Evaluating the relationship between right-to-left shunt and white matter hyperintensities in migraine patients: A systematic review and meta-analysis
IntroductionWhite matter hyperintensities (WMHs) have been observed with greater frequency in patients with migraine and are thought to be associated with impaired cognition and function. The relationship between WMHs and right-to-left shunt (RLS) in migraine patients is unknown. We performed a syst...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.972336/full |
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| author | Joshua Y. P. Yeo Claire X. Y. Goh Ying Kiat Tan Bryan T. S. Sim Beverly L. X. Chan Nicholas L. Syn Yinghao Lim Amanda C. Y. Chan Vijay K. Sharma Jonathan J. Y. Ong Leonard L. L. Yeo Ching-Hui Sia Benjamin Y. Q. Tan |
| author_facet | Joshua Y. P. Yeo Claire X. Y. Goh Ying Kiat Tan Bryan T. S. Sim Beverly L. X. Chan Nicholas L. Syn Yinghao Lim Amanda C. Y. Chan Vijay K. Sharma Jonathan J. Y. Ong Leonard L. L. Yeo Ching-Hui Sia Benjamin Y. Q. Tan |
| author_sort | Joshua Y. P. Yeo |
| collection | DOAJ |
| description | IntroductionWhite matter hyperintensities (WMHs) have been observed with greater frequency in patients with migraine and are thought to be associated with impaired cognition and function. The relationship between WMHs and right-to-left shunt (RLS) in migraine patients is unknown. We performed a systematic review to determine if there is an association between RLS and WMHs in patients with migraine.MethodsA systematic search of the literature was performed in PubMed and Embase using a suitable keyword search strategy from inception up to 16th June 2021. All studies that included patients with migraine and studied RLS and WMHs were included.ResultsA total of 8 non-randomized observational studies comprising 1125 patients with migraine were included; 576 had an RLS, compared to 549 patients with no RLS. The mean age of the study populations ranged from 28.4 to 43 years, while the average duration from migraine diagnosis ranged from 5.1 to 19 years. The proportion of female to male patients was consistently higher in all studies (60.0–94.4%). Amongst migraine patients with RLS, 338 patients (58.7%) had WMHs. In contrast, 256 (46.6%) of migraine patients without RLS had WMHs. RLS was significantly associated with the presence of WMHs in migraine patients (OR: 1.56, 95% CI: 1.05–2.34, p = 0.03).ConclusionIn migraine patients, RLS was significantly associated with the presence of WMHs. Longitudinal studies are warranted to establish RLS as a risk factor for WMHs in patients with migraine, and to establish the significance of these changes. |
| first_indexed | 2024-04-11T21:55:37Z |
| format | Article |
| id | doaj.art-2e114fbf45f8468aadcedb947b63b33c |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-11T21:55:37Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-2e114fbf45f8468aadcedb947b63b33c2022-12-22T04:01:07ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-08-011310.3389/fneur.2022.972336972336Evaluating the relationship between right-to-left shunt and white matter hyperintensities in migraine patients: A systematic review and meta-analysisJoshua Y. P. Yeo0Claire X. Y. Goh1Ying Kiat Tan2Bryan T. S. Sim3Beverly L. X. Chan4Nicholas L. Syn5Yinghao Lim6Amanda C. Y. Chan7Vijay K. Sharma8Jonathan J. Y. Ong9Leonard L. L. Yeo10Ching-Hui Sia11Benjamin Y. Q. Tan12Department of Medicine, National University Health System, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDepartment of Cardiology, National University Heart Centre, Singapore, SingaporeDivision of Neurology, Department of Medicine, National University Health System, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDivision of Neurology, Department of Medicine, National University Health System, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeIntroductionWhite matter hyperintensities (WMHs) have been observed with greater frequency in patients with migraine and are thought to be associated with impaired cognition and function. The relationship between WMHs and right-to-left shunt (RLS) in migraine patients is unknown. We performed a systematic review to determine if there is an association between RLS and WMHs in patients with migraine.MethodsA systematic search of the literature was performed in PubMed and Embase using a suitable keyword search strategy from inception up to 16th June 2021. All studies that included patients with migraine and studied RLS and WMHs were included.ResultsA total of 8 non-randomized observational studies comprising 1125 patients with migraine were included; 576 had an RLS, compared to 549 patients with no RLS. The mean age of the study populations ranged from 28.4 to 43 years, while the average duration from migraine diagnosis ranged from 5.1 to 19 years. The proportion of female to male patients was consistently higher in all studies (60.0–94.4%). Amongst migraine patients with RLS, 338 patients (58.7%) had WMHs. In contrast, 256 (46.6%) of migraine patients without RLS had WMHs. RLS was significantly associated with the presence of WMHs in migraine patients (OR: 1.56, 95% CI: 1.05–2.34, p = 0.03).ConclusionIn migraine patients, RLS was significantly associated with the presence of WMHs. Longitudinal studies are warranted to establish RLS as a risk factor for WMHs in patients with migraine, and to establish the significance of these changes.https://www.frontiersin.org/articles/10.3389/fneur.2022.972336/fullmigrainemigraine with aurawhite matterpatent foramen ovaleultrasonographydoppler |
| spellingShingle | Joshua Y. P. Yeo Claire X. Y. Goh Ying Kiat Tan Bryan T. S. Sim Beverly L. X. Chan Nicholas L. Syn Yinghao Lim Amanda C. Y. Chan Vijay K. Sharma Jonathan J. Y. Ong Leonard L. L. Yeo Ching-Hui Sia Benjamin Y. Q. Tan Evaluating the relationship between right-to-left shunt and white matter hyperintensities in migraine patients: A systematic review and meta-analysis Frontiers in Neurology migraine migraine with aura white matter patent foramen ovale ultrasonography doppler |
| title | Evaluating the relationship between right-to-left shunt and white matter hyperintensities in migraine patients: A systematic review and meta-analysis |
| title_full | Evaluating the relationship between right-to-left shunt and white matter hyperintensities in migraine patients: A systematic review and meta-analysis |
| title_fullStr | Evaluating the relationship between right-to-left shunt and white matter hyperintensities in migraine patients: A systematic review and meta-analysis |
| title_full_unstemmed | Evaluating the relationship between right-to-left shunt and white matter hyperintensities in migraine patients: A systematic review and meta-analysis |
| title_short | Evaluating the relationship between right-to-left shunt and white matter hyperintensities in migraine patients: A systematic review and meta-analysis |
| title_sort | evaluating the relationship between right to left shunt and white matter hyperintensities in migraine patients a systematic review and meta analysis |
| topic | migraine migraine with aura white matter patent foramen ovale ultrasonography doppler |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.972336/full |
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