The Characteristics of White Matter Hyperintensities in Patients With Migraine

2021 ◽  
Author(s):  
Catherine Chong ◽  
Todd J Schwedt ◽  
Meesha Trivedi ◽  
Brian W Chong
Keyword(s):  
White Matter ◽  
Basal Ganglia ◽  
White Matter Hyperintensities ◽  
Rating Scale ◽  
Right Hemisphere ◽  
Brain Magnetic Resonance Imaging ◽  
Brain Regions ◽  
Visual Rating ◽  
Radiology Reports ◽  
Visual Rating Scale

Abstract BackgroundThe presence of white matter hyperintensities (WMH) in migraine is well-documented, but the location of brain WMH in patients with migraine are insufficiently researched. Although recent semi-automatic software packages have been developed for calculating WMH, visual inspection remains the gold standard for measuring WMH. The goal of this study was to assess WMH in patients with migraine using a modified version of the Scheltens visual rating scale, a semiquantitative scale for categorizing WMH in the following brain regions: periventricular, lobar (frontal, temporal, parietal, occipital), basal ganglia, and infratentorial regions.Methods263 patients with migraine (31 male/232 female; mean age: 48.0) who were enrolled in the American Registry for Migraine Research from Mayo Clinic with a diagnosis of episodic (n = 46; 17.5%) or chronic migraine (n = 217; 82.5%) and who had brain magnetic resonance imaging were included in this study. Those with imaging evidence for gross anatomical abnormalities other than WMH were excluded. WMH were identified on axial T2 and FLAIR sequences by a board certified neuroradiologist. WMH were characterized via manual inspection and categorized according to the scale’s criteria.Results95 patients (36.1 %: mean age: 41.8) had no WMH on axial T2 and FLAIR imaging and 168 patients (63.9%, mean age: 51.4) had WMH. Of those with WMH, 94.1% (n = 158) had lobar hyperintensities (frontal: 148/158, 93.7%; parietal: 57/158, 36.1%; temporal: 35/158, 22.1%; occipital: 9/158, 5.7%), 13/168, 7.7% had basal ganglia WMH, 49/168, 29.1% had periventricular WMH, and 17/168, 10.1% had infratentorial WMH. 101/168 patients (60.1%) had bilateral WMH and 67/168 (39.9%) had unilateral WMH (34 right hemisphere /33 left hemisphere). 30.0% of patients with WMH did not have WMH reported in their clinical radiology reports.DiscussionNearly 2/3 of patients with migraine had WMH. They were most common in the lobar regions, specifically in the frontal lobe. The categorization of WMH in migraine using the modified Scheltens visual rating scale could help in future studies to clarify the relationship between WMH and headache features and might be a useful method for developing classifiers that differentiate between migraine-specific WMH and other causes of WMH.

scholarly journals A New Visual Rating Scale to Assess Strategic White Matter Hyperintensities Within Cholinergic Pathways in Dementia

Stroke ◽  
2005 ◽  
Vol 36 (10) ◽  
pp. 2126-2131 ◽  
Author(s):  
Christian Bocti ◽  
Richard H. Swartz ◽  
Fu-Qiang Gao ◽  
Demetrios J. Sahlas ◽  
Pearl Behl ◽  
...  
Keyword(s):  
White Matter ◽  
White Matter Hyperintensities ◽  
Rating Scale ◽  
Visual Rating ◽  
Cholinergic Pathways ◽  
Visual Rating Scale

scholarly journals Fronto-striatal atrophy correlates of neuropsychiatric dysfunction in frontotemporal dementia (FTD) and Alzheimer's disease (AD)

2013 ◽  
Vol 7 (1) ◽  
pp. 75-82 ◽  
Author(s):  
Dong Seok Yi ◽  
Maxime Bertoux ◽  
Eneida Mioshi ◽  
John R. Hodges ◽  
Michael Hornberger
Keyword(s):  
Frontotemporal Dementia ◽  
Rating Scale ◽  
Brain Regions ◽  
Abnormal Behaviour ◽  
Behavioural Symptoms ◽  
Visual Rating ◽  
Prefrontal Cortical ◽  
Mri Scans ◽  
Visual Rating Scale ◽  
Cortical Regions

ABSTRACT Behavioural disturbances in frontotemporal dementia (FTD) are thought to reflect mainly atrophy of cortical regions. Recent studies suggest that subcortical brain regions, in particular the striatum, are also significantly affected and this pathology might play a role in the generation of behavioural symptoms. Objective: To investigate prefrontal cortical and striatal atrophy contributions to behavioural symptoms in FTD. Methods: One hundred and eighty-two participants (87 FTD patients, 39 AD patients and 56 controls) were included. Behavioural profiles were established using the Cambridge Behavioural Inventory Revised (CBI-R) and Frontal System Behaviour Scale (FrSBe). Atrophy in prefrontal (VMPFC, DLPFC) and striatal (caudate, putamen) regions was established via a 5-point visual rating scale of the MRI scans. Behavioural scores were correlated with atrophy rating scores. Results: Behavioural and atrophy ratings demonstrated that patients were significantly impaired compared to controls, with bvFTD being most severely affected. Behavioural-anatomical correlations revealed that VMPFC atrophy was closely related to abnormal behaviour and motivation disturbances. Stereotypical behaviours were associated with both VMPFC and striatal atrophy. By contrast, disturbance of eating was found to be related to striatal atrophy only. Conclusion: Frontal and striatal atrophy contributed to the behavioural disturbances seen in FTD, with some behaviours related to frontal, striatal or combined fronto-striatal pathology. Consideration of striatal contributions to the generation of behavioural disturbances should be taken into account when assessing patients with potential FTD.

