Association Between Mitral Valve Prolapse, Migraine, and White Matter Hyperintensities on Magnetic Resonance Imaging

Objective: Migraine is linked with an elevation in vascular risk factors, ischemic stroke, and a variety of constitutional brain lesions. However, the pathogenesis of this relationship is still inexplicit. The link between cardiac diseases and comorbid migraine-ischemic stroke might be a vascular di...

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Main Authors: Aynur Yılmaz Avcı, Münire Kılınç Toprak, Hatice Lakadamyalı, Sinan Akıncı
Format: Article
Language:English
Published: Galenos Yayinevi 2018-12-01
Series:Türk Nöroloji Dergisi
Subjects:
Online Access:http://tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-04468
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author Aynur Yılmaz Avcı
Münire Kılınç Toprak
Hatice Lakadamyalı
Sinan Akıncı
author_facet Aynur Yılmaz Avcı
Münire Kılınç Toprak
Hatice Lakadamyalı
Sinan Akıncı
author_sort Aynur Yılmaz Avcı
collection DOAJ
description Objective: Migraine is linked with an elevation in vascular risk factors, ischemic stroke, and a variety of constitutional brain lesions. However, the pathogenesis of this relationship is still inexplicit. The link between cardiac diseases and comorbid migraine-ischemic stroke might be a vascular disease involving both heart and brain. In this study, an association between mitral valve prolapse (MVP), migraine, and the presence of brain white matter hyperintensities (WMHs) were evaluated among adult subjects with migraine headache devoid of any traditional vascular risk factors. Materials and Methods: Four hundred subjects (200 subjects with migraine headache, 200 healthy controls; age range 18-50 years) were incorporated in the retrospective study. Existence of a headache compatible with migraine was diagnosed according to the International Headache Society-2 criteria. The participants were devoid of any known comorbid diseases, vascular risk factors or inflammatory diseases. All patients, both those with migraine and controls were screened with echocardiography to assess for MVP and with brain magnetic resonance imaging to evaluate the presence of any WMHs. Results: The prevalence of MVP was found to be higher in the migraine group (p<0.011). The odds ratio (OR) for the presence of MVP in patients with migraine compared with controls was 2.44 [95% confidence interval (CI): 1.25-4.74; p=0.0086]. The OR for the presence of WMHs in patients with migraine compared with controls was 5.88 (95% CI: 3.42-10.10; p<0.0001). After modifying for confounding factors, multiple linear regression analyses revealed that migraine was independently and positively associated with MVP (p=0.044), tricuspid regurgitation (p=0.003), and WMHs (p<0.001), and mitral regurgitation and migraine was independently and positively connected with WMHs (p<0.005 and p<0.001, respectively). Conclusion: MVP is found to be independently associated with migraine when compared with controls. Therefore, we suggest that MVP might have an association with migraine. Nevertheless, we could not demonstrate any correlation between MVP and WMHs. Hence, we suggest that MVP might not be involved in the evolution of WMHs in migraine.
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spelling doaj.art-96b641a63c394a519c1296306eb248a12023-02-15T16:21:10ZengGalenos YayineviTürk Nöroloji Dergisi1301-062X1309-25452018-12-0124432332910.4274/tnd.04468Association Between Mitral Valve Prolapse, Migraine, and White Matter Hyperintensities on Magnetic Resonance ImagingAynur Yılmaz Avcı0Münire Kılınç Toprak1Hatice Lakadamyalı2Sinan Akıncı3Baskent University Faculty of Medicine, Department of Neurology, Ankara, TurkeyBaskent University Faculty of Medicine, Department of Neurology, Ankara, TurkeyBaskent University Faculty of Medicine, Department of Radiology, Ankara, TurkeyBaskent University Faculty of Medicine, Department of Cardiology, Ankara, TurkeyObjective: Migraine is linked with an elevation in vascular risk factors, ischemic stroke, and a variety of constitutional brain lesions. However, the pathogenesis of this relationship is still inexplicit. The link between cardiac diseases and comorbid migraine-ischemic stroke might be a vascular disease involving both heart and brain. In this study, an association between mitral valve prolapse (MVP), migraine, and the presence of brain white matter hyperintensities (WMHs) were evaluated among adult subjects with migraine headache devoid of any traditional vascular risk factors. Materials and Methods: Four hundred subjects (200 subjects with migraine headache, 200 healthy controls; age range 18-50 years) were incorporated in the retrospective study. Existence of a headache compatible with migraine was diagnosed according to the International Headache Society-2 criteria. The participants were devoid of any known comorbid diseases, vascular risk factors or inflammatory diseases. All patients, both those with migraine and controls were screened with echocardiography to assess for MVP and with brain magnetic resonance imaging to evaluate the presence of any WMHs. Results: The prevalence of MVP was found to be higher in the migraine group (p<0.011). The odds ratio (OR) for the presence of MVP in patients with migraine compared with controls was 2.44 [95% confidence interval (CI): 1.25-4.74; p=0.0086]. The OR for the presence of WMHs in patients with migraine compared with controls was 5.88 (95% CI: 3.42-10.10; p<0.0001). After modifying for confounding factors, multiple linear regression analyses revealed that migraine was independently and positively associated with MVP (p=0.044), tricuspid regurgitation (p=0.003), and WMHs (p<0.001), and mitral regurgitation and migraine was independently and positively connected with WMHs (p<0.005 and p<0.001, respectively). Conclusion: MVP is found to be independently associated with migraine when compared with controls. Therefore, we suggest that MVP might have an association with migraine. Nevertheless, we could not demonstrate any correlation between MVP and WMHs. Hence, we suggest that MVP might not be involved in the evolution of WMHs in migraine.http://tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-04468Headachevascular riskcardiovascular riskmagnetic resonance imagingechocardiography
spellingShingle Aynur Yılmaz Avcı
Münire Kılınç Toprak
Hatice Lakadamyalı
Sinan Akıncı
Association Between Mitral Valve Prolapse, Migraine, and White Matter Hyperintensities on Magnetic Resonance Imaging
Türk Nöroloji Dergisi
Headache
vascular risk
cardiovascular risk
magnetic resonance imaging
echocardiography
title Association Between Mitral Valve Prolapse, Migraine, and White Matter Hyperintensities on Magnetic Resonance Imaging
title_full Association Between Mitral Valve Prolapse, Migraine, and White Matter Hyperintensities on Magnetic Resonance Imaging
title_fullStr Association Between Mitral Valve Prolapse, Migraine, and White Matter Hyperintensities on Magnetic Resonance Imaging
title_full_unstemmed Association Between Mitral Valve Prolapse, Migraine, and White Matter Hyperintensities on Magnetic Resonance Imaging
title_short Association Between Mitral Valve Prolapse, Migraine, and White Matter Hyperintensities on Magnetic Resonance Imaging
title_sort association between mitral valve prolapse migraine and white matter hyperintensities on magnetic resonance imaging
topic Headache
vascular risk
cardiovascular risk
magnetic resonance imaging
echocardiography
url http://tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-04468
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AT haticelakadamyalı associationbetweenmitralvalveprolapsemigraineandwhitematterhyperintensitiesonmagneticresonanceimaging
AT sinanakıncı associationbetweenmitralvalveprolapsemigraineandwhitematterhyperintensitiesonmagneticresonanceimaging