Our data
suggest that MA has an increased volume of WMLs compared with MO. Disease duration does not seem to influence the WMLs load, while aging positively correlates with the increased number and volume of WMLs, suggesting that they increase over the time. At the same time, both the presence of cognitive dysfunctions and WMLs seem unrelated to the severity of migraine. On the basis of our results, we cannot confirm that the frontal lobe cognitive dysfunction in migraine patients is linked to WMLs. We cannot exclude the possibility that this could depend, at least in part, on some limitations in our study such as the small size of the sample and the CH5424802 clinical trial use of 1.5 T MRI to detect WMLs instead of 3 T or higher magnet which could have better visualized smaller lesions. Therefore, cognitive deficit could be due to other causes. It is possible to hypothesize different pathogenetic mechanisms to explain executive dysfunctions. A voxel-based
morphometry AG-14699 study showed that migraine patients with brain T2-visible lesions had areas of reduced gray matter density, mainly located in the frontal and temporal lobes, and strongly related to age, disease duration, and T2-visible lesion load.[29] This is confirmed by the relationship between frontal atrophy and executive dysfunctions[30] and between frontal atrophy and clinical migraine features (attacks frequency and disease duration).[31] Our data suggest that the presence of executive deficits in migraine exists, but it is not related to the presence of WMLs, in disagreement with what previously hypothesized by Camarda et al.[6] MRI hyperintensities, accumulating over time in migraine patients, remain meaningless. The clinical Vitamin B12 relevance in migraine of this brain damage deserves further investigations. (a) Conception and Design (a) Drafting the Manuscript (a)
Final Approval of the Completed Manuscript “
“To identify factors associated with triptan discontinuation among migraine patients. It is unclear why many migraine patients who are prescribed triptans discontinue this treatment. This study investigated correlates of triptan discontinuation with a focus on potentially modifiable factors to improve compliance. This multicenter cross-sectional survey (n = 276) was performed at US tertiary care headache clinics. Headache fellows who were members of the American Headache Society Headache Fellows Research Consortium recruited episodic and chronic migraine patients who were current triptan users (use within prior 3 months and for ≥1 year) or past triptan users (no use within 6 months; prior use within 2 years).