Endothelial dysfunction state in migraine headache and neutrally mediated syncope in children and young adults

Sabri, Mohammad Reza; Dehghan, Bahar; Yaghini, Omid; Nasiri, Jafar; Mansourian, Marjan; Khalifehsoltani, Shiva

doi:10.4103/1735-1995.168384

Cited by 14 publications

(5 citation statements)

References 19 publications

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“…The few studies that found a decrease in FMD included one with an exaggerated contextual nitrate-mediated dilation, 71 one involving only MO patients, 72 and one involving CM patients. 9 Conversely, other studies found an increase in FMD in young migraine patients, 73 particularly during migraine attacks, 74 supporting the role of NO release in the induction of migraine pain. Rajan et al 75 and Larsen et al 76 (in a large population-based study) could not find any differences in FMD between migraineurs and controls.…”

Section: Resultsmentioning

confidence: 94%

The Role of Endothelial Dysfunction in the Pathophysiology and Cerebrovascular Effects of Migraine: A Narrative Review

2021

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Background and Purpose Migraine is a complex neurovascular disorder whose triggers are not entirely understood. Endothelial dysfunction might play a role in migraine, and there have been numerous reports on endothelium dysfunction and migraine pathophysiology, but their reciprocal cause–effect relationship remains unclear. This review reports the current evidence on endothelium dysfunction, its link with migraine, and its possible consequences for cerebral hemodynamics. Methods We performed a systematic literature search of PubMed up to March 2020. We included 115 articles in a narrative review. Results Several studies have demonstrated that endothelium dysfunction may play an important role in migraine. Despite the lack of specific biomarkers, there is evidence of oxidative stress and inflammation—two of the primary causes of endothelial damage—in migraine. The main consequences of endothelial dysfunction are increased vascular tone, thrombosis, inflammation, and increased vascular permeability. As a consequence of oxidative stress, the activity of endothelin-1 is not counterbalanced by nitric oxide (NO), whose levels decrease to lead to vasoconstriction and a possible contribution to cortical spreading depression. NO is involved in pain perception via the cyclic guanosine monophosphate (cGMP) pathway and the induction of calcitonin gene-related peptide. Oxidative stress may induce a hypercoagulable state that mainly affects platelet function through different mechanisms. Endothelial dysfunction seems to be particularly pronounced in migraine with aura (MA). Endothelial dysfunction in migraine particularly involves intracranial vessels, since flow-mediated dilation cannot detect overt peripheral vascular dysfunction. Conclusions Endothelial dysfunction is a vascular risk marker. How it impacts migraine, and particularly MA, needs to be understood better by defining its possible role in increasing the stroke risk in migraine patients.

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Section: Resultsmentioning

confidence: 94%

The Role of Endothelial Dysfunction in the Pathophysiology and Cerebrovascular Effects of Migraine: A Narrative Review

2021

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“…In the other study on the contrary, IMT was lower and flow-mediated dilatation of the brachial artery – another marker of vascular dysfunction – was higher (i.e. better) in 21 patients (aged 5–20 years) with migraine and 20 patients with migraine and history of syncope compared to 30 healthy controls [ 45 ]. No study has previously evaluated PWV in children with headaches.…”

Section: Discussionmentioning

confidence: 99%

Early Vascular Ageing in adolescents with migraine with aura: a community-based study

