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Volume : 24 Issue : 3 Year : 2018

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Association between mitral valve prolapse, migraine and white matter hyperintensities on magnetic resonance imaging [Turk J Neurol]
Turk J Neurol. Ahead of Print: TJN-04468

Association between mitral valve prolapse, migraine and white matter hyperintensities on magnetic resonance imaging

Aynur Yılmaz Avcı1, Münire Kılınç Toprak1, Hatice Lakadamyalı2, Sinan Akıncı3
1Department of Neurology, Baskent University Faculty of Medicine, Ankara, Turkey
2Department of Radiology, Baskent University Faculty of Medicine, Ankara, Turkey
3Department of Cardiology, Baskent University Faculty of Medicine, Ankara, Turkey

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 presence of brain white matter hyperintensities were evaluated among adult subjects with migraine headache devoid of any traditional vascular risk factors.
Materials and Methods: This retrospective study included 400 subjects (200 adults with migraine headache, 200 healthy controls; age range 18–50 years). Presence of headache compatible with migraine was diagnosed according to the International Headache Society II criteria. The participants had no known vascular risk factors, inflammatory diseases, or comorbid diseases. Both the patients with migraine and controls were screened with echocardiography to detect MVP and magnetic resonance imaging of the brain to detect WMHs.
Results: The prevalence of MVP was found to be higher in migraine group (P<0.011). The odds ratio (OR) for the presence of MVP in patients with migraine -compared to 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 to 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), while 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 suggested that MVP might have an association with migraine. Nevertheless we could not demonstrate any correlation between MVP and WMHs. Hence, we suggested that MVP might not be involved in the evolution of WMHs in migraine.

Keywords: Headache, vascular risk, cardiovascular risk, magnetic resonance imaging, echocardiography.




Corresponding Author: Aynur Yılmaz Avcı, Türkiye


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