Association between Migraine and Cryptogenic Ischemic Stroke in Young Adults

被引：34

作者：

Martinez-Majander, Nicolas ^{[1
,2
]}

Artto, Ville ^{[1
,2
]}

Ylikotila, Pauli ^{[3
]}

von Sarnowski, Bettina ^{[4
]}

Waje-Andreassen, Ulrike ^{[5
]}

Yesilot, Nilufer ^{[6
]}

Zedde, Marialuisa ^{[7
]}

Huhtakangas, Juha ^{[8
]}

Numminen, Heikki ^{[9
]}

Jakala, Pekka ^{[10
,11
]}

Fonseca, Ana C. ^{[12
]}

Redfors, Petra ^{[13
,14
]}

Wermer, Marieke J. H. ^{[15
]}

Pezzini, Alessandro ^{[16
]}

Putaala, Jukka ^{[1
,2
]}

机构：

[1] Helsinki Univ Hosp, Neurol, Haartmaninkatu 4, FI-00029 Helsinki, Finland

[2] Univ Helsinki, Haartmaninkatu 4, FI-00029 Helsinki, Finland

[3] Turku Univ, Turku Univ Hosp, Clin Neurosci, Neuroctr, Turku, Finland

[4] Univ Med Greifswald, Dept Neurol, Greifswald, Germany

[5] Haukeland Hosp, Dept Neurol, Bergen, Norway

[6] Istanbul Univ, Dept Neurol, Istanbul Fac Med, Istanbul, Turkey

[7] Reggio Emilia Natl Inst Res & Treatment, Co Local Hlth Unit, Neurol Unit, Reggio Emilia, Italy

[8] Oulu Univ Hosp, Dept Neurol, Oulu, Finland

[9] Tampere Univ Hosp, Dept Neurosci & Rehabil, Tampere, Finland

[10] Kuopio Univ Hosp, Neuroctr Neurol, Kuopio, Finland

[11] Univ Eastern Finland, Kuopio, Finland

[12] Univ Lisbon, Hosp Santa Maria, Dept Neurosci Neurol, Lisbon, Portugal

[13] Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Dept Clin Neurosci, Gothenburg, Sweden

[14] Sahlgrens Univ Hosp, Dept Neurol, Gothenburg, Sweden

[15] Leiden Univ, Med Ctr, Leiden, Netherlands

[16] Univ Brescia, Dept Clin & Expt Sci, Neurol Clin, Brescia, Italy

来源：

ANNALS OF NEUROLOGY | 2021年 / 89卷 / 02期

基金：

芬兰科学院; 欧洲研究理事会;

关键词：

PATENT FORAMEN OVALE; RISK-FACTORS; PREVENTION; ATTACK; QUESTIONNAIRE; EXPLANATIONS; METAANALYSIS; CONNECTION; PREVALENCE; VALIDATION;

D O I：

10.1002/ana.25937

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective To assess the association between migraine and cryptogenic ischemic stroke (CIS) in young adults, with subgroup analyses stratified by sex and presence of patent foramen ovale (PFO). Methods We prospectively enrolled 347 consecutive patients aged 18 to 49 years with a recent CIS and 347 age- and sex-matched (+/- 5 years) stroke-free controls. Any migraine and migraine with (MA) and migraine without aura (MO) were identified by a screener, which we validated against a headache neurologist. We used conditional logistic regression adjusting for age, education, hypertension, diabetes, waist-to-hip ratio, physical inactivity, current smoking, heavy drinking, and oral estrogen use to assess independent association between migraine and CIS. The effect of PFO on the association between migraine and CIS was analyzed with logistic regression in a subgroup investigated with transcranial Doppler bubble screen. Results The screener performance was excellent (Cohen kappa > 0.75) in patients and controls. Compared with nonmigraineurs, any migraine (odds ratio [OR] = 2.48, 95% confidence interval [CI] = 1.63-3.76) and MA (OR = 3.50, 95% CI = 2.19-5.61) were associated with CIS, whereas MO was not. The association emerged in both women (OR = 2.97 for any migraine, 95% CI = 1.61-5.47; OR = 4.32 for MA, 95% CI = 2.16-8.65) and men (OR = 2.47 for any migraine, 95% CI = 1.32-4.61; OR = 3.61 for MA, 95% CI = 1.75-7.45). Specifically for MA, the association with CIS remained significant irrespective of PFO. MA prevalence increased with increasing magnitude of the right-to-left shunt in patients with PFO. Interpretation MA has a strong association with CIS in young patients, independent of vascular risk factors and presence of PFO. ANN NEUROL 2020

引用

页码：242 / 253

页数：12