White Matter Hyperintensities Linked to Tension-Type Headaches

brain MRI
brain MRI
Investigators sought to determine the relationship between headache and white matter hyperintensities.

Patients with extensive white matter hyperintensities are likely to have tension-type headaches or to have headaches develop during middle age, according to results published in Cephalagia.

Currently, there are no established treatments or strategies for managing white matter hyperintensities. Thus, the researchers note that their results do not indicate that patients with headache should undergo brain magnetic resonance imaging (MRI) to map white matter hyperintensities. However, addressing cardiovascular risk factors may delay the progression of white matter hyperintensities.

The study included participants of the Nord-Trøndelag Health Study (HUNT MRI), who were categorized into 4 headache groups using validated questionnaires: headache-free (n=551), tension-type headache (n=94), migraine (n=91), and unclassified headache (n=126). The researchers used prospective questionnaires to further categorize participants into groups according to the evolution of headache during the previous 12 years: stable headache-free, past headache, new-onset headache, and persistent headache.

The researchers assessed participants’ white matter hyperintensities amount using Fazekas and Scheltens scales and by manual and automated volumetry of MRI.

Compared with headache-free participants, participants with tension-type headaches were more likely to have extensive white matter hyperintensities (Scheltens scale: odds ratio 2.46; 95% CI, 1.44-4.20).

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Participants in the migraine and unclassified headache groups were not more likely to have extensive white matter hyperintensities compared with headache-free participants.

Compared with participants who were stable headache-free, participants with new-onset headaches were more likely to have extensive white matter hyperintensities (Scheltens scale: odds ratio 2.24; 95% CI, 1.13-4.44).


Honningsvåg LM, Håberg AK, Hagen K, Kvistad KA, Stovner LJ, Linde M. http:White matter hyperintensities and headache: a population-based imaging study (HUNT MRI) [published online March 11, 2018]. Cephalagia. doi:10.1177/0333102418764891