Abstract
It is suspected that the pathophysiology of migraine has a relation to the autonomic dysfunction. We studied to assess the autonomic function in migraine using the spectral analysis of heart rate variability (HRV) by accelerated plethysmography (APG). Five-hundred-twenty-four patients received the health check-ups in an affiliated hospital since September, 2011 to April, 2013. Eighty-three patients with headache and 38 controls were enrolled in this study. The patients were subdivided into 19 with migraine (19 female), 26 with tension-type headache (TTH) (7 male, 19 female) and 31 of other headaches using a questionnaire based on the International Classification of Headache Disorders 2nd Edition. Patients with migraine or tension-type headache underwent examinations using APG with an orthostatic load. Twenty-four controls without headache received same examinations. As a result, the standing/sitting ratio of spectral power of high-frequency (HF) in the migraine group was higher than those of TTH (p=0.0277) and normal controls (p=0.0104). The cut-off value of 1.058 could separate migraine from TTH with sensitivity of 0.632 and specificity of 0.846. The results suggested that the parasympathetic activity accentuated by orthostatic load in patients with migraine, on the contrarily the parasympathetic activities diminished by orthostatic load in patients with TTH or normal controls. This study showed that spectral analysis of HRV by APG is a supportive tool to distinguish migraine from TTH.
Highlights
The majority of primary headaches are migraines and tensiontype headaches (TTH)
According to the criteria of ICHD II, we obtained the data of 23 patients with migraine and 27 patients with TTH
We used the data from 19 migraine patients, 26 with TTH and 24 normal controls (Table 1)
Summary
The majority of primary headaches are migraines and tensiontype headaches (TTH). Knowledge about migraine has been accumulated, there are still unclear issues regarding its pathophysiology. The leading explanation of migraine involves the trigeminovascular theory [1,2], which asserts its relationship with the trigeminal nerve and intracranial vessels. In the course of migraine attacks, vasoactive substances trigger the cascades of migraine. The processes of degranulation of mast cells, increased permeability of vessels and vasodilatation are induced, which cause nausea and vomiting in patients. After these processes, afferent transmissions are sensed as headache by patients, and the trigeminal nerves secrete neuropeptide at the nerve terminals
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