Abstract
BackgroundThere is a growing interest in the role of the endothelium in migraine. Recently, our group showed differences in endothelial function between the anterior and posterior cerebral circulation in healthy subjects, reduced vasodilatatory capacity of the posterior cerebral circulation and unimpaired systemic endothelial function in migraine patients without comorbidities. However, the relationship between cerebral and systemic endothelial function and the anterior and posterior cerebral endothelial function in migraine patients is still not clear.MethodsWe compared cerebral and systemic endothelial function through post-hoc linear regression analysis of cerebrovascular reactivity (CVR) to L-arginine between the middle cerebral artery (MCA) and flow-mediated vasodilatation (FMD) of the right brachial artery and the posterior cerebral artery (PCA) and FMD in migraine patients without comorbidities and in healthy subjects. The anterior and posterior cerebral endothelial function was also compared using post-hoc linear regression analysis between CVR to L-arginine in the MCA and the PCA.ResultsNo significant correlation was found between CVR to L-arginine in the MCA and FMD and in the PCA and FMD in migraine patients with aura (p = 0.880 vs. p = 0.682), without aura (p = 0.153 vs. p = 0.179) and in healthy subjects (p = 0.869 vs. p = 0.662). On the other hand, we found a significant correlation between CVR to L-arginine in the MCA and PCA in migraine patients with aura (p = 0.004), without aura (p = 0.001) and in healthy subjects (p = 0.002). Detailed analysis of the linear regression between all migraine patients and healthy subjects did not show any difference in the regression coefficient (slope) (p = 0.382). However, a significant difference in curve elevation (intercept) was found (p = 0.002).ConclusionsOur study suggests that the endothelial function in the cerebral and systemic circulation might be different in migraine patients without comorbidities, while that of the anterior and posterior cerebral circulation might be coupled. These results could improve understanding of endothelial function in migraine patients without comorbidities.
Highlights
There is a growing interest in the role of the endothelium in migraine
We did not find any significant correlation between flow-mediated vasodilatation (FMD) and cerebrovascular reactivity (CVR) to L-arginine in the middle cerebral artery (MCA) (p = 0.287; r2 = 0.031; Figure 1) and between FMD and CVR to L-arginine in the posterior cerebral artery (PCA) (p = 0.582; r2 = 0.008; Figure 2) in all migraine patients
We did not find any significant correlation between FMD and CVR to L-arginine in the MCA in migraine with aura (MwA) (p = 0.880; r2 = 0.001) and MwoA (p = 0.153; r2 = 0.117), or between FMD and CVR to L-arginine in the PCA in
Summary
Our group showed differences in endothelial function between the anterior and posterior cerebral circulation in healthy subjects, reduced vasodilatatory capacity of the posterior cerebral circulation and unimpaired systemic endothelial function in migraine patients without comorbidities. In recent years it has been proposed that migraine patients have endothelial dysfunction [1] Both our group and that of Vanmolkot have found unimpaired systemic endothelial function in migraine patients without comorbidities [2,3]. We have shown that endothelial dysfunction in migraine patients without comorbidities could be limited to the posterior cerebral circulation [4]. This study compared endothelial function in the anterior cerebral and systemic circulation. No study comparing the posterior cerebral and systemic endothelial function has yet been undertaken
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