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Migraine patients who have frequent attacks or a long history of migraines have an increased risk of progressive brain damage as seen on MRI, according to a report from the Netherlands.

Migraine patients who have frequent attacks or a long history of migraines have an increased risk of progressive brain damage as seen on MRI, according to a report from the Netherlands in the July/August issue of Headache.

Previous neuroimaging research has shown that migraine patients are more likely to show silent brain damage than control subjects are, the authors explain, but the predilection sites have not been specified and only white matter lesions (hyperintensities) have been investigated.

Dr. Nicole Schmitz and colleagues from Leiden University Medical Center sought to identify predilection sites of possible brain damage and different aspects of migraine headaches in 28 female migraine patients, comparing them with 28 matched controls.

The frontal lobe, limbic system, parietal lobes, basal ganglia (globus pallidus and putamen), brainstem, and cerebellum appeared abnormal by several criteria more commonly in migraine patients than in control subjects, the authors report.

Patients who had more than three migraine attacks per month showed significantly more abnormalities than did those who had less than three attacks per month, the report indicates.

Moreover, the researchers note, individuals with more than 15 years of migraine attacks showed significantly worse changes than did those with less than 15 years of migraine attacks.

"In order to reveal the causes and consequences of brain damage in migraineurs, further neuroimaging investigations have to quantify brain abnormalities in a longitudinal design, using interictal, ictal, and postictal assessments," the investigators point out.

Headache 2008;48:1044-1055