{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T13:47:55Z","timestamp":1785332875809,"version":"3.55.0"},"reference-count":47,"publisher":"Georg Thieme Verlag KG","issue":"11","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":51,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Neuropsiquiatr"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>White matter hyperintensities (WMH) are commonly detected on brain magnetic resonance imaging (MRI) scans of migraine patients, but their clinical relevance and underlying mechanisms remain uncertain.<\/jats:p>\n                  <jats:p>To systematically review the relationship between WMH and migraine, focusing on prevalence, progression, and associations with clinical and demographic characteristics.<\/jats:p>\n                  <jats:p>We conducted a systematic review of observational studies published between 1990 and May 2025, including adult patients with migraine (with or without aura) who underwent brain MRIs with at least 1.5T scanners. Data extraction was performed by two independent reviewers, with disagreements resolved by a third. Study quality was assessed using the Newcastle-Ottawa scale for observational studies.<\/jats:p>\n                  <jats:p>A total of 25 studies were included, comprising approximately 3,600 participants, of whom 1,725 had migraine. Most participants were women and reported age means or medians typically between 30 and 60 years. Frequently, WMHs were observed in migraine patients, particularly in those with aura, longer disease duration, and higher headache frequency. No consistent association was found between WMH and comorbidities. Significant heterogeneity in imaging protocols, lesion quantification methods, and study design limited data comparability and precluded meta-analysis.<\/jats:p>\n                  <jats:p>Migraine patients often present with WMHs, but their clinical significance remains unclear. Future studies should employ standardized MRI protocols, volumetric lesion quantification, and consistent migraine phenotyping to clarify its pathophysiological role in migraine and potential implications for diagnosis and management.<\/jats:p>","DOI":"10.1055\/s-0045-1812886","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T23:57:13Z","timestamp":1766447833000},"page":"001-013","source":"Crossref","is-referenced-by-count":3,"title":["Unraveling the relationship between white matter lesions in MRI and migraine: a systematic review"],"prefix":"10.1055","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7827-814X","authenticated-orcid":false,"given":"Verena Subtil","family":"Viuniski","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Medicina Interna, Porto Alegre RS, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6885-8646","authenticated-orcid":false,"given":"Matheus de Lima","family":"Ruffini","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Medicina Interna, Porto Alegre RS, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0786-5571","authenticated-orcid":false,"given":"Adolfo Moraes de","family":"Souza","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Medicina Interna, Porto Alegre RS, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4979-0106","authenticated-orcid":false,"given":"Raquel Prates dos","family":"Santos","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Medicina Interna, Porto Alegre RS, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1345-4068","authenticated-orcid":false,"given":"Davi Henrique Galvao Fonseca","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Medicina Interna, Porto Alegre RS, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3388-5443","authenticated-orcid":false,"given":"Leandro Lisboa","family":"Faoro","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Medicina Interna, Porto Alegre RS, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2256-4379","authenticated-orcid":false,"given":"Fabiano","family":"Reis","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas, Faculdade de Ci\u00eancias M\u00e9dicas, Departamento de Cl\u00ednica M\u00e9dica, Disciplina de Medicina Interna e Semiologia, Campinas SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9780-4739","authenticated-orcid":false,"given":"Renata Gomes","family":"Londero","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Medicina Interna, Porto Alegre RS, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4973-2889","authenticated-orcid":false,"given":"Juliana Avila","family":"Duarte","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Medicina Interna, Porto Alegre RS, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1402569","DOI":"10.3389\/fneur.2024.1402569","article-title":"Revolutionizing migraine management: advances and challenges in CGRP-targeted therapies and their clinical implications","volume":"15","author":"A \u00d6zge","year":"2024","journal-title":"Front Neurol"},{"issue":"01","key":"ref2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/0333102417738202","article-title":"The International Classification of Headache Disorders, 3rd edition","volume":"38","author":"Headache Classification Committee of the International Headache Society (IHS).","year":"2018","journal-title":"Cephalalgia"},{"issue":"10","key":"ref3","doi-asserted-by":"publisher","first-page":"1274","DOI":"10.1001\/jama.296.10.1274","article-title":"Does this patient with headache have a migraine or need neuroimaging?","volume":"296","author":"M E Detsky","year":"2006","journal-title":"JAMA"},{"issue":"02","key":"ref4","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1111\/head.13720","article-title":"Neuroimaging for Migraine: The American Headache Society Systematic Review and Evidence-Based Guideline","volume":"60","author":"R W Evans","year":"2020","journal-title":"Headache"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/j.clineuro.2016.07.006","article-title":"Migraine: Does aura require investigation?","volume":"148","author":"N Vijiaratnam","year":"2016","journal-title":"Clin Neurol Neurosurg"},{"issue":"06","key":"ref6","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1177\/1756285613489765","article-title":"The role of neuroimaging in the diagnosis of headache disorders","volume":"6","author":"D Holle","year":"2013","journal-title":"Ther Adv Neurol Disord"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"c3666","DOI":"10.1136\/bmj.c3666","article-title":"The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis","volume":"341","author":"S Debette","year":"2010","journal-title":"BMJ"},{"issue":"04","key":"ref9","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1001\/jama.291.4.493","article-title":"Is migraine a progressive brain disease?","volume":"291","author":"R B Lipton","year":"2004","journal-title":"JAMA"},{"issue":"14","key":"ref10","doi-asserted-by":"publisher","first-page":"1260","DOI":"10.1212\/WNL.0b013e3182a6cb32","article-title":"Migraine and 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Hamedani","year":"2013","journal-title":"Neurology"},{"issue":"01","key":"ref20","doi-asserted-by":"publisher","first-page":"10881","DOI":"10.1038\/s41598-021-90341-0","article-title":"White matter hyperintensity in different migraine subtypes","volume":"11","author":"L A Dobrynina","year":"2021","journal-title":"Sci Rep"},{"issue":"01","key":"ref21","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1186\/s12883-022-02680-8","article-title":"Risk factors of white matter hyperintensities in migraine patients","volume":"22","author":"J Y Al-Hashel","year":"2022","journal-title":"BMC Neurol"},{"issue":"04","key":"ref22","doi-asserted-by":"publisher","first-page":"435","DOI":"10.4103\/aian.aian_183_23","article-title":"Do Mean Platelet Volume and Platelet Distribution Width Have An Association with White Matter Hyperintensities in Migraine Patients?","volume":"26","author":"I Iyigundogdu","year":"2023","journal-title":"Ann Indian Acad 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Pain"},{"issue":"03","key":"ref26","doi-asserted-by":"publisher","first-page":"e70063","DOI":"10.1111\/ene.70063","article-title":"Coagulation Factors and White Matter Hyperintensities in Middle-Aged Women With and Without Migraine and Ischemic Stroke","volume":"32","author":"M Ali","year":"2025","journal-title":"Eur J Neurol"},{"issue":"10","key":"ref27","doi-asserted-by":"publisher","first-page":"TC01","DOI":"10.7860\/JCDR\/2023\/62607.18539","article-title":"Association between Migraine Patterns and White Matter Hyperintensities in MRI Brain: A Cross-sectional Analytical Study","volume":"17","author":"J Antony","year":"2023","journal-title":"J Clin Diagn Res"},{"issue":"13","key":"ref28","doi-asserted-by":"publisher","first-page":"1927","DOI":"10.1177\/0333102418764891","article-title":"White matter hyperintensities and headache: A population-based imaging study (HUNT MRI)","volume":"38","author":"L M Honningsv\u00e5g","year":"2018","journal-title":"Cephalalgia"},{"issue":"04","key":"ref29","doi-asserted-by":"publisher","first-page":"799","DOI":"10.3390\/diagnostics13040799","article-title":"White Matter Lesions Identified by Magnetic Resonance in Women with Migraine: A Volumetric Analysis and Clinical Correlations","volume":"13","author":"N Silva","year":"2023","journal-title":"Diagnostics (Basel)"},{"issue":"01","key":"ref30","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1186\/s10194-025-01988-3","article-title":"Neuroimaging differences between chronic migraine with and without medication overuse headache: a 7","volume":"26","author":"Y Sun","year":"2025","journal-title":"J Headache Pain"},{"issue":"07","key":"ref31","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1016\/j.clineuro.2012.10.033","article-title":"Brain white matter hyperintensities in migraine: clinical and radiological correlates","volume":"115","author":"U Seneviratne","year":"2013","journal-title":"Clin Neurol Neurosurg"},{"issue":"05","key":"ref32","doi-asserted-by":"publisher","first-page":"1725","DOI":"10.1007\/s13760-022-02015-x","article-title":"Association of white matter hyperintensities with migraine phenotypes and response to treatment","volume":"123","author":"S R Ahmed","year":"2023","journal-title":"Acta Neurol Belg"},{"issue":"03","key":"ref33","doi-asserted-by":"publisher","first-page":"355","DOI":"10.2169\/internalmedicine.9776-22","article-title":"Reversible Cerebral Vasoconstriction Syndrome Patients with a History of Migraine: A Retrospective