Subclinical Cerebral Lesions in Migraine: A Proof-of-Concept Study on Platelet Aggregation.
6 affiliations
- 1Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
- 2Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
- 3Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
- 4Department of Neurology, Sant'Antonio Abate Hospital, Trapani, Italy.
- 5IRCCS Neuromed, Pozzilli, Italy.
- 6Department of Neurology, Fatebenefratelli Hospital-Gemelli Isola, Rome, Italy.
Abstract
Background
Migraine patients exhibit cerebral white matter lesions (WMLs) more frequently than the general population, with a potential micro-ischemic origin. Although platelet function in migraine patients has been extensively studied, no previous research has evaluated platelet function in those with WMLs. Our aim was to assess platelet aggregation in migraine patients with WMLs, to investigate their potential correlation with ischemic pathophysiology.Methods
We enrolled consecutive 34 patients diagnosed with episodic or chronic migraine, with or without aura (ICHD3 criteria), out of attacks, including 20 with WMLs and 14 without lesions. Patients on antiplatelet therapy, or those with inherited platelet disorders or thrombophilia, were excluded. All patients underwent MRI to identify and quantify WMLs in mm³. Platelet aggregation was assessed in response to various agonists (ADP, collagen, epinephrine, and arachidonic acid) and compared to a group of matched healthy volunteers (HV).Results
Platelet aggregation in response to epinephrine was lower in migraine patients compared to HV. Among migraine patients, those with a lesion load ≥ 146.25 mm³ (forth quartile of the WMLs total volume) showed significantly higher platelet aggregation in response to epinephrine (1.25 and 2.5 μM), compared to those with a lesion load < 146.25 mm³ or no lesions (p = 0.043 and p = 0.0047, respectively).Conclusions
Migraine is associated with reduced platelet aggregation compared to HV, which may serve as a protective mechanism. However, in patients with a higher burden of WMLs, platelet aggregation levels were comparable to those of HV, raising the possibility of an ischemic contribution to WMLs in migraine patients.
Related
- Association between early platelet aggregation function and 30-day mortality in patients with cerebral hemorrhage: a retrospective neurocritical care cohort study
- Incidence of left ventricular thrombus and subclinical cerebral infarction by magnetic resonance imaging 2 weeks after anterior ST-elevation myocardial infarction with impaired left ventricular function and apical akinesis
- Streptococcus oralis induces platelet aggregation through coordinated GPIbα and FcγRIIA signalling
- Interindividual variability in platelet aggregation among aspirin-treated patients: a large retrospective analysis
- PFOCUS study protocol: a prospective case–control study investigating genetic, haemodynamic, and platelet function in migraine with aura with or without patent foramen ovale
BibTeX
@article{maestrini2026subclinical,
title = {{Subclinical Cerebral Lesions in Migraine: A Proof-of-Concept Study on Platelet Aggregation.}},
author = {Ilaria Maestrini and Mariaignazia Curreli and Marta Puma and Costanza Giannì and Eleonora Schiera and Giada Giuliani and Massimiliano Toscano and Marta Altieri and Patrizia Pantano and Fabio Pulcinelli and Vittorio Di Piero},
journal = {European journal of neurology},
year = {2026},
month = nov,
doi = {10.1111/ene.70432},
url = {https://europepmc.org/article/MED/42969654},
note = {CC BY},
}
RIS
TY - JOUR
TI - Subclinical Cerebral Lesions in Migraine: A Proof-of-Concept Study on Platelet Aggregation.
AU - Ilaria Maestrini
AU - Mariaignazia Curreli
AU - Marta Puma
AU - Costanza Giannì
AU - Eleonora Schiera
AU - Giada Giuliani
AU - Massimiliano Toscano
AU - Marta Altieri
AU - Patrizia Pantano
AU - Fabio Pulcinelli
AU - Vittorio Di Piero
PY - 2026
DA - 2026/11/01
JO - European journal of neurology
DO - 10.1111/ene.70432
UR - https://europepmc.org/article/MED/42969654
AB - Background Migraine patients exhibit cerebral white matter lesions (WMLs) more frequently than the general population, with a potential micro-ischemic origin. Although platelet function in migraine patients has been extensively studied, no previous research has evaluated platelet function in those with WMLs. Our aim was to assess platelet aggregation in migraine patients with WMLs, to investigate their potential correlation with ischemic pathophysiology.Methods We enrolled consecutive 34 patients diagnosed with episodic or chronic migraine, with or without aura (ICHD3 criteria), out of attacks, including 20 with WMLs and 14 without lesions. Patients on antiplatelet therapy, or those with inherited platelet disorders or thrombophilia, were excluded. All patients underwent MRI to identify and quantify WMLs in mm³. Platelet aggregation was assessed in response to various agonists (ADP, collagen, epinephrine, and arachidonic acid) and compared to a group of matched healthy volunteers (HV).Results Platelet aggregation in response to epinephrine was lower in migraine patients compared to HV. Among migraine patients, those with a lesion load ≥ 146.25 mm³ (forth quartile of the WMLs total volume) showed significantly higher platelet aggregation in response to epinephrine (1.25 and 2.5 μM), compared to those with a lesion load < 146.25 mm³ or no lesions (p = 0.043 and p = 0.0047, respectively).Conclusions Migraine is associated with reduced platelet aggregation compared to HV, which may serve as a protective mechanism. However, in patients with a higher burden of WMLs, platelet aggregation levels were comparable to those of HV, raising the possibility of an ischemic contribution to WMLs in migraine patients.
SN - 1351-5101
SN - 1468-1331
ER -