Abstract
BackgroundMigraine is a complex and disabilitating neurovascular disorder predominantly affecting women. There is strong evidence that nitric oxide is critically involved in migraine pathophysiology. The aim of the present study was to test the hypothesis that chronic migraine is associated with ultrasonographic endothelial dysfunction and increase in arterial stiffness. These parameters were assessed using a novel plethysmograph by peripheral arterial tonometry.MethodsTwenty-one patients with chronic migraine and twenty-one healthy controls matched by sex and gender were recruited. Measurement of the ultrasonographic endothelial function and augmentation index were made according to manufacturer’s protocol.ResultsThe mean of patient’s peripheral arterial tonometry ratios was 1.93 ± 0.39 and for healthy control 2.21 ± 0.44 (p = 0.040). The median of patients’ augmentation index was −6,0 (IQR: 6.5 to −15) in healthy controls and 9.0 (IQR: 4 to 12) in chronic migraine, (p = 0.002).ConclusionsPatients with chronic migraine have ultrasonographic endothelial dysfunction and increase in the arterial stiffness. An improved understanding of the role in the endothelial system of migraine may provide a basis for preventive drugs in migraine and restore the endothelial function.
Highlights
Migraine is a complex and disabilitating neurovascular disorder predominantly affecting women
The aim of the present study was to test the hypothesis that chronic migraine is associated with ultrasonographic endothelial dysfunction and an increase in arterial stiffness using a novel non-invasive peripheral finger plethysmograph (EndoPAT)
We study the chronic migraines because is probably than the changes in the ultrasonographic endothelial dysfunction were more important and persistent than in episodic migraines
Summary
Migraine is a complex and disabilitating neurovascular disorder predominantly affecting women. The aim of the present study was to test the hypothesis that chronic migraine is associated with ultrasonographic endothelial dysfunction and increase in arterial stiffness These parameters were assessed using a novel plethysmograph by peripheral arterial tonometry. Endothelial dysfunction is commonly described as the inability of the artery to sufficiently dilate in response to an appropriate endothelial stimulus, and comprises endothelial activation, which is characterized by proinflammatory and procoagulatory milieu By ultrasound it can be assessed by measurement of the arterial pulse wave at a finger artery or by the measurement of flow-mediated dilation (FMD) of the brachial artery after occlusion of the blood flow. FMD has several disadvantages: it is operator dependent and as FMD is measured at one arm only, there are not possibilities to correct for potential measurement-induced changes in the systemic hemodynamics, such as those resulting from alterations in the autonomous nervous system tone To overcome these problems, the EndoPAT was developed. Several EndoPAT studies have demonstrated an improvement in ultrasonographic endothelial function as a result of lifestyle modification [7] or prolonged pharmacological intervention [8]
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