Bengül Fatma Gölge, M. Sungur et al.· Neuroepidemiology· 0 citations
Background Despite available diagnostic and therapeutic options, a major unmet need persists in migraine care. This study applied artificial intelligence (AI) to extract structured insights from routine care and assess migraine burden, diagnosis, and treatment in Türkiye. Methods The Türkiye Migraine Registry Study was a retrospective, observational study across 23 hospitals and clinics in eight cities. Anonymized electronic health records (EHRs) of 11,023 adults treated between January 2021 and October 2023 were analyzed. A validated AI framework with natural language processing and machine learning extracted demographics, comorbidities, imaging, and prescriptions. Descriptive statistics summarized outcomes. Results Of 90,381 neurology patients, 16,751 (18.5%) had migraine or suspected migraine; 11,023 met inclusion. Only 46.9% carried an ICD-10 migraine code, while 53.1% were coded under other headache syndromes yet frequently received migraine-specific therapies. The cohort was 73% female, mean age 41.5. Neuroimaging was frequent (58.7% MRI, 15.2% CT), and 18.4% visited emergency care. Preventive therapy was prescribed to 63.7%, mainly antidepressants (31.4%) and beta-blockers (19.4%). OnabotulinumtoxinA and CGRP monoclonal antibodies were used in 10.3 and 3.4%. Conclusion AI-assisted EHR analysis revealed underdiagnosis, high imaging use, and limited adoption of mechanism-specific preventives in Türkiye, underscoring the need for improved diagnostic accuracy and broader access to modern therapies.
P. Yalınay Dikmen, E. Aydınlar, S. N. Dumlu et al.· Frontiers in Neurology· 0 citations
Background Young-onset stroke represents a growing public health concern, yet data from the United Arab Emirates (UAE) remain limited. This study aimed to examine the risk factors and clinical outcomes associated with young-onset stroke in the UAE. Methods A retrospective chart review was conducted on 419 patients aged below 50 years who were admitted at Al Qassimi Hospital, Sharjah, UAE, with a diagnosis of stroke between 2016 and 2022. Data on demographics, comorbidities, stroke subtype, management, and outcomes were collected and analyzed using Python-based statistical libraries. Results The study population comprised predominantly of male individuals (78.28%), with most patients originating from South Asia (63.96%) and the Middle East and North Africa region (19.33%). Ischemic stroke was the most common subtype (50.12%), followed by intracerebral hemorrhage (27.21%) and non-traumatic subarachnoid hemorrhage (22.67%). Hypertension (45.45%) and diabetes mellitus (24.42%) were the most prevalent comorbidities. Only 0.24% of patients underwent mechanical thrombectomy, and 9.41% received intravenous thrombolysis. The overall mortality rate was 12.68%, with coronary artery disease significantly associated with death (p < 0.001). South Asian patients were 2.19 times more likely to have large-artery atherosclerosis compared to non–South Asians (95% CI: 1.11–4.30, p = 0.02). Conclusions Young-onset stroke in the UAE is characterized by a high burden of modifiable cardiovascular risk factors, particularly hypertension and diabetes mellitus. Targeted preventive strategies and region-specific research are essential to reduce disease burden and improve patient outcomes.
Sobia Siddiq, Saryia Adra, K. Samara et al.· PLoS ONE· 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
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