Case-control Study","volume":"62","author":"M Imai","year":"2023","journal-title":"Intern Med"},{"issue":"06","key":"ref34","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.4103\/ni.ni_894_22","article-title":"Assessment of White Matter Alterations in Patients of Migraine Using Diffusion Tensor Imaging","volume":"72","author":"C Nanda","year":"2024","journal-title":"Neurol India"},{"issue":"01","key":"ref35","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1007\/s00234-024-03477-x","article-title":"Comparison of Syn T2-FLAIR and Syn DIR with conventional T2-FLAIR in displaying white matter hyperintensities in migraine patients","volume":"67","author":"Z Z Liu","year":"2025","journal-title":"Neuroradiology"},{"issue":"01","key":"ref36","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/s13005-024-00478-2","article-title":"Migraine and MRI: uncovering potential associations","volume":"21","author":"K Abdalla","year":"2025","journal-title":"Head Face Med"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"103312","DOI":"10.1016\/j.nicl.2023.103312","article-title":"Prevalence and clinical characteristics of white matter hyperintensities in migraine: A meta-analysis","volume":"37","author":"W Zhang","year":"2023","journal-title":"Neuroimage Clin"},{"issue":"03","key":"ref38","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1007\/s10548-021-00824-6","article-title":"Is Migraine Associated to Brain Anatomical Alterations? New Data and Coordinate-Based Meta-analysis","volume":"34","author":"R Masson","year":"2021","journal-title":"Brain Topogr"},{"issue":"01","key":"ref39","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/0022-510x(93)90041-v","article-title":"A semiquantative rating scale for the assessment of signal hyperintensities on magnetic resonance imaging","volume":"114","author":"P Scheltens","year":"1993","journal-title":"J Neurol Sci"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1016\/j.nicl.2018.02.033","article-title":"DEWS (DEep White matter hyperintensity Segmentation framework): A fully automated pipeline for detecting small deep white matter hyperintensities in migraineurs","volume":"18","author":"B Y Park","year":"2018","journal-title":"Neuroimage Clin"},{"issue":"02","key":"ref41","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1080\/14728222.2020.1724285","article-title":"Calcitonin gene-related peptide (CGRP): role in migraine pathophysiology and therapeutic targeting","volume":"24","author":"A S Wattiez","year":"2020","journal-title":"Expert Opin Ther Targets"},{"issue":"06","key":"ref42","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1111\/j.1526-4610.1992.hed3206287.x","article-title":"The prevalence of cerebral damage varies with migraine type: a MRI study","volume":"32","author":"F Fazekas","year":"1992","journal-title":"Headache"},{"issue":"01","key":"ref43","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1186\/s13195-024-01435-6","article-title":"White matter hyperintensity patterns: associations with comorbidities, amyloid, and cognition","volume":"16","author":"D Bachmann","year":"2024","journal-title":"Alzheimers Res Ther"},{"issue":"08","key":"ref44","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1016\/S1474-4422(19)30185-1","article-title":"Migraine and the trigeminovascular system-40 years and counting","volume":"18","author":"M Ashina","year":"2019","journal-title":"Lancet Neurol"},{"issue":"11","key":"ref45","doi-asserted-by":"publisher","first-page":"1955","DOI":"10.1016\/j.ajpath.2021.02.007","article-title":"White Matter Lesions in Migraine","volume":"191","author":"K Eikermann-Haerter","year":"2021","journal-title":"Am J Pathol"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"2059","DOI":"10.1093\/brain\/120.11.2059","article-title":"Comparison of MRI criteria at first presentation to predict conversion to clinically definite multiple sclerosis","volume":"120","author":"F Barkhof","year":"1997","journal-title":"Brain"},{"issue":"04","key":"ref47","first-page":"501","article-title":"White matter hyperintensities and carotid intima media thickness in migraine without aura patients","volume":"25","author":"M Kocat\u00fcrk","year":"2020","journal-title":"Neurol Asia"},{"issue":"05","key":"ref48","first-page":"345","article-title":"The Association of MRI findings in migraine with the headache characteristics and response to treatment","volume":"15","author":"W H Alkhaffaf","year":"2021","journal-title":"Revista Latinoamericana de Hipertension"}],"container-title":["Arquivos de Neuro-Psiquiatria"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0045-1812886.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T23:57:16Z","timestamp":1766447836000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0045-1812886"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":47,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,7,28]]},"published-print":{"date-parts":[[2025,11]]}},"alternative-id":["s00451812886"],"URL":"https:\/\/doi.org\/10.1055\/s-0045-1812886","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0004-282X","1678-4227"],"issn-type":[{"value":"0004-282X","type":"print"},{"value":"1678-4227","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]}}}