Cerebellar and Cerebral Autoregulation in Migraine

Reinhard, Matthias; Schork, Joscha; Allignol, Arthur; Weiller, Cornelius; Kaube, Holger

doi:10.1161/strokeaha.111.644674

Cited by 36 publications

(31 citation statements)

References 33 publications

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“…It has previously been reported that dCA is impaired in migraineurs [9], [18]. Müller et al studied 22 migraine patients and 33 healthy controls and found that dCA phase and gain appeared to be completely different in migraineurs compared with healthy controls [9].…”

Section: Discussionmentioning

confidence: 97%

Compromised Dynamic Cerebral Autoregulation in Patients with a Right-to-Left Shunt: A Potential Mechanism of Migraine and Cryptogenic Stroke

et al. 2014

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Background and PurposeThe relationship between right-to-left shunts (RLS) and migraine and cryptogenic stroke is not well understood. In this study, we investigated whether RLS are associated with impairment of dynamic cerebral autoregulation (dCA), which may play a role in migraine and cryptogenic stroke.MethodsSixty-six migraineurs were enrolled in the study, including 36 non-RLS patients and 30 RLS patients. Non-invasive continuous cerebral blood flow velocity and arterial blood pressure were recorded simultaneously from each patient by using transcranial Doppler and servo-controlled plethysmograph, respectively. Transfer function analysis was applied to derive autoregulatory parameters of gain, phase difference (PD), and autoregulation index.ResultsThe PD in migraineurs with RLS was 50.6±22.9 degrees, which was significantly lower than that observed in the non-RLS group (67.2±18.2 degrees, P<0.001). The PD in the large RLS group (45.4±22.6 degrees) was significantly lower than that of the small RLS group (64.9±17.1 degrees, P<0.01) and non-RLS group (P<0.001); however, the PD in the small RLS group was similar to that of the non-RLS group. The PD in the permanent group (48.8±19.9 degrees) was similar to that of the latent group (52.6±26.1 degrees), and both were significantly lower than that of the non-RLS group (P<0.05). The autoregulation index results were similar to the PD findings.ConclusionsdCA is impaired in migraineurs with large RLS, and this may represent a potential mechanism linking RLS, migraine, and cryptogenic stroke.

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Section: Discussionmentioning

confidence: 97%

Compromised Dynamic Cerebral Autoregulation in Patients with a Right-to-Left Shunt: A Potential Mechanism of Migraine and Cryptogenic Stroke

et al. 2014

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“…A higher gain indicates less dampening effects and thus poorer autoregulatory ability. 13 An example recording is shown in Figure 1. Autoregulation parameters in the MCA and PCA of pregnant study participants were compared with autoregulation parameters of 26 healthy nonpregnant women of similar age (29±7 years) who participated in a previous study.…”

Section: Methodsmentioning

confidence: 99%

Dynamic Cerebral Autoregulation in Pregnancy and the Risk of Preeclampsia

et al. 2014

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Abstract-Preeclampsia may affect severely the cerebral circulation leading to impairment of cerebral autoregulation, edema, and ischemia. It is not known whether impaired autoregulation occurs before the clinical onset of preeclampsia, and whether this can predict the occurrence of preeclampsia. Seventy-two women at 25 to 28 weeks of gestation were studied. Control values were derived from 26 nonpregnant women. Dynamic properties of cerebral autoregulation (DCA) were measured in the middle and posterior cerebral artery using transcranial Doppler and transfer function analysis (phase and gain) of respiratory-induced 0.1 Hz hemodynamic oscillations. Uterine artery ultrasound was performed to search for a notch sign as an early marker of general endothelial dysfunction. All women were followed up until 6 weeks after delivery for the occurrence of preeclampsia. The autoregulation parameter gain did not differ between pregnant and nonpregnant women. Phase was slightly but significantly higher in pregnant women, indicating better DCA. Women with a notch sign did not show altered DCA. A history of preeclampsia during a previous pregnancy was associated with lower phase in middle cerebral artery and posterior cerebral artery (P<0.05 each). During follow-up, 9 women developed preeclampsia. None of the DCA parameters were associated with the occurrence of preeclampsia. In conclusion, DCA is well preserved during late midterm pregnancy, even in women with disturbed uterine blood flow. Yet, pregnant women with preeclampsia in a previous pregnancy seem to have poorer DCA. Although limited in statistical power, this study does not support DCA as a strong early risk marker of preeclampsia. (Hypertension. 2014;63:161-166.)

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“…Although further work is needed, these findings may explain why long-term hypertension was more frequent in the migraine with aura group in our study. 22 We suspected that there might be ethnic and racial factors in the association of migraines and hypertension, which could conceivably contribute to greater stroke risks in Blacks and Hispanics. Both hypertension and migraine are risk factors for silent brain lesions, both white matter hyperintensities and silent brain infarctions, as well as adverse cardiac and cerebrovascular events.…”

Section: Hypertension and Migraine -Gardener Et Almentioning

confidence: 99%