History of Migraine and Volume of Brain Infarcts: The Italian Project on Stroke at Young Age (IPSYS)

Italian Project on Stroke in Young Adults (IPSYS) Investigators

Research output: Contribution to journalArticle

Abstract

Background and PURPOSE: Migraine has been shown to increase cerebral excitability, promote rapid infarct expansion into tissue with perfusion deficits, and result in larger infarcts in animal models of focal cerebral ischemia. Whether these effects occur in humans has never been properly investigated.

METHODS: In a series of consecutive patients with acute ischemic stroke, enrolled in the setting of the Italian Project on Stroke at Young Age, we assessed acute as well as chronic infarct volumes by volumetric magnetic resonance imaging, and compared these among different subgroups identified by migraine status.

RESULTS: A cohort of 591 patients (male, 53.8%; mean age, 37.5±6.4 years) qualified for the analysis. Migraineurs had larger acute infarcts than non-migraineurs (median, 5.9 cm3 [interquartile range (IQR), 1.4 to 15.5] vs. 2.6 cm3 [IQR, 0.8 to 10.1], P<0.001), and the largest volumes were observed in patients with migraine with aura (median, 9.0 cm3 [IQR, 3.4 to 16.6]). In a linear regression model, migraine was an independent predictor of increased log (acute infarct volumes) (median ratio [MR], 1.64; 95% confidence interval [CI], 1.22 to 2.20), an effect that was more prominent for migraine with aura (MR, 2.92; 95% CI, 1.88 to 4.54).

CONCLUSION: s These findings reinforce the experimental observation of larger acute cerebral infarcts in migraineurs, extend animal data to human disease, and support the hypothesis of increased vulnerability to ischemic brain injury in people suffering migraine.

Original languageEnglish
Pages (from-to)324-331
Number of pages8
JournalJournal of Stroke
Volume21
Issue number3
DOIs
Publication statusPublished - Sep 2019

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Migraine Disorders
Stroke
Migraine with Aura
Brain
Linear Models
Confidence Intervals
Tissue Expansion
Brain Ischemia
Brain Injuries
Animal Models
Perfusion
Magnetic Resonance Imaging
Observation

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History of Migraine and Volume of Brain Infarcts : The Italian Project on Stroke at Young Age (IPSYS). / Italian Project on Stroke in Young Adults (IPSYS) Investigators.

In: Journal of Stroke, Vol. 21, No. 3, 09.2019, p. 324-331.

Research output: Contribution to journalArticle

Italian Project on Stroke in Young Adults (IPSYS) Investigators 2019, 'History of Migraine and Volume of Brain Infarcts: The Italian Project on Stroke at Young Age (IPSYS)', Journal of Stroke, vol. 21, no. 3, pp. 324-331. https://doi.org/10.5853/jos.2019.00332
Italian Project on Stroke in Young Adults (IPSYS) Investigators. / History of Migraine and Volume of Brain Infarcts : The Italian Project on Stroke at Young Age (IPSYS). In: Journal of Stroke. 2019 ; Vol. 21, No. 3. pp. 324-331.
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abstract = "Background and PURPOSE: Migraine has been shown to increase cerebral excitability, promote rapid infarct expansion into tissue with perfusion deficits, and result in larger infarcts in animal models of focal cerebral ischemia. Whether these effects occur in humans has never been properly investigated.METHODS: In a series of consecutive patients with acute ischemic stroke, enrolled in the setting of the Italian Project on Stroke at Young Age, we assessed acute as well as chronic infarct volumes by volumetric magnetic resonance imaging, and compared these among different subgroups identified by migraine status.RESULTS: A cohort of 591 patients (male, 53.8{\%}; mean age, 37.5±6.4 years) qualified for the analysis. Migraineurs had larger acute infarcts than non-migraineurs (median, 5.9 cm3 [interquartile range (IQR), 1.4 to 15.5] vs. 2.6 cm3 [IQR, 0.8 to 10.1], P<0.001), and the largest volumes were observed in patients with migraine with aura (median, 9.0 cm3 [IQR, 3.4 to 16.6]). In a linear regression model, migraine was an independent predictor of increased log (acute infarct volumes) (median ratio [MR], 1.64; 95{\%} confidence interval [CI], 1.22 to 2.20), an effect that was more prominent for migraine with aura (MR, 2.92; 95{\%} CI, 1.88 to 4.54).CONCLUSION: s These findings reinforce the experimental observation of larger acute cerebral infarcts in migraineurs, extend animal data to human disease, and support the hypothesis of increased vulnerability to ischemic brain injury in people suffering migraine.",
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T1 - History of Migraine and Volume of Brain Infarcts

