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An Observation, Not a Disease

Tobias Kurth, MD, ScD; Christophe Tzourio, MD, PhD

JAMA. 2009;301(24):2594-2595.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Migraine is a common, chronic-intermittent neurovascular headache disorder characterized by moderate to severe headache attacks and various combinations of gastrointestinal and autonomic nervous system disturbances.^1-2 The prevalence peaks in midlife and approximately 12% of the population is affected, with women being affected 3 to 4 times more often than men.³ In approximately one-third of patients with migraine, transient neurological symptoms occur that mostly involve the visual field but can also involve the sensory or motor system (migraine aura). While the specifics of migraine pathophysiology are still being unveiled, dysfunction of brain cells and arteries has been identified as a major component.^{1, 4}

In several neuroimaging studies and a meta-analysis,⁵ migraine has been associated with brain lesions, mostly in white matter, with the meta-analysis finding an odds ratio (OR) of 3.9 (95% confidence interval [CI], 2.3-6.7). However, the cause and mechanisms of the white . . . [Full Text of this Article]

Author Affiliations: INSERM Unit 708–Neuroepidemiology, and the Faculty of Medicine, University Pierre et Marie Curie, Paris, France (Drs Kurth and Tzourio); and the Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, and the Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts (Dr Kurth).

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