Transcranial Doppler measurements in migraine and nitroglycerin headache

Abstract

The objective of this study was to examine the cerebral circulation during spontaneous migraine attacks and to compare changes to an experimental headache model induced by nitroglycerin (NTG) infusion. This prospective study was carried out in a tertiary care hospital on migraineurs with or without aura. Healthy volunteers served as controls. There were no interventions. Flow velocity (FV) and pulsatility index (PI) were measured in migraineurs between and during headache attacks. In controls, FV and PI of the middle cerebral arteries were performed at baseline and after each IV infusion of 0.125, 0.25 and 0.5 μg/kg/min of NTG. In migraineurs, a significant increase in the mean flow velocity (MFV) in the left vertebral artery (VA) and the V V PI of the right VA during spontaneous migraine headache was found. In controls, all FV significantly decreased after infusion of NTG. The NTG model produces expected and substantially different f f vascular effects than those seen with f f spontaneous migraine headache.

Measurement of Blood Flow Velocity in the Middle Cerebral Artery During Spontaneous Migraine Attacks: A Systematic Review

“…About 14 studies reported use of TCD measurements at 2 MHz pulsed ultrasound, but the depth variations as well as using the same parts of the temporal window or meato‐orbital‐line and other inter‐operator methodological discrepancies cannot be ruled out. The remaining three studies did not report technical TCD information . The included studies thus represent a very heterogeneous group rendering quantitative data synthesizing inappropriate for this review.…”

Advanced neuroimaging of migraine

“…A multitude of studies using mostly indirect measurements of vascular diameter have provided conflicting results. (13–17) A recent 3-Tesla magnetic resonance angiography study has questioned the importance of the cerebral vasculature in the pathophysiology of migraine. (18) Investigations of twenty migraine without aura attacks provoked by nitroglycerin identified no significant changes in cerebral artery diameters or cerebral blood flow during migraine.…”

Opposite Reactivity of Meningeal versus Cortical Microvessels to the Nitric Oxide Donor Glyceryl Trinitrate Evaluated In Vivo with Two-Photon Imaging

“…In order to obtain novel information on intracranial vascular processes during headache, a variety of methods have been employed, ranging from transcranial Doppler (TCD) [8] to high resolution magnetic resonance angiography (MRA) [6]. In animal models, closed cranial window with intravital epifluorescence microscopy is one of the best established methods since the end of 90s [9].…”