Abstract
Asymmetrical changes in blood perfusion and asynchronous blood supply to head tissues likely contribute to migraine pathophysiology. Imaging was widely used in order to understand hemodynamic variations in migraine. However, mapping of blood pulsations in the face of migraineurs has not been performed so far. We used the Blood Pulsation Imaging (BPI) technique, which was recently developed in our group, to establish whether 2D-imaging of blood pulsations parameters can reveal new biomarkers of migraine. BPI characteristics were measured in migraineurs during the attack-free interval and compared to healthy subjects with and without a family history of migraine. We found a novel phenomenon of transverse waves of facial blood perfusion in migraineurs in contrast to healthy subjects who showed synchronous blood delivery to both sides of the face. Moreover, the amplitude of blood pulsations was symmetrically distributed over the face of healthy subjects, but asymmetrically in migraineurs and subjects with a family history of migraine. In the migraine patients we found a remarkable correlation between the side of unilateral headache and the direction of the blood perfusion wave. Our data suggest that migraine is associated with lateralization of blood perfusion and asynchronous blood pulsations in the facial area, which could be due to essential dysfunction of the autonomic vascular control in the face. These findings may further enhance our understanding of migraine pathophysiology and suggest new easily available biomarkers of this pathology.
Highlights
Migraine is a common neurological disorder with complex and still essentially unknown mechanisms [1,2]
Blood perfusion asymmetry in migraine In the maps of blood pulsations obtained from the facial area, two key parameters of the peripheral blood flow, the bloodpulsation amplitude and blood pulsation phase were determined [14,17]
The maps of blood pulsation amplitude are shown in row A, while the maps of blood pulsation phase are shown in row B of Fig. 3
Summary
Migraine is a common neurological disorder with complex and still essentially unknown mechanisms [1,2]. One typical criterion of migraine is the unilateral character of the headache [10]. Such lateralization suggests potential asymmetrical function in the vascular bed including extracranial vessels. Classical migraine studies have already noted that frontal branches of the superficial temporal artery may be dilated on the side of the headache [3]. Asymmetry in the sympathetic skin responses was found in the headache-free period in unilateral migraineurs [13], supporting the impairment of sympathetic control in the face. The relative phase of blood pulsations in the face of migraine patients has not been studied so far
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