Visually-induced hemodynamic response and white matter hyperintensities in middle-aged women with ischemic stroke or migraine with aura

Cephalalgia, vol. 46, pp. 3331024261439256

Abstract

BackgroundMigraine, especially with aura (MA), increases the risk of brain white matter hyperintensities (WMH) and ischemic stroke. Altered microvascular function has been proposed as a shared underlying mechanism, potentially involving endothelial dysfunction. Visually-induced hemodynamic response describes the process by which cerebral blood flow is locally increased to meet the metabolic demands of neuronal activity and may serve as a surrogate measure of cerebral endothelial function. We investigated the relationship between visually-induced hemodynamic responseand WMH volume in middle-aged women with ischemic stroke or MA.MethodsWe cross-sectionally measured hemodynamic response using blood-oxygen-level-dependent (BOLD) fMRI upon visual stimulation on 7T-MRI, and WMH volume on 3T-MRI, in three groups of women aged 40-60 with: (I)ischemic stroke, (II)MA, and (III)no history of stroke or migraine. We assessed the associations between BOLD parameters in the posterior circulation (amplitude, time-to-peak [TTP], and time-to-baseline [TTB]) and WMH volume using multivariable linear regression within each group.ResultsWe included 87 women (mean age 51 years): (I)25 with ischemic stroke, (II)25 with MA, and (III)37 without stroke or migraine. Visually-induced hemodynamic response was similar across groups and not associated with WMH volume overall. However, lower amplitude was associated with higher deep WMH volume in those without stroke or migraine (adjusted-β= -0.28;95%CI = -0.53 to -0.02 mL), shorter TTB with greater periventricular WMH volume in women with MA (adjusted-β= -0.12;95%CI = -0.21 to -0.02 mL), and longer TTP with increased periventricular WMH volume in women with stroke (adjusted-β=0.22;95%CI = 0.06 to 0.40 mL).ConclusionsNo overall association was observed between visually-induced hemodynamic response and WMH volume. Exploratory findings suggest potential differences in hemodynamic response in the posterior circulation across groups, which require replication in larger datasets and confirmation in longitudinal studies to clarify their temporal or mechanistic relevance to WMH development.

Authors 13

1. Nelleke van der Weerd Aachen Human Genetics

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Human Genetics, LUMC, Leiden, the Netherlands

   Leiden University Medical Centre (LUMC)

2. Mariam Ali corresponding Aachen

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Centre (LUMC)

3. Thijs W. van Harten Aachen

   Leiden University Medical Center · Massachusetts General Hospital

   Affiliation as printed

   LUMC

   Massachusetts General Hospital

4. Ay-Min Ma Aachen

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Centre (LUMC)

5. Ghislaine Holswilder Aachen

   Leiden University Medical Center

   Affiliation as printed

   LUMC

6. Annelise E. Wilms Aachen

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Centre (LUMC)

7. Erik W. van Zwet Aachen Medical Statistics

   Leiden University Medical Center

   Affiliation as printed

   Medical Statistics, LUMC, Leiden, the Netherlands

8. Mark C. Kruit Aachen

   Leiden University Medical Center

   Affiliation as printed

   LUMC

9. Arn M. J. M. van den Maagdenberg Aachen Human Genetics

   Leiden University Medical Center

   Affiliation as printed

   Human Genetics, LUMC, Leiden, the Netherlands

10. Gisela M. Terwindt Aachen

    Leiden University · Leiden University Medical Center

    Affiliation as printed

    Leiden University Medical Centre (LUMC)

11. Matthias J.P. van Osch Aachen

    Leiden University Medical Center

    Affiliation as printed

    LUMC

12. Hendrikus J. A. van Os Aachen Public Health and Primary Care

    Leiden University · Leiden University Medical Center

    Affiliation as printed

    Leiden University Medical Centre (LUMC)

    Public Health & Primary Care, LUMC, Leiden, the Netherlands

13. Marieke J.H. Wermer Aachen

    Leiden University · University Medical Center Groningen · Leiden University Medical Center

    Affiliation as printed

    Groningen University Medical Centre

    Leiden University Medical Centre (LUMC)