Subclinical Brain Lesions in Magnetic Resonance Imaging are a Potential Indicator of Patent Foramen Ovale Related Migraines in Younger Patients.

IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Reviews in cardiovascular medicine Pub Date : 2025-08-29 eCollection Date: 2025-08-01 DOI:10.31083/RCM37480
Hong Yang, Fei Ma, Rui Li, Qiang Zhou, Fan Lin, Hesong Zeng, Dao Wen Wang, Jiangang Jiang, Xiang Luo, Hong Wang
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Abstract

Background: The causal relationship between migraines and patent foramen ovale (PFO) remains controversial, and a major unresolved question is how to define migraines attributable to PFO. Thus, this study aimed to determine if brain lesions could be a potential indicator of PFO-related migraines.

Methods: Consecutive migraine patients from 2017 to 2019 who underwent transthoracic echocardiography or transcranial Doppler examination with an agitated saline contrast injection were assessed for right-to-left shunts. We then presented diffusion-weighted imaging (DWI) in brain magnetic resonance imaging and its association with PFO in the included patients.

Results: A total of 424 patients with a mean age of 44.39 ± 12.06 years were included in this retrospective study. Among them, 244 patients (57.5%) had PFO, and 246 patients (58%) had subclinical brain lesions-the brain lesions presented as single or multiple scattered lesions. No association was observed between PFO prevalence and brain lesions in the total cohort (odds ratio (OR) 0.499); however, a significant association was observed in patients aged less than 46 years (OR, 3.614 in the group aged <34 years, 95% confidence interval (CI) 1.128-11.580, and 3.132 in the group of 34 years ≤ age < 46 years, 95% CI 1.334-7.350, respectively). Lesions in patients with PFO observed using DWI came more from the anterior or multiple than the posterior vascular territory (p = 0.033). DWI lesion numbers, location, and right-to-left shunt amounts did not affect the association between DWI-observed lesions and PFO.

Conclusions: This study demonstrated that subclinical brain lesions are associated with PFO and may be used as a potential predictor of PFO-related migraines in patients aged less than 46 years. This may help identify candidate patients for PFO closure in future clinical decisions.

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磁共振成像中的亚临床脑病变是年轻患者卵圆孔未闭相关性偏头痛的潜在指标。
背景:偏头痛与卵圆孔未闭(PFO)之间的因果关系仍然存在争议,其中一个主要的未解决的问题是如何定义可归因于PFO的偏头痛。因此,本研究旨在确定脑损伤是否可能是pfo相关偏头痛的潜在指标。方法:对2017年至2019年连续接受经胸超声心动图或经颅多普勒检查并注射激流生理盐水造影剂的偏头痛患者进行右至左分流评估。然后,我们介绍了脑磁共振成像中的弥散加权成像(DWI)及其与PFO的关系。结果:回顾性研究共纳入424例患者,平均年龄44.39±12.06岁。其中244例(57.5%)有PFO, 246例(58%)有亚临床脑病变,即脑病变表现为单个或多个分散病灶。在整个队列中,未观察到PFO患病率与脑病变之间的关联(优势比(OR) 0.499);然而,在年龄小于46岁的患者中观察到显著的相关性(OR为3.614,年龄组p = 0.033)。DWI病变数量、位置和右至左分流量不影响DWI观察到的病变与PFO之间的关系。结论:本研究表明,亚临床脑病变与PFO相关,可作为年龄小于46岁患者PFO相关偏头痛的潜在预测因子。这可能有助于在未来的临床决策中确定PFO闭合的候选患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Reviews in cardiovascular medicine
Reviews in cardiovascular medicine 医学-心血管系统
CiteScore
2.70
自引率
3.70%
发文量
377
审稿时长
1 months
期刊介绍: RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.
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