Bernar

Gande

Stock

et al. 2023

BMC Cardiovasc Disord

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Background Migraine with aura is associated with an increased risk of cardiovascular disease, yet the pathophysiology is unknown. Suggested underlying mechanisms of aura formation point into the direction of an abnormal vasoreactivity that also extends to the extracranial vasculature. Methods In the Early Vascular Ageing Tyrol study, a community-based non-randomized controlled trial conducted in 45 schools and companies in Tyrol (Austria) and South-Tyrol (Italy) between May 2015 and September 2018 aiming to increase cardiovascular health in adolescents, headache syndromes were classified according to the International Classification of Headache Disorders in a face-to-face interview. Carotid-femoral pulse-wave-velocity was measured by applanation tonometry and carotid intima-media-thickness by high-resolution ultrasound of the distal common carotid arteries. Differences in pulse-wave-velocity and carotid intima-media-thickness in youngsters with migraine with aura were compared respectively to those without headache and with other headaches by multivariable linear regression analysis. Results Of the 2102 study participants 1589 were aged 14 to 19 (mean 16.8) years and had complete data. 43 (2.7%) reported migraine with aura and 737 (46.4%) other headaches. Mean pulse-wave-velocity was 6.17 m/s (± 0.85) for migraine with aura, 6.06 m/s (± 0.82) for all other headaches and 6.15 (0.95) m/s for participants without headaches. Carotid intima-media-thickness was 411.3 µm (± 43.5) for migraine with aura, 410.9 µm (± 46.0) for all other headaches and 421.6 µm (± 48.4) for participants without headaches. In multivariable linear regression analysis, we found no differences in carotid-femoral pulse-wave-velocity or carotid intima-media-thickness in young subjects with migraine with aura, all other headaches, or no headaches. Conclusions In line with previous large-scale studies in adults, we could not demonstrate relevant associations of migraine with aura with markers of arterial stiffness or subclinical atherosclerosis making early vascular ageing an unlikely pathophysiological link between migraine with aura and cardiovascular diseases. Trial registration First registered on ClinicalTrials.gov 29/04/2019 (NCT03929692).

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“…A special pattern of inflammatory indicators has been detected in the systemic circulation in migraine patients, including increased levels of C-reactive proteins (CRP) 79 , interleukins (ILs e.g. IL-1 and IL-6) 80 , 81 , tumor necrosis factor-alpha (TNF-α) and adhesion molecules (ICAM and VCAM) 23 , 82 . These inflammatory markers disrupt the tendency of the blood cells to aggregate and lead to thrombosis and endothelial dysfunction 83 , 84 .…”

Section: Discussionmentioning

confidence: 99%

“…sVCAMs are involved in inflammation by mediating leukocyte adhesion to vascular cells 41 . CAM serum levels show elevated levels of the intracellular adhesion molecules (ICAM) and vascular cell adhesion molecules (VCAM) in children and young adults with migraine 23 , 42 , 43 .…”

Section: Introductionmentioning

confidence: 99%

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

Kelishadi

Naeini

Khorvash

et al. 2022

Sci Rep

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The current study was performed to evaluate the effects of alpha-lipoic acid (ALA) supplementation on lactate, nitric oxide (NO), vascular cell adhesion molecule-1 (VCAM-1) levels, and clinical symptoms in women with episodic migraines. Considering the inclusion and exclusion criteria, ninety-two women with episodic migraines participated in this randomized, double-blind, placebo-controlled, parallel-design trial. The participants were randomly assigned to receive either 300 mg/day ALA or placebo, twice per day for 12 weeks. The primary outcomes included headache severity, headache frequency per month, and duration of attacks and the secondary outcomes included lactate (a marker of mitochondrial function), NO, and VCAM-1 serum levels were measured at baseline and the end of the intervention. At the end of the study, there was a significant decrease in lactate serum levels (− 6.45 ± 0.82 mg/dl vs − 2.27 ± 1.17 mg/dl; P = 0.039) and VCAM-1 (− 2.02 ± 0.30 ng/ml vs − 1.21 ± 0.36 ng/ml; P = 0.025) in the ALA as compared to the placebo group. In addition, the severity (P < 0.001), frequency (P = 0.001), headache impact test (HIT-6) (P < 0.001), headache dairy results (HDR) (P = 0.003), and migraine headache index score (MHIS) (P < 0.001) had significantly decreased in the intervention as compared to the control group. No significant changes were observed for NO levels and duration of migraine pains. ALA supplementation can be considered a potential adjunct treatment in patients with migraine due to its improving mitochondrial and endothelial functions and clinical symptoms.

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Endothelial dysfunction state in migraine headache and neutrally mediated syncope in children and young adults

Cited by 14 publications

References 19 publications

The Role of Endothelial Dysfunction in the Pathophysiology and Cerebrovascular Effects of Migraine: A Narrative Review

The Role of Endothelial Dysfunction in the Pathophysiology and Cerebrovascular Effects of Migraine: A Narrative Review

Early Vascular Ageing in adolescents with migraine with aura: a community-based study

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

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