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Neurology. 2013 Oct 8;81(15):1308-13. doi: 10.1212/WNL.0b013e3182a8235b. Epub 2013 Aug 23.

Migraine and white matter hyperintensities: the ARIC MRI study.

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From the Department of Neurology (A.G.H., B.L.P., R.F.G.), Johns Hopkins School of Medicine, Baltimore; Department of Epidemiology (A.G.H., R.F.G.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Epidemiology (K.M.R.), Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Department of Medicine-Geriatrics (T.H.M.), University of Mississippi Medical Center, Jackson, MS; Department of Social Sciences and Health Policy (L.H.C.), Division of Public Health Services, Wake Forest School of Medicine, Winston-Salem, NC; Departments of Radiology (C.R.J.) and Neurology (D.S.K.), Mayo Clinic, Rochester, MN; and Division of Epidemiology and Community Health (A.A.), School of Public Health, University of Minnesota, St. Paul.



Migraine is associated with white matter hyperintensities (WMH) cross-sectionally, but its effect on WMH progression is uncertain.


Participants in the Atherosclerosis Risk in Communities cohort study (n = 10,924) completed a standardized headache questionnaire between 1993 and 1995. A subset of participants (n = 1,028) received 2 MRIs 8 to 12 years apart: once at the time of headache ascertainment, and again from 2004 to 2006. WMH were quantified using both a visually graded score (0-9) and semiautomated volumetric analysis. Linear and logistic regression models adjusted for age, sex, and other vascular risk factors were constructed.


Individuals who had migraine without aura were cross-sectionally associated with an 87% greater odds of having a WMH score ≥3 than individuals without headache (adjusted odds ratio = 1.87; 95% confidence interval [CI]: 1.04, 3.37). Participants with migraine had an average of 2.65 cm(3) more WMH than those without headache (95% CI: 0.06, 5.24). However, there was no significant difference in WMH progression over the study period between individuals with and without migraine (1.58 cm(3) more progression for individuals with migraine compared to those without; 95% CI: -0.37, 3.53).


Migraine is associated with WMH volume cross-sectionally but not with WMH progression over time. This suggests that the association between migraine and WMH is stable in older age and may be primarily attributable to changes occurring earlier in life, although further work is needed to confirm these findings.

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