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首页> 外文期刊>Journal of neurology >Small deep white matter lesions are associated with right-to-left shunts in migraineurs.
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Small deep white matter lesions are associated with right-to-left shunts in migraineurs.

机译：小的深部白质病变与偏头痛患者从右向左的分流有关。

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The right-to-left shunts (RLS) and white matter lesions (WMLs) are frequently observed in migraineurs and in patients with ischemic stroke. Previous studies have reported that the burden of WMLs did not increase with the intracardiac right-to-left shunt (RLS) in migraineurs. However, some types of WMLs are known to be associated with RLS in patients with stroke and dementia. The aim of the study was to demonstrate the difference in the size and location of WMLs, according to the existence of RLS in patients with headache. From the prospective headache registry, a total of 425 subjects (age, 30.8 +/- 5.1 years; 303 women; 242 migraineurs; 183 patients with tension-type headache (TTH)) were retrospectively reviewed and evaluated for RLS and WMLs using M-mode power transcranial Doppler sonography (mTCD) and brain magnetic resonance imaging scans. We scored WMLs, according to the Rotterdam Scan Study, and assessed the association between RLS presence and the location and size of WMLs. The number of small deep WMLs (dWMLs) and the prevalence of RLS, defined as microembolic signals (MES) >/= 11, were higher in patients with migraine (small dWMLs, 6.23 vs. 4.05; RLS, 36.8% vs. 10.9%), compared to patients with TTH. There was no significant difference in the sum of periventricular WML grades or the total volume of dWMLs between TTH and migraine patients. Among the migraineurs, the patients with RLS more frequently had small dWMLs, aura, and heart disease compared to those without RLS. In addition, RLS were also independent predictors for the presence of small dWMLs from the multivariate binary regression analysis (p < 0.01; OR = 3.24; 95%CI 1.56-6.72). Small dWMLs are associated with RLS in young migraineurs. These results imply that paradoxical embolism may cause the small WMLs in some migraineurs.
机译：在偏头痛患者和缺血性中风患者中经常观察到从右向左分流（RLS）和白质病变（WML）。先前的研究报道，偏头痛患者的心内从右向左分流（RLS）不会增加WML的负担。但是，已知某些类型的WML与中风和痴呆患者的RLS有关。这项研究的目的是根据头痛患者存在的RLS来证明WML的大小和位置的差异。从前瞻性头痛登记簿中，回顾性审查了总共425名受试者（年龄，30.8 +/- 5.1岁; 303名女性; 242名偏头痛患者; 183名患有张力型头痛（TTH）的患者），并使用M-进行了RLS和WML评估模式功率经颅多普勒超声（mTCD）和脑磁共振成像扫描。根据鹿特丹扫描研究，我们对WML进行了评分，并评估了RLS的存在与WML的位置和大小之间的关联。偏头痛患者中较小的深部WML（dWML）数量和RLS的患病率（定义为微栓塞信号（MES）> / = 11）更高（小型dWML，分别为6.23和4.05; RLS，分别为36.8％和10.9％ ），相比于TTH患者。在TTH和偏头痛患者之间，室间隔WML总和或dWML总量没有显着差异。在偏头痛患者中，与无RLS的患者相比，具有RLS的患者更常患有dWML小，先兆和心脏病。此外，RLS还是多元二元回归分析中存在小dWML的独立预测因子（p <0.01; OR = 3.24; 95％CI 1.56-6.72）。小型dWML与年轻偏头痛中的RLS相关。这些结果表明自相矛盾的栓塞可能会导致某些移民中的小WML。

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