Correlations Between Endothelial Dysfunction and Cerebral Imaging in Migraine

Abstract

Objective: Despite its high prevalence, the basic pathophysiologic mechanism of migraine is still poorly understood. Our aim was to research endothelial dysfunction in patients with recently diagnosed episodic migraine, and to determine whether there was a correlation between endothelial dysfunction and white matter lesions (WMLs) on magnetic resonance imaging (MRI). Materials and Methods: This study was conducted between 2013 and 2014. A total of 51 patients and 27 healthy controls were included in the study. MRI was performed in the patient group. Blood samples were collected to investigate serum level of lipids, thyroid hormones, asymmetric dimethyl arginine, and endothelin levels in the patient and control groups. Homeostasis model assessment = insulin resistance factor and brachial artery index flow-mediated dilatation (FMD) were investigated in both groups. Results: WMLs on MRI were present in 40 patients with migraine. FMD was low in patients with migraine (p=0.021). There was a negative correlation between the severity of migraine headache and FMD. A positive correlation was seen between severity of headache and WMLs (p=0.001). The other blood sample concentrations in both the case and control groups were not significantly different. When the blood parameters were evaluated with MRI lesion load, there was a positive correlation with age, cholesterol, low-density lipoprotein, body mass index and triglyceride, and contrary to expectations, there was no relationship with homocysteine. However, there was a significant correlation between insulin resistance and lesion load (p<0.03). Conclusion: In this study, especially in patients with episodic migraine with WMLs, FMD as a marker for endothelial dysfunction was found to be statistically significant. This finding contributes to the pathogenesis of migraine. An endothelial therapeutic drug could be considered as an option, especially in patients who need prophylaxis.

Serotonin and Neuropeptides in Blood From Episodic and Chronic Migraine and Cluster Headache Patients in Case‐Control and Case‐Crossover Settings: A Systematic Review and Meta‐Analysis

“…In Han et al 36 and Tvedskov et al, 21 8.3% and 33.3% of the patients had menstrual migraine, respectively, with no association detected between menstrual migraine and the neuropeptide plasma level. D'Andrea et al 37 considered different phases of the menstrual cycle in non‐menstrual migraine patients, Caproni et al 38 and Juhasz et al 39 only assessed women in the follicular phase, and Fekrazad et al 40 and Sacmaci et al 41 only included women outside the menstruation period.…”

Prevalence and clinical characteristics of white matter hyperintensities in Migraine: A meta-analysis

“…The reported prevalence of WMHs in migraine varies widely across studies, ranging from 9.9 % to 78.4 % ( Honningsvåg et al, 2016 , Sacmaci et al, 2019 ). The correlations between WMHs and demographics or migraine characteristics (e.g., migraine subtypes and attack frequency) are also inconsistent across studies.…”

The beneficial effect of Alpha-lipoic acid supplementation as a potential adjunct treatment in episodic migraines

“…Past studies have reported increased cerebral blood flow (CBF) in migraine patients 30 . Following elevated CBF, NO production in endothelial cells increases as a response to shear forces and leads to flow-mediated dilation (FMD); thus, it can increase inflammatory responses 28 , 31 , 32 . Increased NO levels have been demonstrated in both migraines with and without aura 33 .…”