Migraine, White Matter Hyperintensities, and Subclinical Brain Infarction in a Diverse Community The Northern Manhattan Study

Background and Purpose-Migraine with aura is a risk factor for ischemic stroke. The goals of this study are to examine the association between migraine and subclinical cerebrovascular damage in a race/ethnically diverse older population-based cohort study. Methods-In the Northern Manhattan Study (NOMAS), we quantified subclinical brain infarctions and white matter hyperintensity volumes among participants with self-reported migraine, confirmed by the International Classification of Headache Disorders-2 criteria. Results-Of 546 study participants with imaging and migraine data (41% men; mean age at MRI, 71 +/- 8 years; mostly Hispanic [65%]), those reporting migraine overall had double the odds of subclinical brain infarction (adjusted odds ratio, 2.1; 95% confidence interval, 1.0-4.2) when compared with those reporting no migraine, after adjusting for sociodemographics and vascular risk factors. No association was observed between migraine with or without aura and white matter hyperintensity volume. Conclusions-Migraine may be a risk factor for subclinical brain infarction. Prospective studies are needed in race/ethnically diverse populations.