scholarly journals White Matter Hyperintensities Predict Cognitive Decline: A Community-Based Study

2019 ◽  
Vol 46 (04) ◽  
pp. 383-388 ◽  
Author(s):  
Xuemei Qi ◽  
Huidong Tang ◽  
Qi Luo ◽  
Bei Ding ◽  
Jie Chen ◽  
...  
Keyword(s):  
White Matter ◽  
Cognitive Decline ◽  
White Matter Hyperintensities ◽  
Smoking Status ◽  
Brain Magnetic Resonance Imaging ◽  
The Elderly ◽  
Brain Regions ◽  
Cholinergic Pathways ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri

ABSTRACT:Introduction: White matter hyperintensities (WMHs) were commonly seen in brain magnetic resonance imaging (MRI) of the elderly. Many studies found that WMHs were associated with cognitive decline and dementia. However, the association between WMHs in different brain regions and cognitive decline remains debated. Methods: We explored the association of the severity of WMHs and cognitive decline in 115 non-demented elderly (≥50 years old) sampled from the Wuliqiao Community located in urban area of Shanghai. MRI scans were done during 2009–2011 at the beginning of the study. Severity of WMHs in different brain regions was scored by Improved Scheltens Scale and Cholinergic Pathways Hyperintensities Scale (CHIPS). Cognitive function was evaluated by Mini-Mental State Examination (MMSE) every 2 to 4 years during 2009–2018. Results: After adjusting for confounding factors including age, gender, education level, smoking status, alcohol consumption, depression, hypertension, diabetes, hyperlipidemia, brain infarcts, brain atrophy, apoE4 status, and baseline MMSE score, periventricular and subcortical WMH lesions as well as WMHs in cholinergic pathways were significantly associated with annual MMSE decline ( p < 0.05), in which the severity of periventricular WMHs predicted a faster MMSE decline (–0.187 points/year, 95% confidence interval: –0.349, –0.026, p = 0.024). Conclusions: The severity of WMHs at baseline was associated with cognitive decline in the non-demented elderly over time. Interventions on WMH lesions may offer some benefits for cognitive deterioration.

scholarly journals Are Apathy and Depressive Symptoms Related to Vascular White Matter Hyperintensities in Severe Late Life Depression?

2020 ◽  
Vol 34 (1) ◽  
pp. 21-28 ◽  
Author(s):  
Mardien Leoniek Oudega ◽  
Amna Siddiqui ◽  
Mike P. Wattjes ◽  
Frederik Barkhof ◽  
Mara ten Kate ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
White Matter ◽  
Older Patients ◽  
White Matter Hyperintensities ◽  
Rating Scale ◽  
Brain Magnetic Resonance Imaging ◽  
Late Life ◽  
Late Life Depression ◽  
Symptom Profile ◽  
Interest And Motivation

Objective: Apathy symptoms are defined as a lack of interest and motivation. Patients with late-life depression (LLD) also suffer from lack of interest and motivation and previous studies have linked apathy to vascular white matter hyperintensities (WMH) of the brain in depressed and nondepressed patients. The aim of this study was to investigate the relationship between apathy symptoms, depressive symptoms, and WMH in LLD. We hypothesize that late-onset depression (LOD; first episode of depression after 55 years of age) is associated with WMH and apathy symptoms. Methods: Apathy scores were collected for 87 inpatients diagnosed with LLD. Eighty patients underwent brain magnetic resonance imaging. Associations between depressive and apathy symptoms and WMH were analyzed using linear regression. Results: All 3 subdomains of the 10-item Montgomery–Åsberg Depression Rating Scale correlated significantly with the apathy scale score (all P < .05). In the total sample, apathy nor depressive symptoms were related to specific WMH. In LOD only, periventricular WMH were associated with depression severity (β = 5.21, P = .04), while WMH in the left infratentorial region were associated with apathy symptoms (β coefficient = 5.89, P = .03). Conclusion: Apathy and depressive symptoms are highly overlapping in the current cohort of older patients with severe LLD, leading to the hypothesis that apathy symptoms are part of depressive symptoms in the symptom profile of older patients with severe LLD. Neither apathy nor depressive symptoms were related to WMH, suggesting that radiological markers of cerebrovascular disease, such as WMH, may not be useful in predicting these symptoms in severe LLD.

