Author Affiliation: Departments of Neurology, Epidemiology and Public Health (Dr Lipton) and Neuroscience (Dr Pan), Albert Einstein College of Medicine, Bronx, NY.
In this issue of THE JOURNAL, Kruit and colleagues1 provide
important new data on the prevalence of brain infarction and white matter
lesions in persons with migraine. The authors systematically recruited individuals
with migraine with aura and migraine without aura as well as group-matched
controls without migraine from the general Dutch population. By using population
surveys, the authors identified a representative sample of migraine cases,
addressing concerns about selection bias in earlier studies.2- 4 An
appropriate population control group without migraine was recruited from the
screened sample. The use of 3-mm magnetic resonance imaging (MRI) sections
improved lesion detection, and imaging studies were interpreted masked to
case status, minimizing bias in the assessment of radiographic findings. Demographic
factors, cardiovascular diseases, headache features, and treatment patterns
were carefully assessed so that these potential confounders and effect modifiers
could be taken into account.
Lipton RB, Pan J. Is Migraine a Progressive Brain Disease?. JAMA. 2004;291(4):493-494. doi:10.1001/jama.291.4.493