T2 - The Italian Project on Stroke at Young Age (IPSYS)

AU - Italian Project on Stroke in Young Adults (IPSYS) Investigators

AU - Giuli, Valeria De

AU - Besana, Michele

AU - Grassi, Mario

AU - Zedde, Marialuisa

AU - Zini, Andrea

AU - Lodigiani, Corrado

AU - Marcheselli, Simona

AU - Cavallini, Anna

AU - Micieli, Giuseppe

AU - Rasura, Maurizia

AU - DeLodovici, Maria Luisa

AU - Tomelleri, Giampaolo

AU - Checcarelli, Nicoletta

AU - Chiti, Alberto

AU - Giorli, Elisa

AU - Sette, Massimo Del

AU - Tancredi, Lucia

AU - Toriello, Antonella

AU - Braga, Massimiliano

AU - Morotti, Andrea

AU - Poli, Loris

AU - Caria, Filomena

AU - Gamba, Massimo

AU - Patella, Rosalba

AU - Spalloni, Alessandra

AU - Simone, Anna Maria

AU - Pascarella, Rosario

AU - Beretta, Sandro

AU - Fainardi, Enrico

AU - Padovani, Alessandro

AU - Gasparotti, Roberto

AU - Pezzini, Alessandro

PY - 2019/9

Y1 - 2019/9

N2 - Background and PURPOSE: Migraine has been shown to increase cerebral excitability, promote rapid infarct expansion into tissue with perfusion deficits, and result in larger infarcts in animal models of focal cerebral ischemia. Whether these effects occur in humans has never been properly investigated.METHODS: In a series of consecutive patients with acute ischemic stroke, enrolled in the setting of the Italian Project on Stroke at Young Age, we assessed acute as well as chronic infarct volumes by volumetric magnetic resonance imaging, and compared these among different subgroups identified by migraine status.RESULTS: A cohort of 591 patients (male, 53.8%; mean age, 37.5±6.4 years) qualified for the analysis. Migraineurs had larger acute infarcts than non-migraineurs (median, 5.9 cm3 [interquartile range (IQR), 1.4 to 15.5] vs. 2.6 cm3 [IQR, 0.8 to 10.1], P<0.001), and the largest volumes were observed in patients with migraine with aura (median, 9.0 cm3 [IQR, 3.4 to 16.6]). In a linear regression model, migraine was an independent predictor of increased log (acute infarct volumes) (median ratio [MR], 1.64; 95% confidence interval [CI], 1.22 to 2.20), an effect that was more prominent for migraine with aura (MR, 2.92; 95% CI, 1.88 to 4.54).CONCLUSION: s These findings reinforce the experimental observation of larger acute cerebral infarcts in migraineurs, extend animal data to human disease, and support the hypothesis of increased vulnerability to ischemic brain injury in people suffering migraine.

AB - Background and PURPOSE: Migraine has been shown to increase cerebral excitability, promote rapid infarct expansion into tissue with perfusion deficits, and result in larger infarcts in animal models of focal cerebral ischemia. Whether these effects occur in humans has never been properly investigated.METHODS: In a series of consecutive patients with acute ischemic stroke, enrolled in the setting of the Italian Project on Stroke at Young Age, we assessed acute as well as chronic infarct volumes by volumetric magnetic resonance imaging, and compared these among different subgroups identified by migraine status.RESULTS: A cohort of 591 patients (male, 53.8%; mean age, 37.5±6.4 years) qualified for the analysis. Migraineurs had larger acute infarcts than non-migraineurs (median, 5.9 cm3 [interquartile range (IQR), 1.4 to 15.5] vs. 2.6 cm3 [IQR, 0.8 to 10.1], P<0.001), and the largest volumes were observed in patients with migraine with aura (median, 9.0 cm3 [IQR, 3.4 to 16.6]). In a linear regression model, migraine was an independent predictor of increased log (acute infarct volumes) (median ratio [MR], 1.64; 95% confidence interval [CI], 1.22 to 2.20), an effect that was more prominent for migraine with aura (MR, 2.92; 95% CI, 1.88 to 4.54).CONCLUSION: s These findings reinforce the experimental observation of larger acute cerebral infarcts in migraineurs, extend animal data to human disease, and support the hypothesis of increased vulnerability to ischemic brain injury in people suffering migraine.

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DO - 10.5853/jos.2019.00332

M3 - Article

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VL - 21

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JO - Journal of Stroke

JF - Journal of Stroke

SN - 2287-6391

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ER -