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 language | English |
|---|---|
| Pages (from-to) | 324-331 |
| Number of pages | 8 |
| Journal | Journal of Stroke |
| Volume | 21 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Sep 2019 |
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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 journal › Article
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TY - JOUR
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.
U2 - 10.5853/jos.2019.00332
DO - 10.5853/jos.2019.00332
M3 - Article
C2 - 31590476
VL - 21
SP - 324
EP - 331
JO - Journal of Stroke
JF - Journal of Stroke
SN - 2287-6391
IS - 3
ER -