CEREBRAL AND SYSTEMIC ENDOTHELIAL DYSFUNCTION IN MIGRAINE: CURRENT KNOWLEDGE AND PERSPECTIVE

I Made Oka Adnyana,Valentina Tjandra Dewi

doi:10.37897/rjn.2021.2.3

Abstract

Migraine still causes a high rate of disability and is reported to increase the risk of cardiovascular and cerebrovascular diseases. Endothelial dysfunction is considered to be one of the underlying mechanisms linking migraine and vascular disorders. Investigation of endothelial function in migraine includes a variety of examinations including biomarkers and ultrasonography-based studies. Several proposed biomarkers for endothelial dysfunction are endothelial progenitor cells (EPCs), von Willebrand factor (vWF), nitric oxide (NO), tissue-type plasminogen activator antigen (tPA antigen), C-reactive protein (CRP), endothelin-1 (ET-1), and vascular endothelial growth factor (VEGF). Brachial flow-mediated dilatation (FMD) is quite commonly used to reflect systemic endothelial dysfunction, while cerebral endothelial function can be assessed using breath holding index (BHI) on transcranial Doppler (TCD). The results of most studies in migraine sufferers indicate that endothelial dysfunction is found locally in the cerebral circulation, especially at the posterior circulation, while evidence for endothelial dysfunction in the systemic circulation remains controversial.

Highlights

Migraine is one of the primary headache conditions that cause a high burden for patients, families, and society [1]
A study conducted by Tietjen et al showed decrease concentration of nitric oxide (NO) stable metabolites in urine during the interictal period in patients with migraine compared to controls [8]. von Willebrand factor (vWF) activity correlated with nitrates/nitrites in the migraine group
Endothelial dysfunction is thought to be causally related to the pathophysiology of migraine and its association with vascular events

Summary

Introduction

Migraine is one of the primary headache conditions that cause a high burden for patients, families, and society [1]. The amount of circulating EPCs is a biomarker representing vascular function where decreasing number of EPCs is associated with higher risk of cardiovascular diseases. The study result was the number and function of EPCs are decreased in patients with migraine, indicating EPCs might be the connecting basis between migraine and cardiovascular disease risk.

Results

Conclusion