A New Visual Rating Scale for White Matter Low Attenuation on CT

2001 ◽  
Vol 45 (3) ◽  
pp. 140-144 ◽  
Author(s):  
H.K. Mendes Ribeiro ◽  
L.P.D. Barnetson ◽  
E. Hogervorst ◽  
A.J. Molyneux
Keyword(s):  
White Matter ◽  
Rating Scale ◽  
Visual Rating ◽  
Visual Rating Scale

Tracing Toothache Intensity in the Brain

2011 ◽  
Vol 91 (2) ◽  
pp. 156-160 ◽  
Author(s):  
M. Brügger ◽  
K. Lutz ◽  
B. Brönnimann ◽  
M.L. Meier ◽  
R. Luechinger ◽  
...  
Keyword(s):  
Rating Scale ◽  
Brain Regions ◽  
Magnetic Resonance Images ◽  
Canine Tooth ◽  
Visual Rating ◽  
Cortical Responses ◽  
Visual Rating Scale ◽  
Study Participants ◽  
The Brain ◽  
Linear Correlations

Identification of brain regions that differentially respond to pain intensity may improve our understanding of trigeminally mediated nociception. This report analyzed cortical responses to painless and painful electrical stimulation of a right human maxillary canine tooth. Functional magnetic resonance images were obtained during the application of five graded stimulus strengths, from below, at, and above the individually determined pain thresholds. Study participants reported each stimulus on a visual rating scale with respect to evoked sensation. Based on hemodynamic responses of all pooled stimuli, a cerebral network was identified that largely corresponds to the known lateral and medial nociceptive system. Further analysis of the five graded stimulus strengths revealed positive linear correlations for the anterior insula bilaterally, the contralateral (left) anterior mid-cingulate, as well as contralateral (left) pregenual cingulate cortices. Cerebral toothache intensity coding on a group level can thus be attributed to specific subregions within the cortical pain network.

scholarly journals Cerebral Perivascular Spaces Visible on Magnetic Resonance Imaging: Development of a Qualitative Rating Scale and its Observer Reliability

2015 ◽  
Vol 39 (3-4) ◽  
pp. 224-231 ◽  
Author(s):  
Gillian M. Potter ◽  
Francesca M. Chappell ◽  
Zoe Morris ◽  
Joanna M. Wardlaw
Keyword(s):  
White Matter ◽  
Basal Ganglia ◽  
White Matter Hyperintensities ◽  
Rating Scale ◽  
Kappa Statistics ◽  
Perivascular Spaces ◽  
Ageing Population ◽  
Centrum Semiovale ◽  
Observer Reliability ◽  
Morphological Criteria

Background: Perivascular spaces (PVS) are an important component of cerebral small vessel disease (SVD), several inflammatory disorders, hypertension and blood-brain barrier breakdown, but are difficult to quantify. A recent international collaboration of SVD experts has highlighted the need for a robust, easy-to-use PVS rating scale for the effective investigation of the diagnostic and prognostic significance of PVS. The purpose of the current study was to develop and extend existing PVS scales to provide a more comprehensive scale for the measurement of PVS in the basal ganglia, centrum semiovale and midbrain, and to test its intra- and inter-rater agreement, assessing reasons for discrepancy. Methods: We reviewed previously published PVS scales, including site of PVS assessed, rating method, and size and morphological criteria. Retaining key features, we devised a more comprehensive scale in order to improve the reliability of PVS rating. Two neuroradiologists tested the new scale in MRI brain scans of 60 patients from two studies (stroke, ageing population), chosen to represent a full range of PVS, and demonstrating concomitant features of SVD such as lacunes and white matter hyperintensities. We rated basal ganglia, centrum semiovale, and midbrain PVS. Basal ganglia and centrum semiovale PVS were rated 0 (none), 1 (1-10), 2 (11-20), 3 (21-40) and 4 (>40), and midbrain PVS were rated 0 (none visible) or 1 (visible). We calculated kappa statistics for rating, assessed consistency in use of PVS categories (Bhapkar test) and reviewed sources of discrepancy. Results: Intra- and inter-rater kappa statistics were highest for basal ganglia PVS (range 0.76-0.87 and 0.8-0.9, respectively) than for centrum semiovale PVS (range 0.68-0.75 and 0.61-0.8, respectively) or midbrain PVS (inter-rater range 0.51-0.52). Inter-rater consistency was better for basal ganglia compared to centrum semiovale PVS (Bhapkar statistic 2.49-3.72, compared to 6.79-21.08, respectively). Most inter-rater disagreements were due to very faint PVS, coexisting extensive white matter hyperintensities (WMH) or the presence of lacunes. Conclusions: We developed a more inclusive and robust visual PVS rating scale allowing rating of all grades of PVS severity on structural brain imaging. The revised PVS rating scale has good observer reliability for basal ganglia and centrum semiovale PVS, best for basal ganglia PVS, and moderate reliability for midbrain PVS. Agreement is influenced by PVS severity and the presence of background features of SVD. The current scale can be used in further studies to assess the clinical implications of PVS.

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