A thicker intima-media carotid wall was found in a cohort of children with recent onset migraine

Cluster and network analysis of non-headache symptoms in migraine patients reveals distinct subgroups based on onset age and vestibular-cochlear symptom interconnection

Objective

The present study endeavors to identify natural subgroups of migraine patients based on the patterns of non-headache symptoms, utilizing cluster analysis. Subsequently, network analysis was performed to estimate the structure of symptoms and explore the potential pathophysiology of these findings.

Method

A total of 475 patients who met the diagnostic criteria for migraine were surveyed face-to-face during the period of 2019 to 2022. The survey included collecting demographic and symptom data. Four different solutions were generated by the K-means for mixed large data (KAMILA) clustering algorithm, from which the final cluster solutions were selected based on a series of cluster metrics. Subsequently, we performed network analysis using Bayesian Gaussian graphical models (BGGM) to estimate the symptom structure across subgroups and conducted global and pairwise comparisons between structures.

Result

Cluster analysis identified two distinct patient groups, and the onset age of migraine proved to be an effective characteristic differentiating the two patient groups. Participants assigned to late-onset group showed a longer course of migraine, higher frequency of monthly headache attacks, and greater tendency toward medication overuse. In contrast, patients in early-onset group exhibited a higher frequency of nausea, vomiting, and phonophobia compared to their counterparts in the other group. The network analysis revealed a different symptom structure between the two groups globally, while the pairwise differences indicated an increasing connection between tinnitus and dizziness, and a decreasing connection between tinnitus and hearing loss in the early-onset group.

Conclusion

Utilizing clustering and network analysis, we have identified two distinct non-headache symptom structures of migraine patients with early-onset age and late-onset age. Our findings suggest that the vestibular-cochlear symptoms may differ in the context of different onset ages of migraine patients, which may contribute to a better understanding of the pathology of vestibular-cochlear symptoms in migraine.

Ultrasonic assessment of carotid intima-media thickness in migraine: a meta-analysis

Objective

Migraine is believed to be a risk factor for cerebrovascular diseases, and previous studies have indicated an association between migraine and cerebral atherosclerosis. Carotid artery intima-media thickness (IMT) is considered to be a biomarker of atherosclerosis pathology. This study aimed to investigate the relationship between carotid IMT and migraine by conducting a meta-analysis.

Methods

We searched Web of Science, PubMed, and the Cochrane Library for eligible studies assessing carotid IMT in patients with migraine and controls. Data were extracted independently by two reviewers and analyzed using Review Manager 5.3 software.

Results

The meta-analysis included seven articles with 555 subjects (279 migraine patients, 276 controls). Carotid IMT was significantly greater in patients with migraine compared with controls. However, there were no significant differences in IMT between patients with migraine with aura (MA) and controls, migraine without aura (MO) and controls, and patients with MA and MO.

Conclusion

Patients with migraine have greater carotid IMT than individuals without migraine, suggesting an association between atherosclerosis and migraine. However, further studies with more samples are needed to confirm this finding.