5 results on '"Dinia, L."'
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2. Cerebral distribution of white matter lesions in migraine with aura patients
- Author
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Rossato, G, Adami, A, Thijs, V, Cerini, R, Pozzi Mucelli, R, Mazzucco, S, Anzola, G, Del Sette, M, Dinia, L, Meneghetti, G, Zanferrari, C, SAM study group, and Diomedi, M
- Subjects
Adult ,Male ,medicine.medical_specialty ,Aura ,male ,magnetic resonance imaging ,migraine with aura ,female ,brain ,adult ,humans ,Migraine with Aura ,Fluid-attenuated inversion recovery ,White matter ,Medicine ,Humans ,migraine ,white matter lesions ,MRI ,medicine.diagnostic_test ,business.industry ,Brain ,Magnetic resonance imaging ,General Medicine ,medicine.disease ,Magnetic Resonance Imaging ,Hyperintensity ,Migraine with aura ,Clinical neurology ,medicine.anatomical_structure ,Migraine ,Anesthesia ,Settore MED/26 - Neurologia ,Female ,Neurology (clinical) ,Radiology ,medicine.symptom ,business - Abstract
Objective: The objective of the study was to compare the cerebral distribution of white matter lesions (WMLs) between migraine patients with different aura symptoms. Methods: Migraine with aura (MA) patients were consecutively enrolled as part of the Shunt-Associated Migraine (SAM) study. According to clinical symptoms, aura was classified as motor, aphasic, sensory, visual or vertebrobasilar. Standard and FLAIR (fluid attenuated inversion recovery) T2-weighted MRI sequences were inspected for WMLs by three independent raters blinded to clinical data. WMLs were assessed in the periventricular areas (PV-WMLs) with the Fazekas scale and in the deep white matter (D-WMLs) with the Schelten's scale. Interobserver agreement was good to excellent ( k = 0.64 to 0.96, p Results: One hundred and eighty-five patients (77% women) were included. Aura symptoms were classified as visual in 172 (99%) patients, sensory in 76 (42%), aphasic in 54 (30%), motor in 39 (21%) and vertebrobasilar in 17 (9%) patients. One hundred and four patients (57%) exhibited more than one type of aura. D-WMLs were mainly detected in the frontal lobes (86%). There was no association between type of aura and the presence of WMLs in any cerebral location. Conclusion: Aura symptoms do not influence the cerebral distribution of WMLs associated with migraine disease.
- Published
- 2010
3. Right-to-left shunt does not increase white matter lesion load in migraine with aura patients
- Author
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Adami, A, Rossato, G, Cerini, R, Thijs, V, Pozzi Mucelli, R, Anzola, G, Del Sette, M, Finocchi, C, Meneghetti, G, Zanferrari, C, Pascazio, L, Morandi, E, Gamba, M, Dinia, L, Sivori, G, Caputi, L, Parati, E, Carriero, M, Marchioretto, F, Santarello, G, Manzoni, G, Torelli, P, Devetak, A, Tanzi, A, Bosone, D, Diomedi, M, Leone, G, Vernieri, F, Altamura, C, Tiburzi, F, Mazzucco, S, and Inchingolo, E
- Subjects
Male ,Aura ,Ultrasonography, Doppler, Transcranial ,Right-to-left shunt ,Migraine with Aura ,Comorbidity ,Nerve Fibers, Myelinated ,Nerve Fibers ,Blood coagulation test ,Ultrasonography ,Doppler ,Settore MED/37 - Neuroradiologia ,Contraceptives ,Foramen Ovale, Patent ,Multivariate Analysis ,Middle Aged ,Female ,Heart Diseases ,Causality ,Humans ,Magnetic Resonance Imaging ,Adult ,Hypertension ,Contraceptives, Oral ,right-to-left shunt (RLS) ,Neuroradiology ,Cardiology ,Patent ,Settore MED/26 - Neurologia ,medicine.symptom ,MRI ,Foramen Ovale ,Oral ,medicine.medical_specialty ,Transcranial ,Internal medicine ,medicine.artery ,medicine ,business.industry ,medicine.disease ,Hyperintensity ,Migraine with aura ,Surgery ,Transcranial Doppler ,Migraine ,Patent foramen ovale ,Myelinated ,White matter lesions (WMLs) ,Neurology (clinical) ,business - Abstract
White matter lesions (WMLs) are commonly found on brain MRI of migraine patients. Migraine with aura (MA+) is associated with an increased frequency of right-to-left shunt (RLS) mostly due to patent foramen ovale. The relationship between WML load and RLS in MA+ is currently unknown.MA+ patients were consecutively enrolled as part of the Shunt Associated Migraine (SAM) study. Patients underwent a standardized headache and vascular risk factors questionnaire, contrast-enhanced transcranial Doppler, blood coagulation tests, and brain MRI. RLS was categorized into four grades: no shunt,10 microbubbles (mb),10 mb single spikes pattern, and10 mb shower/curtain pattern. Standard and fluid-attenuated inversion recovery T2-weighted MRI sequences were inspected for WMLs by three independent raters blinded to RLS grade. WML load was scored in the periventricular areas (PV-WMLs) with the Fazekas scale and in the deep white matter (D-WMLs) with the Scheltens scale. Interobserver agreement was good to excellent (kappa = 0.64 to 0.96, p0.0001). WML load was then correlated between patients with and without RLS.One hundred eighty-five patients (77% women) were included. PV-WML load was similar between patients with and without RLS. D-WML load decreased in patients with RLS (p = 0.045). On logistic regression analysis, only age was associated with WMLs (p0.001).The presence of right-to-left shunt does not increase white matter lesion load in patients who have migraine with aura.
