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Migraine as a Risk Factor for Subclinical Brain Lesions
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To The Editor: Dr Kruit and colleagues1 concluded that some patients with migraine, either with or without aura, are at increased risk for subclinical brain lesions.
I have several reservations about the design and analysis of this study. First, the study was underpowered due to insufficient outcomes, which limits the number of potential confounding factors that can be included in the analysis.
Second, and related to this lack of statistical power, the authors based their conclusion on their secondary outcome of increased brain lesion load in the posterior circulation. The primary outcome in the study—increased total brain lesion load in any location—was not statistically different between the patients with migraine headache and those without. The sample size and the power calculation were based on the primary outcome; thus, any secondary outcome results would also be underpowered and would require an additional power calculation.
Third, the authors did not describe the . . . [Full Text of this Article]
Osama O. Zaidat, MD
osama.zaidat@duke.edu
Department of Radiology
Duke University Medical Center
Durham, NC
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