According to a study by researchers, middle-aged women who had migraine headaches with neurological aura (sensory disturbances, such as with vision, balance or speech) had a higher prevalence of damage to brain tissue when they were older compared to individuals without similar types of headaches.

The researchers found that women are more susceptible than men to localized brain tissue damage identified on magnetic resonance images (MRI) and that women who reported having migraines with aura were almost twice as likely to have such damage in the cerebellum as women who reported not having headaches. The cerebellum is located in the lower back side of the brain and is involved in functions such as motor activity, balance and cognition.

The researchers noted that while the study shows an association in women between migraine and cerebellar tissue damage later in life, the functional significance of such brain changes remains an open question.

Migraine is a common neurovascular disorder that affects approximately 11 percent of adults and occurs more commonly in women. Migraine is often accompanied by extreme sensitivity to light and sound, nausea and vomiting. Approximately one-third of individuals with migraine experience neurological aura symptoms before headache onset (migraine with aura). Migraine is considered to be an episodic condition with no long-term consequences. However, recent studies suggest that migraine attacks may be associated with brain lesions identified on magnetic resonance imaging (MRI), particularly in the cerebellum.

The researchers examined the relationship of midlife migraine symptoms and late-life infarct (tissue death)-like lesions evident on MRI. The study included 4,689 men and women in Reykjavik, Iceland (born between 1907-1935; 57 percent women) who were followed-up since 1967, examined, and interviewed about migraine symptoms in midlife (average age, 51 years; range, 33-65 years).

Between 2002 and 2006, more than 26 years later, brain MRIs were performed. Participants reporting headaches once or more per month were asked about migraine symptoms and were classified as having migraine without aura, migraine with aura, or non migraine headache. A comprehensive cardiovascular risk assessment was performed at examinations. Infarct-like lesions were present on MRI in 39.3 percent of men and 24.6 percent of women.

After adjusting for age, sex, and follow-up time, participants with midlife migraine with aura were at increased risk for total infarct-like lesions. Lesions in the cerebellum, but not in other locations of the brain, were more prevalent in women with migraine with aura compared with women without headache (23 percent vs. 15 percent); there was no difference in prevalence for men (19 percent vs. 21 percent).

The relationship between migraine with aura and cerebellar infarcts was only significant in women, but was not statistically different by the age at which headache symptoms were assessed. Migraine without aura and non migraine headache were not associated with an increased risk of lesions. The clinical significance of the infarct-like lesions, such as whether the individuals with them had any symptoms, was not assessed.

"In summary, this study suggests that a remote history of migraine with aura is associated with brain lesions commonly found in older populations. Results persisted after controlling for cardiovascular risk factors and history of cardiovascular disease, thus suggesting that the mechanism linking the migraine aura with these lesions is independent of the usual risk factors for ischemic vascular disease and may be specifically related to migraine with aura. Additional longitudinal studies with repeated MRIs are needed to better establish the temporality and dose-response relationship between migraine with aura and brain infarcts. Finally, the clinical implications of the infarct-like lesions identified have not been established and will require investigation," the authors write.
References:
1. Scher, Ann I., et al., Migraine Headache in Middle Age and Late-Life Brain Infarcts. Journal of the American Medical Association, June 24, 2009—Vol. 301, No. 24, 2563–2570.