Notable comments from the authors:
- "These results suggest that patients with migraine from the general population are at increased risk of subclinical cerebellar PCT infarcts and that the risk increases with increasing attack frequency. Patients with migraine with aura and a high attack frequency are at greatest risk. In addition, women, but not men, with migraine with and without aura are at increased risk of high DWML (dense white matter lesion) load, and this risk also increases with increasing attack frequency."1
- "Our study confirms the vulnerability of the PCT, especially for the cerebellum in migraine patients with aura."3
- "Several hemodynamic features of migraine may contribute to the pathogenesis of both WMLs and infarcts in migraine. Repeated or prolonged reduced perfusion pressure, reduced blood flow, and oligemia in large and/or small arteries, combined with activation of the clotting system or vasoconstriction, possibly mediated or induced by endothelium perturbation (endothelin 1) could lead to arterial or venous (micro) embolism, thrombosis, or ischemia. Dehydration during migraine attacks might contribute to formation of local thromboses. It is also possible that local changes during migraine attacks, such as excessive neuronal activation, neurogenic inflammation, neuropeptide and cytokine release, or excitotoxity, directly lead to tissue damage. Cardiac abnormalities, such as patent foramen ovale or mitral valve prolapse, might also increase the risk of ischemic brain changes in patients with migraine."1
Worthy of special notice:
If one paragraph of the JAMA article speaks to the importance of such research and the need for continuing research, it is the paragraph quoted below.
"MAGNUM has long held that Migraine Disease is a major public health issue," commented MAGNUM Executive Director Michael John Coleman. He "was encouraged by publication of the Dutch study as the authors addressed many concerns about biases and problems in the methodology of past studies of Migraine and stroke. The current JAMA article powerfully demonstrates the importance of such needed research and expanding the scientific dialogue on Migraine disease research." The study makes his his and my point very proficiently as follows.
