Perivascular spaces and headache: A population-based imaging study (HUNT-MRI)

Background In four previous clinic-based MRI studies headache sufferers (in particular migraineurs) had more perivascular spaces (PVS) than individuals who were headache-free. Methods The present study was part of a large longitudinal, epidemiological study (Nord-TrOndelag Health Survey (HUNT)). The 1006 participants, age 50-65 years at inclusion, had participated in all previous HUNT surveys (1-3), and been randomly selected to a population-based imaging study of the head (HUNT-MRI, 2007-2009). The number of visible PVS in the basal ganglia (BG) and hemispheric white matter (HWM) was compared in headache sufferers (migraine with and without aura, non-migrainous headache) and people who were headache-free. Results The results showed in general small differences between headache sufferers and headache-free participants. In the cross-sectional analysis migraineurs without aura had fewer PVS than headache-free individuals in BG (OR=0.84, 95% CI=0.76--0.94, p value=0.003) and in BG and HWM together (OR=0.97, 95% CI=0.95-1.00, p value=0.046). No difference between long-term headache sufferers and long-term headache-free individuals with regard to number of PVS was found. Discussion In contrast to previous studies, the present large, blinded, population-based study showed no increase in number of dilated PVS among headache sufferers. Fewer PVS among those with migraine without aura may be a spurious finding.