- Published
- 2008
4. White matter lesions in migraine and right-to-left shunt: a conventional and diffusion MRI study.
- Author
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Del Sette, M., Dinia, L., Bonzano, L., Roccatagliata, L., Finocchi, C., Parodi, R. C., Sivori, G., and Gandolfo, C.
- Subjects
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MAGNETIC resonance imaging , *DIAGNOSTIC imaging , *MEDICAL imaging systems , *MIGRAINE , *PRECANCEROUS conditions - Abstract
Subjects with migraine with aura (MA) have a high prevalence of white matter lesions (WMLs) on magnetic resonance imaging (MRI). Moreover, right-to-left shunt (RILES), mainly due to patent foramen ovale, is frequently associated with MA. The aim of this study was to clarify the relationship between RILES and WML in MA. We enrolled 87 consecutive subjects affected by MA. Patients were screened for migraine characteristics and cerebrovascular risk factors. Transcranial Doppler was used to diagnose RILES and MRI with T2-weighted and diffusion-weighted imaging (DWI) to evaluate presence, number and volume of WMLs. RILES was present in 45% of patients. We did not detect any DWI hyperintense lesion; WMLs were present in 61% of patients on T2-weighted images. Presence of WMLs did not correlate with any migraine clinical feature, whereas the presence, number and volume of WMLs increased with subjects' age. There was no significant difference in the total volume and number of WMLs in the group with and without RILES. In conclusion, RILES does not increase the likelihood of finding WMLs in migraineurs. [ABSTRACT FROM AUTHOR]
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- 2008
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5. Is migraine associated with right-to-left shunt a separate disease? Results of the SAM study.
- Author
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Anzola, G. P., Meneghetti, G., Zanferrari, C., Adami, A., Dinia, L., and Del Sette, M.
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RESEARCH , *MIGRAINE , *BLOOD coagulation disorders , *PATIENTS , *CLINICAL trials - Abstract
Migraine with aura (MA) is associated with the persistence of patent foramen ovale (PFO) in about 50% of cases, and migraineurs tend to have larger shunts than controls, suggesting that right-to-left shunt (RILES) determined by PFO could play a role in triggering migraine attacks. Moreover, some preliminary reports have suggested that PFO closure may give relief to both migraine and aura attacks. The aim of this study was to clarify if shunt-associated migraine (SAM) has clinical features that allow a distinction from shunt-unrelated migraine (SUM), in a prospective, multicentre, observational study (SAM study). We enrolled consecutive MA patients, who underwent a structured, standardized questionnaire for family and personal history and for detailed migraine features. All were systematically screened for RILES with transcranial Doppler, and for coagulation disorders. Overall, 460 patients were included; the SUM and SAM classes comprised 58% and 42% of patients, respectively. SAM patients were significantly younger (34.1 ± 10 vs. 37.1 ± 11 years), had a more frequent family history of migraine (76% vs. 66%) and a higher frequency of sensory symptoms of aura (51% vs. 41%); by contrast, there was a lesser association of SAM with other cardiac abnormalities and with coagulation disorders. The SAM study suggests that the effect of RILES on migraine features is not relevant. The higher family history of migraine in SAM suggests a possible genetic linkage between migraine and RILES. [ABSTRACT FROM AUTHOR]
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- 2008
- Full Text
- View/download PDF
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