Migraine Clinical Trial
Official title:
MIBRAIN - Migraine and the Brain: Consequences, Causes, and Vascular Interaction
Migraine is a very common, chronic/intermittent and disabling neurovascular headache disorder
that has long believed to have no severe consequences. Recent evidence, however, strongly
suggest that migraine is associated with increased risk of ischemic stroke and there is
initial evidence that migraine is associated with structural brain changes independent of the
occurrence of stroke.
As migraine has strong links with the vascular system, it is plausible that vascular
functions interact on the association between migraine and structural brain changes as well
as cognition.
Our primary objectives are to investigate: (i) the relationship of migraine and migraine
subtypes on magnetic resonance imaging (MRI) changes in a cohort of patients with active
migraine; (ii) the relationship of migraine on cognitive performance among patients with
active migraine; and (iii) the relationship of migraine and migraine specifics with vascular
functions and morbidity. As secondary objective, we investigate whether the association of
migraine on structural brain changes or cognitive performance is modified by vascular
functions.
This will be an observational study conducted in the Headache Center in Bordeaux. 300
patients have to be included (150 patients with migraine with aura and 150 patients with
migraine without aura).
Inclusion criteria are: all patients with a clearly defined migraine (as per
IHS[International Headache Classification] criteria) who are aged 30 and older, are able to
fluently speak French, and who are willing to participate.
Exclusion criteria are: pregnant woman and patient who have a major psychiatric disease or
major anxiety disorder or had a pacemaker (which would not allow to perform a MRI imaging).
The cognitive status in the patient cohort will be ascertained by the Repeatable Battery for
the Assessment of Neuropsychological Status (RBANS). In addition to the RBANS, we will use
the HIT-6 (Headache Impact Test) and MIDAS (MIgraine Disability ASessment) and the depression
scale CES-D (Center for Epidemiologic Studies Depression Scale).
Vascular risk status will be assessed by measurement of blood pressure and reports of
vascular risk factors. The endothelial function will be measured with a noninvasive
Peripheral Arterial Tone (PAT) signal technology using the EndoPAT device (Itamar Medical
Inc, Framingham, MA).
For crude comparisons, chi-square tests will be used for categorical variables and t-test for
continuous variables. Multivariable-multinominal modeling techniques will be utilized for the
comparisons adjusting for potential confounding variables. All statistical tests will be
two-tailed and a P <0.05 will be considered statistically significant.
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