Migraine and autonomic nervous system function

Shechter, Aaron; Stewart, Walter F.; Silberstein, Stephen D.; Lipton, Richard B.

doi:10.1212/wnl.58.3.422

Cited by 137 publications

(141 citation statements)

References 38 publications

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“…20 Several clinical observations have found autonomic abnormalities in migraineurs compared to normal controls. [21][22][23][24] Periaqueductal gray (PAG) has been demonstrated to be dysfunctional in migraine. MRI imaging has determined that iron accumulation occurs in the PAG and that these changes correlate with duration of migraine frequency, are not independent of the presence of aura, and do not correlate with patient age.…”

Section: Commentsmentioning

confidence: 99%

Gastric Stasis in Migraine: More Than Just a Paroxysmal Abnormality During a Migraine Attack

Aurora¹,

Kori²,

Barrodale³

et al. 2006

Headache

111

123

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Objective.-The aim of this article is to evaluate gastric motility and emptying in the ictal and interictal period in migraine.Background.-Nausea is a predominant symptom of migraine and the basis of it is thought to be gastric stasis. Objective methods to establish this are however lacking. We utilized gastric scintigraphy studies to determine gastric motility in the ictal and interictal period of migraine.Methods.-Ten migraine subjects were compared to equal number of age and sex matched controls. Gastric scintigraphy using a standard meal was performed in all control subjects once and in all 10 migraine subjects in the interictal period and nine studies were performed in the ictal period migraine.Results.-The time to half emptying was delayed in migraine ictally (78%) and interictal period (80%) using normative data at this institution. Gastric stasis was less pronounced ictally (149.9 minutes) compared to interictal period (188.8 minutes). There was a significant delay compared to nonmigrainous controls (migraine 188.8 minutes vs normal controls 111.8 minutes; P < .05). These data were replicated in percentage of radioactive material remaining in the stomach at 2 hours.Conclusions.-Contrary to previous belief, this study has demonstrated that migraineurs suffer from gastric stasis both during and outside an acute migraine attack. This may suggest that migraineurs may have an abnormal autonomic function compared to nonmigrainous controls. The potential role of this in pathophysiology of migraine is discussed and avenues for further investigations are explored.

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Section: Commentsmentioning

confidence: 99%

Gastric Stasis in Migraine: More Than Just a Paroxysmal Abnormality During a Migraine Attack

Aurora¹,

Kori²,

Barrodale³

et al. 2006

Headache

111

123

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“…Controversial theories about the cause and mechanisms of migraine range from experiments that show impaired brain energy metabolism [4], autonomic nervous system (ANS) hypofunction [5,6], brain cell hyperexcitability to low intracellular brain magnesium [7][8][9][10][11][12][13][14][15]. Once considered solely a vascular event, current research supports a combination of both neural and vascular causes [16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Transcranial magnetic stimulation for migraine: clinical effects

et al. 2006

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The objective was to assess the impact of transcranial magnetic stimulation (TMS) on pain and the autonomic nervous system (ANS) in migraine. Fortytwo people [mean age 41.43±11.69 (SD) years, 36 females] were randomised into high vs. low TMS stimulation groups and received 2 brief pulses of TMS. Thirty-three (33/42) individuals had heart-rate variability assessed, before and after stimulation. No group effects were found. Pain decreased by 75%; 32% of people after 1 treatment reported no headache after 24 h. Mean heart rate decreased from 79.05±10.27 to 72.89±11.35 beats/min. The low-frequency (LF) and the high-frequency (HF) areas derived from power spectral analyses increased [mean 6522±1277 to 8315±1009 beats/min 2 (LF) (p=0.001) and mean 5600±1568 to 8755±3071 beats/min 2 (HF) (p=0.001)]. The LF:HF ratio decreased from mean 1.31±0.51 to 1.13±0.48 (NS). TMS produces immediate, sustained reductions in pain and modification of the ANS.

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“…The observed significant increase in sBP and unchanged dBP variables might be related with inhibition of PNS activity in M2 group patients. However, in some studies an opposite effect was found, such as, decreased sBP (Gudmundsson et al, 2006) and increased dBP (Shechter et al, 2002) at rest. These discrepancies may be associated with different ANS activity properties of migraine patients.…”

Section: Discussionmentioning

confidence: 93%

Autonomic nervous system properties in migraine patients and nonmedication treatment in headache free period

Voita¹,

Vaļēviča²,

Zakke³

et al. 2010

Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.

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Autonomic nervous system properties in migraine patients and nonmedication treatment in headache free period The aim of the study was to characterise parameters of the autonomic nervous system in migraineurs and to find out and to adapt the optimal biofeedback (BFB) training methods. Heart rate (HR), arterial blood pressure and baroreflex sensitivity (BRS) at rest, static workload, arterial occlusion and during recovery period were measured. 22 migraineurs (female, average age 22.2 ± 2.4 years) and 14 healthy age and gender matched controls participated. Migraine patients were divided into two groups (M1 and M2) according to HR and BRS at rest. At rest 60% of migraine patients (group M1) had significantly decreased HR vs. control group (P< 0.01). The M2 group showed a tendency to decreased BRS at rest comparing to the control group and significantly (P< 0.01) differed in this parameter from the M1 group. In a 10 s precontraction period M1 group had a significantly lower HR increase comparing to other analysed groups (P< 0.01). HR was significantly decreased in the M1 group during the recovery period comparing to the control and M2 groups (P< 0.05). Both parts of autonomic nervous system, PNS and SNS branches, were impaired in migraineurs. The M2 group had most likely decreased PNS activity and impaired SNS activity. M1 group patients showed increased PNS activity. BFB training sessions reduced migraine attack frequency and need for medication in the M2 group.

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Migraine and autonomic nervous system function

Cited by 137 publications

References 38 publications

Gastric Stasis in Migraine: More Than Just a Paroxysmal Abnormality During a Migraine Attack

Gastric Stasis in Migraine: More Than Just a Paroxysmal Abnormality During a Migraine Attack

Transcranial magnetic stimulation for migraine: clinical effects

Autonomic nervous system properties in migraine patients and nonmedication treatment in headache free period

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