Myogenic Cerebrovascular Autoregulation in Migraine Measured by Stress Transcranial Doppler Sonography

Heckmann, J. G.; Hilz, M. J.; Katalinic, Alexander; Marthol, H.; Mück-Weymann, M.; Neundörfer, B.

doi:10.1046/j.1468-2982.1998.1803133.x

Cited by 37 publications

(23 citation statements)

References 10 publications

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“…One study found the vasoconstrictory response during stress-induced ABP increases to being impaired in 15 MA patients. 24 Using spontaneous ABP oscillations in 22 migraine patients (12 with MA), others found clearly pathological phase values in migraine patients in the MCA, both in MO and MA. 25 This led to the assumption of a neurogenic disturbance of the autoregulatory mechanism because of migraine-associated autonomic dysfunction.…”

Section: Previous Studies On Migraine and Autoregulationmentioning

confidence: 97%

Cerebellar and Cerebral Autoregulation in Migraine

Reinhard

Schork

Allignol

et al. 2012

Stroke

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Background and Purpose-Silent ischemic brain lesions frequently occur in migraine with aura and are most often located in cerebellar border zones. This may imply an impairment of cerebellar blood flow autoregulation. This study investigated the characteristics of interictal cerebellar autoregulation in migraine with and without aura. Methods-Thirty-four patients (nϭ17, migraine without aura; nϭ17, migraine with aura) and 35 age-and sex-matched controls were studied. Triple simultaneous transcranial Doppler monitoring of one posterior inferior cerebellar artery, right posterior cerebral artery, and left middle cerebral artery was performed. Autoregulation dynamics were assessed from spontaneous blood pressure fluctuations (correlation coefficient index Dx) and from respiratory-induced 0.1-Hz blood pressure oscillations (phase and gain). Results-Compared with controls, the autoregulatory index Dx was higher (indicating less autoregulation) in the posterior inferior cerebellar artery (Pϭ0.0062) and middle cerebral artery (Pϭ0.0078) in migraine with aura, but not in migraine without aura. Phase and gain did not significantly differ between migraine patients and controls. No significant associations of autoregulation with clinical factors were found, including frequency of migraine attacks and orthostatic intolerance. Conclusions-This

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Section: Previous Studies On Migraine and Autoregulationmentioning

confidence: 97%

Cerebellar and Cerebral Autoregulation in Migraine

Reinhard

Schork

Allignol

et al. 2012

Stroke

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“…[5][6][7][8][9] Especially, studies with f-TCD demonstrated altered interictal cerebrovascular reactivity to several stimuli, such as CO 2 , 10,12-15 visual stimulation, [16][17][18][19][20] Valsalva maneuver, 21,22 or others. [23][24][25] These methods are suggested to reflect interictal vasomotor changes of pathophysiologic interest and could be used as a monitoring tool under prophylactic migraine treatment. However, there have been sparse data on this.…”

Section: Introductionmentioning

confidence: 99%

Cerebrovascular Response in Migraineurs During Prophylactic Treatment with Acupuncture: A Randomized Controlled Trial

Wallasch

Weinschuetz²,

Mueller

et al. 2012

The Journal of Alternative and Complementary Medicine

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“…Ergometer transcranial Doppler (TCD) studies in humans are useful for evaluating cerebrovascular autoregulation and in detecting cerebrovascular abnormalities in patients with defined diseases [6, 7, 8, 9]. The aim of this study was to present the TCD ergometer test as a method of determining the cerebrovascular reactivity and time course in a group of elderly healthy individuals and to compare these results with those of a group of young healthy individuals.…”

Section: Introductionmentioning

confidence: 99%

Delayed Cerebrovascular Autoregulatory Response to Ergometer Exercise in Normotensive Elderly Humans

Heckmann

Brown²,

Cheregi³

et al. 2003

Cerebrovasc Dis

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Background: Relatively little is known about physiological cerebrovascular haemodynamics during physical stress in elderly healthy individuals. The aim of this study was to determine the effect of ergometer stress on cerebrovascular haemodynamics in elderly healthy individuals in comparison with young healthy individuals, using non-invasive methods. Methods: Continuous middle cerebral artery blood flow velocity (CBFV; transcranial Doppler ultrasound), beat-to-beat blood pressure, heart rate and transcutaneous pCO₂ were measured in response to 3 min ergometer exercise stress in 18 elderly healthy subjects (mean age ± SD 66.5 ± 5.8 years) and 18 healthy young subjects (mean age ± SD 29.4 ± 4.7 years). Pulsatility index (PI) was used as a parameter for cerebrovascular resistance. The subjects were in a supine position with an elevated trunk and performed exercise by pedalling on an ergometer, generating 75–100 W. Statistical analysis was carried out using MANOVA, a general linear model with repeated measures. Results: In both groups, blood pressure increased significantly (p < 0.001) with time during exercise, with no significant differences between the groups or regarding interaction (time sequence/group factor). Heart rate increased significantly with time during exercise (p < 0.001) and was significantly more prominent (p = 0.002) and prolonged (p < 0.001) in the young group. pCO₂ did not differ with time or between the groups and with regard to interaction. Mean CBFV (MFV) increased significantly during time (p < 0.001). Between the groups, there was no significant difference (p = 0.836), but with regard to interaction (time sequence/group factor), there was a significant delay in MFV increase in the group of young subjects (p = 0.002). The PI, a measure of cerebrovascular resistance, increased significantly with time without significant differences between the groups (p = 0.061), but was significantly delayed in the elderly regarding the interaction time sequence/group factor (p < 0.001). Conclusion: The cerebrovascular changes during ergometer exercise may reflect the combined activation of the cerebrovascular autoregulative mechanisms (predominantly neurogenic and myogenic). In healthy normotensive elderly subjects, cerebral autoregulatory capacity is retained but delayed in response to ergometer stress compared with young healthy subjects. We speculate that these findings may contribute to a higher risk of cerebral hypoperfusion in the elderly.

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Myogenic Cerebrovascular Autoregulation in Migraine Measured by Stress Transcranial Doppler Sonography

Cited by 37 publications

References 10 publications

Cerebellar and Cerebral Autoregulation in Migraine

Cerebellar and Cerebral Autoregulation in Migraine

Cerebrovascular Response in Migraineurs During Prophylactic Treatment with Acupuncture: A Randomized Controlled Trial

Delayed Cerebrovascular Autoregulatory Response to Ergometer Exercise in Normotensive Elderly Humans

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