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Background <p>Women with migraine, especially with aura (MA), have a higher risk of white matter hyperintensities (WMH) and ischemic stroke. We aimed to assess differences in stroke etiology between women with and without migraine and the impact of migraine on WMH volume in women with stroke.</p> Methods <p>We included women aged 40–60 years with a history of ischemic stroke, migraine or both. Stroke etiology was categorized using the TOAST criteria. WMH volume was measured using 3D-FLAIR images. Presence or absence of cerebellar WMH was scored. We used regression analysis to assess differences between groups, with adjustments for age, BMI, hypertension and smoking status.</p> Results <p>We included 55 women with stroke, 55 with stroke and migraine, and 38 with MA. Women with stroke more often had a history of smoking than those with stroke and migraine (74% vs. 46%, <i>p</i> = 0.004). Stroke of undetermined origin was more common in women with both conditions than with stroke alone (49% vs. 27%, <i>p</i> = 0.019). Periventricular WMH volumes were higher in women with stroke with migraine than in those with MA alone (0.55mL vs. 0.42mL, B = 0.21, 95%CI = 0.01–0.41, <i>p</i> = 0.040). There were no differences in deep WMH volume and cerebellar WMH between groups. Importantly, the addition of migraine did not affect WMH volume in women who had experienced stroke.</p> Conclusion <p>Women with both stroke and migraine more often had undetermined etiology of stroke compared to women with stroke alone, and in women with stroke alone smoking was a more prevalent risk factor. Migraine did not contribute to increased WMH volume in women with stroke.</p>

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Stroke etiology and white matter burden in women with and without migraine

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  • 发表日期：

    2025年2月19日

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  • Anne E. Wilms,
  • Nelleke van der Weerd,
  • Thijs W. van Harten,
  • Katie M. Linstra,
  • Hendrikus J. A. van Os,
  • Irene de Boer,
  • Mark C. Kruit,
  • Antoinette Maassen van den Brink,
  • Marieke J. H. Wermer,
  • Gisela M. Terwindt,
  • Yolande Appelman,
  • Sara Baart,
  • Laura Benschop,
  • Eric Boersma,
  • Laura Brouwers,
  • Ricardo Budde,
  • Suzanne Cannegieter,
  • Veerle Dam,
  • Rene Eijkemans,
  • Bart Fauser,
  • Michel Ferrari,
  • Arie Franx,
  • Christianne de Groot,
  • Marlise Gunning,
  • Annemieke Hoek,
  • Erik Koffijberg,
  • Wendy Koster,
  • Giske Lagerweij,
  • Nils Lambalk,
  • Joop Laven,
  • Aad van der Lugt,
  • Angela Maas,
  • Cindy Meun,
  • Saskia Middeldorp,
  • Karel GM Moons,
  • Bas van Rijn,
  • Jeanine Roeters van Lennep,
  • Jolien Roos-Hesselink,
  • Luuk Scheres,
  • Yvonne T. van der Schouw,
  • Eric Steegers,
  • Regine Steegers,
  • Birgitta Velthuis,
  • Bart Zick,
  • Gerbrand Zoet

摘要

Background

Women with migraine, especially with aura (MA), have a higher risk of white matter hyperintensities (WMH) and ischemic stroke. We aimed to assess differences in stroke etiology between women with and without migraine and the impact of migraine on WMH volume in women with stroke.

Methods

We included women aged 40–60 years with a history of ischemic stroke, migraine or both. Stroke etiology was categorized using the TOAST criteria. WMH volume was measured using 3D-FLAIR images. Presence or absence of cerebellar WMH was scored. We used regression analysis to assess differences between groups, with adjustments for age, BMI, hypertension and smoking status.

Results

We included 55 women with stroke, 55 with stroke and migraine, and 38 with MA. Women with stroke more often had a history of smoking than those with stroke and migraine (74% vs. 46%, p = 0.004). Stroke of undetermined origin was more common in women with both conditions than with stroke alone (49% vs. 27%, p = 0.019). Periventricular WMH volumes were higher in women with stroke with migraine than in those with MA alone (0.55mL vs. 0.42mL, B = 0.21, 95%CI = 0.01–0.41, p = 0.040). There were no differences in deep WMH volume and cerebellar WMH between groups. Importantly, the addition of migraine did not affect WMH volume in women who had experienced stroke.

Conclusion

Women with both stroke and migraine more often had undetermined etiology of stroke compared to women with stroke alone, and in women with stroke alone smoking was a more prevalent risk factor. Migraine did not contribute to increased WMH volume in women with stroke.