Small Demyelination of the Cortex May Be a Potential Marker for the Right-to-Left Shunt of the Heart
Migraine is a common clinical primary headache with unclear aetiology. In recent years, studies have shown that migraine is related to right-to-left shunts (RLS), and some patients with migraine have white matter lesions. However, the relationship among the three is unclear. To explore the character...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/12/7/884 |
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| author | Junyan Huo Mengxia Wan Nan Li Juan Wang Xiao Cai Dongsheng Fan Yu Fu |
| author_facet | Junyan Huo Mengxia Wan Nan Li Juan Wang Xiao Cai Dongsheng Fan Yu Fu |
| author_sort | Junyan Huo |
| collection | DOAJ |
| description | Migraine is a common clinical primary headache with unclear aetiology. In recent years, studies have shown that migraine is related to right-to-left shunts (RLS), and some patients with migraine have white matter lesions. However, the relationship among the three is unclear. To explore the characteristics of white matter lesions (WMLs) in migraine patients with right-to-left shunts and to predict the presence of right-to-left shunts through magnetic resonance imaging (MRI) characteristics in patients with migraine, we conducted a retrospective study. We enrolled 214 patients who were diagnosed with migraines in an outpatient clinic from January 2019 to December 2021. All of them had completed contrast transcranial Doppler ultrasound (cTCD) and magnetic resonance imaging (MRI) examination. Through the inclusion and exclusion criteria, 201 patients were finally included. The patients were grouped according to the presence of WMLs and were compared by age, sex, hypertension, diabetes, RLS, and other characteristic data. We observed the MRI fluid attenuation inversion recovery sequence (FLAIR) image and compared the differences in WMLs between the RLS-positive group and the RLS-negative group. There were 71 cases and 130 cases of migraine with and without WMLs, respectively. A statistically significant difference in near-cortical WMLs with RLS in migraine patients was observed (<i>p</i> = 0.007). Logistic regression analysis was adjusted by age, sex, duration of migraine, and severity. Migraine with aura and family history identified the RLS status as the sole determinant for the presence of near-cortical WMLs (OR = 2.69; 95%CI 1.386–5.219; <i>p</i> = 0.003). Near-cortical white matter lesions in migraine patients are related to RLS, especially in the blood supply area of the anterior cerebral artery. This small demyelination of the near-cortical WMLs may be a potential marker for the right-to-left shunt of the heart. Transcranial Doppler ultrasonography may help finding more RLS in migraineurs with near-cortical WMLs. |
| first_indexed | 2024-03-09T03:38:48Z |
| format | Article |
| id | doaj.art-ca721f2d00b44cd78c85b3bbd842da8b |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-09T03:38:48Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-ca721f2d00b44cd78c85b3bbd842da8b2023-12-03T14:45:07ZengMDPI AGBrain Sciences2076-34252022-07-0112788410.3390/brainsci12070884Small Demyelination of the Cortex May Be a Potential Marker for the Right-to-Left Shunt of the HeartJunyan Huo0Mengxia Wan1Nan Li2Juan Wang3Xiao Cai4Dongsheng Fan5Yu Fu6Department of Neurology, Peking University Third Hospital, Beijing 100191, ChinaDepartment of Neurology, Peking University Third Hospital, Beijing 100191, ChinaResearch Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, ChinaDepartment of Neurology, Peking University Third Hospital, Beijing 100191, ChinaDepartment of Neurology, Peking University Third Hospital, Beijing 100191, ChinaDepartment of Neurology, Peking University Third Hospital, Beijing 100191, ChinaDepartment of Neurology, Peking University Third Hospital, Beijing 100191, ChinaMigraine is a common clinical primary headache with unclear aetiology. In recent years, studies have shown that migraine is related to right-to-left shunts (RLS), and some patients with migraine have white matter lesions. However, the relationship among the three is unclear. To explore the characteristics of white matter lesions (WMLs) in migraine patients with right-to-left shunts and to predict the presence of right-to-left shunts through magnetic resonance imaging (MRI) characteristics in patients with migraine, we conducted a retrospective study. We enrolled 214 patients who were diagnosed with migraines in an outpatient clinic from January 2019 to December 2021. All of them had completed contrast transcranial Doppler ultrasound (cTCD) and magnetic resonance imaging (MRI) examination. Through the inclusion and exclusion criteria, 201 patients were finally included. The patients were grouped according to the presence of WMLs and were compared by age, sex, hypertension, diabetes, RLS, and other characteristic data. We observed the MRI fluid attenuation inversion recovery sequence (FLAIR) image and compared the differences in WMLs between the RLS-positive group and the RLS-negative group. There were 71 cases and 130 cases of migraine with and without WMLs, respectively. A statistically significant difference in near-cortical WMLs with RLS in migraine patients was observed (<i>p</i> = 0.007). Logistic regression analysis was adjusted by age, sex, duration of migraine, and severity. Migraine with aura and family history identified the RLS status as the sole determinant for the presence of near-cortical WMLs (OR = 2.69; 95%CI 1.386–5.219; <i>p</i> = 0.003). Near-cortical white matter lesions in migraine patients are related to RLS, especially in the blood supply area of the anterior cerebral artery. This small demyelination of the near-cortical WMLs may be a potential marker for the right-to-left shunt of the heart. Transcranial Doppler ultrasonography may help finding more RLS in migraineurs with near-cortical WMLs.https://www.mdpi.com/2076-3425/12/7/884migrainewhite matter lesionsright-to-left shunts |
| spellingShingle | Junyan Huo Mengxia Wan Nan Li Juan Wang Xiao Cai Dongsheng Fan Yu Fu Small Demyelination of the Cortex May Be a Potential Marker for the Right-to-Left Shunt of the Heart Brain Sciences migraine white matter lesions right-to-left shunts |
| title | Small Demyelination of the Cortex May Be a Potential Marker for the Right-to-Left Shunt of the Heart |
| title_full | Small Demyelination of the Cortex May Be a Potential Marker for the Right-to-Left Shunt of the Heart |
| title_fullStr | Small Demyelination of the Cortex May Be a Potential Marker for the Right-to-Left Shunt of the Heart |
| title_full_unstemmed | Small Demyelination of the Cortex May Be a Potential Marker for the Right-to-Left Shunt of the Heart |
| title_short | Small Demyelination of the Cortex May Be a Potential Marker for the Right-to-Left Shunt of the Heart |
| title_sort | small demyelination of the cortex may be a potential marker for the right to left shunt of the heart |
| topic | migraine white matter lesions right-to-left shunts |
| url | https://www.mdpi.com/2076-3425/12/7/884 |
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