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White Matter Lesions Does Not Affect Cortical Thickness or Volume

David Bai, PharmD
Results from a recent study showed that only age affects cortical thickness or volume, and intracranial volume affects cortical volume in migraine.
Results from a recent study showed that white matter lesions and clinical migraine characteristics have no effect on cortical thickness and volume of bilateral lobes. Instead, only age affects cortical thickness or volume and only intracranial volume affects cortical volume.

Migraine is a neurological disorder that affects the structure and functional aspects of the cerebral cortex. Some patients with migraine have intracerebral white matter lesions (WMLs) caused from cortical changes because of the migraine attacks. Although WMLs are likely to be microvascular, the effects that they exert on cortical thickness and volume is relatively unknown. In a recent study, investigators assessed patients with migraines with or without WMLs to compare potential cortical thickness and volume differences between them.

During a recruitment period of 7 years, investigators enrolled 161 female patients. Gender similarity was used to exclude any gender-related differences, such as longer headache duration and higher intensity of attacks. Forty healthy patients were also included as a control group. Patients with WMLs were significantly older than patients without WMLs (P = .0003) and patients who were healthy (P = .018). Total number of migraine attacks, disease duration, and rate of aura were also significantly higher in the WMLs group compared with the group without the lesions.

Among the groups, left and right sided lobular and insular volumes and thickness were not significantly different. Cortical thickness and volume for the frontal, parietal, temporal, occipital, and insular were all not statistically different among the 3 groups.

Although the presence of lesions did not significantly affect cortical thickness and volume, patient age did. Age had a significant negative association with both thickness and volume for each of the 5 regions (P < .001). In contrast, intracranial volume had a positive association with cortical volume. Intracranial volume only affected cortical volume, and not thickness (P < .001). There were no significant interactions between group with age, group with intracranial volume, or age with intracranial volume. 

From this female migraine group, investigators found that neither lesions nor any other clinical characteristics affected cortical thickness or volume. For each region, cortical thickness and volume were practically equivalent and within the predefined relevant limit of ±0.1mm. Only age was shown to be a significant predictor of cortical thickness and volume, and intracranial volume for cortical volume.


Komáromy H, He M, Perlaki G. Influence of hemispheric white matter lesions and migraine characteristics on cortical thickness and volume. J Headache Pain. 2019;20(1):4. doi: 10.1186/s10194-019-0959-2.

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