Reduced breath holding index in patients with chronic migraine

Abstract

Migraine is a neurovascular disorder characterized by autonomic nervous system dysfunction and severe headache attacks. Studies have shown that changes in the intracranial vessels during migraine have an important role in the pathophysiology. Many studies have been conducted on the increased risk of stroke in patients with migraine, but insufficient data are available on the mechanism underlying the increase. This study aimed to evaluate basal cerebral blood flow velocity and vasomotor reactivity in patients with chronic migraine. We evaluated 38 patients with chronic migraine. Three of them were excluded because they had auras and four of them were excluded because of their use of medication that can affect cerebral blood flow velocity and breath holding index (beta or calcium channel blockers). Our study population consisted of 31 patients with chronic migraine without aura and 29 age- and gender-matched healthy individuals who were not taking any medication. The mean blood flow velocity and breath holding index were measured on both sides from the middle cerebral artery and posterior cerebral artery, with temporal window insonation. The breath holding index for middle cerebral artery and posterior cerebral artery was significantly lower in the migraine group compared to that of the control group (p < 0.05).The vasomotor reactivity indicates the dilatation potential of a vessel, and it is closely related to autoregulation. According to our results, the vasodilator response of cerebral arterioles to hypercapnia was lower in patients with chronic migraine. These findings showed the existence of impairments in the harmonic cerebral hemodynamic mechanisms in patients with chronic migraine. This finding also supports the existing idea of an increased risk of stroke in patients with chronic migraine due to impaired vasomotor reactivity.

Erenumab does not alter cerebral hemodynamics and endothelial function in migraine without aura

“…It is worth noting that none of our patients suffered from migraine with aura. This finding is in line with previous observations of preserved VMR in patients with migraine without aura (12–14) but contrasts with some reports of reduced VMR and FMD in a chronic condition (16,17). Compared to these latter studies, it is worth noting that our results are derived from a large population of migraine patients with a long-lasting disease history and are based on repeated measures.…”

“…VMR has proven a consistent marker of cerebral hemodynamics efficiency and may correlate with stroke risk (30). However, the studies investigating cerebral VMR in migraine patients were not consistent, leaving unresolved the question of whether migraneurs have a disfunction of cerebral hemodynamics (1–17).…”

Systemic and cerebral endothelial dysfunction in chronic migraine. A case-control study with an active comparator

“…Akgün et al. in 2014 found reduced BHI in CM patients in the interictal state, but only versus controls (16). Corretti et al.…”

Breath holding index in episodic primary headaches

“…The difference in interictal cerebrovascular reactivity in patients with migraine without aura and episodic TTH was not found 9 . That kind of difference did not show neither by comparison of patients with TTH and healty controls 13,14 .…”

“…Cerebrovascular reactivity in patients with migraine have been widely examined by different metodology and different conclusions were brought. [12][13][14][15][16][17][18] . The key point of those differences was whether the vasoconstrictor or vasodilator stimuli was used.…”