Migraine headache in middle age and late-life brain infarcts.
Migraine headache in middle age and late-life brain infarcts.
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DOI：
10.1001/jama.2009.932
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发表时间：
2009-06-24
影响因子：
120.7
通讯作者：
Launer, Lenore J.
中科院分区：
文献类型：
--
作者：
Scher, Ann I.;Gudmundsson, Larus S.;Sigurdsson, Sigurdur;Ghambaryan, Anna;Aspelund, Thor;Eiriksdottir, Gudny;van Buchem, Mark A.;Gudnason, Vilmundur;Launer, Lenore J.
偏头痛被认为是一种发作性疾病，没有长期后果。然而，最近的研究表明，偏头痛发作可能与大脑，特别是小脑的病理变化有关。为了确定与未报告症状的人相比，在中年报告偏头痛症状，特别是先兆偏头痛的个体是否具有增加的晚期梗死样病变（以下称为梗死）的风险。自1967年以来，一个基于人群的男性和女性队列（B 1907-35），回答了关于中年偏头痛症状的问题（平均年龄51岁，范围33-65），在获得脑MRI的晚年检查之前超过26年。那些每月报告头痛一次或多次的人被问及偏头痛症状，包括恶心，单侧位置，恐惧症，视觉障碍和麻木。我们将头痛患者分为无先兆偏头痛（MO）、有先兆偏头痛（MA）和非偏头痛。在两次检查中进行了全面的心血管风险评估。在冰岛雷克雅未克进行的基于人群的研究男性和女性（n= 4 689，57%为女性）。存在梗死-全部梗死和特定位于皮质、皮质下和小脑区域的梗死。在调整年龄、性别和随访时间后，与每月不报告头痛一次或多次的患者（n=3243）相比，中年MA患者（n=361）的晚期梗死风险增加（校正OR，1.4; 95%置信区间[CI]，1.1-1.8），特别反映了女性小脑病变的相关性（女性：23.0% vs. 14.5%，调整后OR 1.9; 95% CI 1.4-2.6 vs.男性：19.3% vs. 21.3%，调整后OR 1.0; 95% CI 0.6-1.8，性别相互作用p<0.04）。与中年MO或非偏头痛或其他大脑区域相关的风险没有增加。中年偏头痛伴先兆与晚年MRI小脑梗死患病率相关。这种关联仅在女性中具有统计学意义。这与中年MA与老年血管疾病相关的假设一致，后者似乎是小脑和女性特有的。
Migraine is considered to be an episodic condition with no long-term consequences. However, recent studies suggest that migraine attacks may be associated with pathologic changes in the brain, particularly in the cerebellum. To determine whether, compared to those not reporting symptoms, individuals reporting migraine symptoms in mid-life, particularly aura, are at increased risk of late-life infarct-like lesions (hereafter referred to as infarcts). A population based cohort of men and women (b 1907-35) followed since 1967, answered questions about migraine symptoms in mid-life (mean age 51, range 33–65), more than 26 years prior to a late-life exam when brain MRI was acquired. Those reporting headaches once or more per month were asked about migraine symptoms, including nausea, unilateral location, photophobia, visual disturbance, and numbness. We classified headache sufferers as having migraine without aura (MO), migraine with aura (MA), or non-migraine headache. A comprehensive cardiovascular risk assessment was performed at both examinations. Population-based study in Reykjavik, Iceland Men and women (n=4689, 57% women). Presence of infarcts – total and specifically located in the cortical, sub-cortical, and cerebellar regions. After adjusting for age, sex, and follow-up time, compared to those not reporting headaches once or more per month (n=3243), those with mid-life MA (n=361) had an increased risk of late-life infarcts (adjusted OR, 1.4; 95% confidence interval [CI], 1.1–1.8) that specifically reflected an association with cerebellar lesions in women (Women: 23.0% vs. 14.5%, adjusted OR 1.9; 95% CI 1.4–2.6 vs. Men 19.3% vs. 21.3%, adjusted OR, 1.0; 95% CI 0.6–1.8, p<0.04 for interaction by sex). There was no increased risk associated with mid-life MO or non-migraine headache or for other brain regions. Migraine with aura in mid-life was associated with late-life prevalence of cerebellar infarcts on MRI. This association was statistically significant only for women. This is consistent with the hypothesis that MA in mid-life is associated with late-life vascular disease that appears to be specific for the cerebellum and in women.
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MTHFR 677C> T多态性，偏头痛和心血管疾病之间的相互关系。
影响因子：
9.9
作者：
Schürks M;Zee RY;Buring JE;Kurth T
通讯作者：
Kurth T
影响因子：
120.7
作者：
Kurth, Tobias;Gaziano, J. Michael;Buring, Julie E.
通讯作者：
Buring, Julie E.
影响因子：
39.2
作者：
SIGURDSSON, E;THORGEIRSSON, G;SIGFUSSON, N
通讯作者：
SIGFUSSON, N
影响因子：
7.7
作者：
Qiu, Chengxuan;Cotch, Mary Frances;Lanner, Lenore J.
通讯作者：
Lanner, Lenore J.
影响因子：
11.2
作者：
Scher, AI;Terwindt, GM;Launer, LJ
通讯作者：
Launer, LJ