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Right-to-left shunt may be prone to affect the white matter integrity of posterior circulation in migraine without aura

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Abstract

Numerous studies have indicated an association between migraine and right-to-left shunt. However, little is known about whether right-to-left shunt has an effect on the migraine brain. This observational study aims to explore the impact of right-to-left shunt on the brain of migraine without aura on microstructural level. Thirty-five patients with migraine without aura were enrolled in this study. Contrast-enhanced Transcranial Doppler was performed to evaluate the status of right-to-left shunt. Three-dimensional T1-weighted and diffusion tensor images were acquired for data analysis. We employed voxel-based morphometry and tract-based spatial statistical analyses to assess the differences of gray and white matter between migraineurs with and without right-to-left shunt, respectively. Among the 35 patients, 19 (54.3%) patients had right-to-left shunt. There were no significant differences in headache features between migraineurs with and without right-to-left shunt. There were significant increases of mean and radial diffusivity in migraineurs with right-to-left shunt compared with migraineurs without right-to-left shunt. The alterations were primarily located in the right posterior thalamic radiation, secondly in the body of corpus callosum and the right superior corona radiata. No significant differences were observed in values of fractional anisotropy and axial diffusivity. No significant between-group differences were found in gray matter volume. Right-to-left shunt may cause alterations of white matter integrity in migraine without aura, and the alterations are more likely to be located at the posterior circulation.

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Authors and Affiliations

  1. Department of Neurology, First Affiliated Hospital of Xi’an Jiaotong University, No. 277, Yanta West Road, Xi’an, Shaanxi-Province, 710061, China

    Hui Xie, Kang Huo, Rui Liu, Dan Zhu, Lihui Zhang, Jun Wu & Guogang Luo

  2. Department of Radiology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China

    Yitong Bian, Zhijie Jian & Jian Yang

  3. Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi’an, China

    Jixin Liu

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  1. Hui Xie
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Correspondence to Guogang Luo.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Xie, H., Bian, Y., Jian, Z. et al. Right-to-left shunt may be prone to affect the white matter integrity of posterior circulation in migraine without aura. Neurol Sci 39, 119–125 (2018). https://doi.org/10.1007/s10072-017-3161-9

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