Migraines, Brain Lesions: New Links Seen

June 23, 2009 -- Women who experience migraine headaches with aura may be more likely to develop brain lesions when they are older, according to a new study.

Researchers say the results add to a growing number of studies that suggest migraines may be more than a transient condition and may cause long-term damage in the form of cell death and lesions in the brain over time.

Migraine headaches are a common problem, affecting about 11% of adults and three to four times as many women than men. About one-third of those who suffer the painful headaches experience aura -- visual or sensory disturbances just prior to the migraine.

The study, published in TheJournal of the American Medical Association, looked at the association between midlife migraines and brain lesions later in life among 4,689 men and women in Iceland who have been followed since 1967. The participants were interviewed about migraine symptoms in midlife and received brain scans 26 years later.

Brain lesions were found in 39% of men and 25% of women. After adjusting for other risk factors, such as age, heart disease, and stroke risk, researchers found that women who had migraines with aura during midlife were more likely to have brain lesions in the cerebellum part of the brain. Twenty-three percent of women with migraine with aura had these types of brain lesions, compared with 15% of women without headaches.

There was no such association between migraine with aura and brain lesions in men.

Researcher Ann I. Scher, PhD, of Uniformed Services University in Bethesda, Md. and colleagues say further long-term studies are needed to better establish this relationship between migraine with aura and brain lesions and determine the mechanism behind the link.

An editorial that accompanies the study also urges caution in interpreting these results.

"It is premature to conclude that migraine has hazardous effects on the brain," write Tobias Kurth, MD, ScD, of the University Pierre et Marie Curie in Paris and Christophe Tzourio, MD, PhD, of the University Pierre et Marie Curie and Harvard School of Public Health, Boston in the editorial.

"However," the editorial notes, "the study raises important questions. New studies examining the association of migraine with structural brain changes and brain function should improve understanding of the associations and perhaps further unveil migraine-specific mechanisms."