The aim of this study was to examine chronic brain white matter hyperintensities in
migraine and to gain data on the characteristics of the lesions.
Migraine associates with a higher incidence of magnetic resonance imaging (MRI)-visible
white matter signal abnormalities. Several attack-related pathomechanisms have been
proposed in the lesion development, including the effect of repeated intracerebral
Supratentorial white matter hyperintensities of 17 migraine patients were investigated
interictally with quantitative MRI, including quantitative single voxel spectroscopy,
diffusion, and perfusion MRI at 3.0-Tesla. The findings were compared with data measured
in the contralateral, normal-appearing white matter of migraineurs and in the white
matter of 17 healthy subjects.
Significantly higher apparent diffusion coefficient values, prolonged T2 relaxation
times, and decreased N-acetyl-aspartate and creatine/phosphocreatine concentrations
were found in the white matter hyperintensities. The cerebral blood flow and blood
volume values were mildly decreased inside the hyperintensities. Differences were
not present between the migraine patients' normal-appearing white matter and the white
matter of healthy subjects.
The MRI measurements denote tissue damage with axonal loss, low glial cell density,
and an enlarged extracellular space with an increased extracellular water fraction.
These radiological features might be the consequences of microvascular ischemic changes
during migraine attacks.