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Cerebellar function and ischemic brain lesions in migraine patients from the general population.

ABSTRACT: Objective The objective of this article is to obtain detailed quantitative assessment of cerebellar function and structure in unselected migraine patients and controls from the general population. Methods A total of 282 clinically well-defined participants (migraine with aura n?=?111; migraine without aura n?=?89; non-migraine controls n?=?82; age range 43-72; 72% female) from a population-based study were subjected to a range of sensitive and validated cerebellar tests that cover functions of all main parts of the cerebellar cortex, including cerebrocerebellum, spinocerebellum, and vestibulocerebellum. In addition, all participants underwent magnetic resonance imaging (MRI) of the brain to screen for cerebellar lesions. As a positive control, the same cerebellar tests were conducted in 13 patients with familial hemiplegic migraine type 1 (FHM1; age range 19-64; 69% female) all carrying a CACNA1A mutation known to affect cerebellar function. Results MRI revealed cerebellar ischemic lesions in 17/196 (8.5%) migraine patients and 3/79 (4%) controls, which were always located in the posterior lobe except for one control. With regard to the cerebellar tests, there were no differences between migraine patients with aura, migraine patients without aura, and controls for the: (i) Purdue-pegboard test for fine motor skills (assembly scores p?=?0.1); (ii) block-design test for visuospatial ability (mean scaled scores p?=?0.2); (iii) prism-adaptation task for limb learning (shift scores p?=?0.8); (iv) eyeblink-conditioning task for learning-dependent timing (peak-time p?=?0.1); and (v) body-sway test for balance capabilities (pitch velocity score under two-legs stance condition p?=?0.5). Among migraine patients, those with cerebellar ischaemic lesions performed worse than those without lesions on the assembly scores of the pegboard task ( p?

SUBMITTER: Koppen H

PROVIDER: S-EPMC5852376 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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Cerebellar function and ischemic brain lesions in migraine patients from the general population.

Koppen Hille H Boele Henk-Jan HJ Palm-Meinders Inge H IH Koutstaal Bastiaan J BJ Horlings Corinne Gc CG Koekkoek Bas K BK van der Geest Jos J Smit Albertine E AE van Buchem Mark A MA Launer Lenore J LJ Terwindt Gisela M GM Bloem Bas R BR Kruit Mark C MC Ferrari Michel D MD De Zeeuw Chris I CI

Cephalalgia : an international journal of headache 20160711 2

Objective The objective of this article is to obtain detailed quantitative assessment of cerebellar function and structure in unselected migraine patients and controls from the general population. Methods A total of 282 clinically well-defined participants (migraine with aura n = 111; migraine without aura n = 89; non-migraine controls n = 82; age range 43-72; 72% female) from a population-based study were subjected to a range of sensitive and validated cerebellar tests that cover functions of a ...[more]

PMID: 27059879

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Project description:BackgroundBrain lesions on diffusion-weighted imaging (DWI) are frequently found after carotid artery stenting (CAS), but their clinical relevance remains unclear.ObjectivesThis study sought to investigate whether periprocedural ischemic DWI lesions after CAS or carotid endarterectomy (CEA) are associated with an increased risk of recurrent cerebrovascular events.MethodsIn the magnetic resonance imaging (MRI) substudy of ICSS (International Carotid Stenting Study), 231 patients with symptomatic carotid stenosis were randomized to undergo CAS (n=124) or CEA (n=107). MRIs were performed 1 to 7 days before and 1 to 3 days after treatment. The primary outcome event was stroke or transient ischemic attack in any territory occurring between the post-treatment MRI and the end of follow-up. Time to occurrence of the primary outcome event was compared between patients with (DWI+) and without (DWI-) new DWI lesions on the post-treatment scan in the CAS and CEA groups separately.ResultsMedian time of follow-up was 4.1 years (interquartile range: 3.0 to 5.2). In the CAS group, recurrent stroke or transient ischemic attack occurred more often among DWI+ patients (12 of 62) than among DWI- patients (6 of 62), with a cumulative 5-year incidence of 22.8% (standard error [SE]: 7.1%) and 8.8% (SE: 3.8%), respectively (unadjusted hazard ratio: 2.85; 95% confidence interval: 1.05 to 7.72; p=0.04). In DWI+ and DWI- patients, 8 and 2 events, respectively, occurred within 6 months after treatment. In the CEA group, there was no difference in recurrent cerebrovascular events between DWI+ and DWI- patients.ConclusionsIschemic brain lesions discovered on DWI after CAS seem to be a marker of increased risk for recurrent cerebrovascular events. Patients with periprocedural DWI lesions might benefit from more aggressive and prolonged antiplatelet therapy after CAS. (A Randomised Comparison of the Risks, Benefits and Cost Effectiveness of Primary Carotid Stenting With Carotid Endarterectomy: International Carotid Stenting Study; ISRCTN25337470).

Project description:Background: White matter lesions (WML) have been proved to be significantly associated with many brain diseases. Precise evaluation of burden of WML at early stage could provide insights in the prognosis and assist in intervention. However, acute ischemic lesions (AIL) exhibit hyperintensities on FLAIR images either, and are detected by diffusion weighted imaging (DWI). It is challenging to identify and segment WML in the patients with WML and AIL. Convolutional neural network (CNN) based architecture has been validated as an efficient tool for automatic segmentation. This study aimed to evaluate the performance of U-net in evaluation of WML in the patients with WML and AIL. Methods: A total of 208 cases from Chinese Atherosclerosis Risk Evaluation (CARE II) study were recruited in the present study. All subjects underwent imaging of FLAIR and DWI on 3.0 Tesla scanners. The contours of WML delineated by the observer and its scores rated by the observer were considered as gold standard. Among all 208 cases, 108 were randomly selected as train set, and the remaining 100 cases were used as test set. The performance of lesion segmentation toolbox (LST) and three U-net models were evaluated on three levels: pixel, lesion, and subject levels. The performance of all methods in WML identification and segmentation was also evaluated among the cases with different lesion volumes and between the cases with and without AIL. Results: All U-net models outperformed LST on pixel, lesion, and subject levels, while no differences were found among three U-net models. All segmentation methods performed best in the cases with WML volume (WMLV) > 20 ml but worst in those with WMLV < 5 ml. In addition, all methods showed similar performance between the cases with and without AIL. The scores determined by U-net exhibited a strong correlation with the gold standard (all Spearman correlation coefficients >0.89, ICCs >0.88, p-values <0.001). Conclusion: U-net performs well on identification and segmentation of WML in the patients with WML and AIL. The performance of U-net is validated by a dataset of multicenter study. Our results indicate that U-net has an advantage in assessing the burden of WML in the patients suffered from both WML and AIL.

Dataset Information

Cerebellar function and ischemic brain lesions in migraine patients from the general population.

Publications

Cerebellar function and ischemic brain lesions in migraine patients from the general population.

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