Cerebrovascular Reactivity in Adolescents With Migraine and Tension‐Type Headache During Headache‐Free Interval and Attack

Rosengarten, Bernhard; Sperner, J.; Görgen-Pauly, Ute; Kaps, Manfred

doi:10.1046/j.1526-4610.2003.03090.x

Cited by 16 publications

(10 citation statements)

References 21 publications

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“…Attenuation and natural frequency were, respectively, significantly higher and significantly lower in males as compared to the females, suggesting that the FD males may have dysfunction of resistance brain arteries since the early stages of disease. Of note, these same fTCD parameters are known to be disturbed in patients with vascular dementia, diabetes mellitus and migraine attacks [29,30,31]. Although it is plausible that these fTCD results are related to endothelial dysfunction, we cannot exclude an autonomic nervous system involvement in the cerebrovascular regulation, as shown in other diseases associated with autonomic failure [32].…”

Section: Discussionmentioning

confidence: 92%

Functional Transcranial Doppler: Presymptomatic Changes in Fabry Disease

Azevedo

Mendes²,

Seixas³

et al. 2012

Eur Neurol

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Background and Aim: Cerebrovascular disease may progress asymptomatically in the early stages of Fabry disease (FD). Our aim was to test whether functional transcranial Doppler (fTCD) could provide useful data in the evaluation of these presymptomatic FD patients. Methods: A cohort of 12 adult FD patients from families with the classical phenotype of the disease was evaluated with fTCD in the posterior cerebral artery. Results: Compared to healthy controls, resting blood velocities were significantly lower in the FD cohort (p = 0.032 for systolic, p = 0.021 for diastolic). FTCD suggested a disturbed neurovascular coupling in the visual cortex of FD patients, with lower gain (p = 0.007) and rate time (p = 0.019). Men had a significantly higher attenuation (p = 0.013) and lower natural frequency (p = 0.046) than the heterozygous women. Conclusion: These data are the first to suggest that patients with FD may develop cortical vascular dysfunction in the territory of the posterior circulation, early in the natural history of the disease. If the present findings are confirmed in larger, prospective studies, fTCD will be useful for assessing stroke risk in as yet asymptomatic FD patients, improving preventive therapeutic management.

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Section: Discussionmentioning

confidence: 92%

Functional Transcranial Doppler: Presymptomatic Changes in Fabry Disease

Azevedo

Mendes²,

Seixas³

et al. 2012

Eur Neurol

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“…reduction of pulmonary vascular resistance, increase in cardiac output, very minor effects on the systemic blood pressure), their impacts on dynamic functions of the provoked cortical perfusion were almost opposite. Iloprost inhalation led to changes in cerebral blood flow regulation which show some analogy to changes occurring during a migraine attack [20]. In contrast, sildenafil reduced the attenuation and the rate time parameter to the levels seen in healthy patients.…”

Section: Discussionmentioning

confidence: 99%

“…Combining the advantage of high temporal resolution with excellent accuracy of assessment of changes in flow velocity, transcranial Doppler technique is ideally suited to characterize the dynamic flow response in the posterior cerebral artery upon visual stimulation [20]. In the present study, we employed this technique, utilizing a visual stimulation paradigm, to assess the evoked flow velocity in the posterior cerebral artery in patients with pulmonary hypertension while undergoing test application of vasodilatory agents for evaluation of treatment concepts.…”

Section: Introductionmentioning

confidence: 99%

Sildenafil Improves Dynamic Vascular Function in the Brain: Studies in Patients with Pulmonary Hypertension

et al. 2006

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Background: Prostaglandins and nitric oxide play a pivotal role in the regulation of macro- and microcirculatory blood flow distribution. Interference with both mediator systems have been implicated in cerebrovascular dysfunction. Inhaled iloprost (long-acting prostacyclin analogue) and the phosphodiesterase-5 inhibitor sildenafil have recently shown efficacy in the treatment of chronic pulmonary hypertension. We investigated the impact of these agents on cerebral microcirculatory regulation in patients suffering from this disease. Methods: In 11 patients suffering from severe pulmonary hypertension, a functional transcranial Doppler test utilizing a visual stimulation paradigm was undertaken to measure the evoked flow velocity in the posterior cerebral artery. Measurements were performed in parallel to right heart catheterization and pharmacological testing of the pulmonary vasoreactivity. After assessment of baseline measurements, inhaled iloprost and oral sildenafil were given consecutively for testing of cerebral and pulmonary vascular function. The data gained from the Doppler measurements were compared to data from 22 healthy volunteers. Results: Both substances provoked a significant reduction of pulmonary arterial pressure and vascular resistance, accompanied by minor changes in systemic vascular resistance. In contrast to these superimposable hemodynamic profiles opposite effects were observed regarding cerebral vascular tone: cerebral microvascular reactivity, as assessed by attenuation and time rate parameters, was significantly improved by sildenafil, but slightly worsened by iloprost. Conclusions: Sildenafil has beneficial effects on cerebral vascular reactivity indicative of an improvement in neurovascular coupling in patients with pulmonary hypertension. These results warrant further investigations of the influence of sildenafil on dynamic vascular function in the brain independent of the underlying disease.

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“…The method and algorithm for analyzing the data sets in terms of a control system are described in detail in an earlier work. 5 The following parameters were specified. The gain (K) indicates the evoked flow velocity level above baseline under stabilized hemodynamics.…”

Section: Methodsmentioning

confidence: 99%

Ethnic Influences on Neurovascular Coupling

Hao

Wong²,

Lin³

et al. 2010

Stroke

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Background and Purpose-An ethnic extraintracranial difference in atherosclerosis has been well reported, whereas the potential mechanism remains unclear. We aimed to investigate neurovascular coupling in healthy whites and Asians. Methods -Twenty volunteers of each ethnicity were recruited to perform a functional transcranial Doppler examination with standardized checkerboard patterns as visual stimulation (3ϫ4, 6ϫ8, and 12ϫ16 checks subtending a visual field section of 18°ϫ24°, flicker rate 1 Hz). Hemodynamic responses in both posterior cerebral arteries were evaluated with a control system approach. Results-The rate time, that is, the initial speed of flow velocity adaptation, was significantly lower in Asians leading to an approximately 2-second delayed hemodynamic adaptation. The other hemodynamic parameters and the dependency of hemodynamic responses in regard to the complexity degree of the stimulus were similar between groups. Conclusion-The constellation suggests a greater initial mismatch between functionally increased metabolic demand of neurons and adjusted cerebral blood flow in Asians. (Stroke. 2010;41:383-384.)

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Cerebrovascular Reactivity in Adolescents With Migraine and Tension‐Type Headache During Headache‐Free Interval and Attack

Abstract: The control system approach utilized here appears to be more sensitive for detecting migraine-associated changes in cerebral vasoreactivity than examination of the maximal flow velocities alone.

Cited by 16 publications

References 21 publications

Functional Transcranial Doppler: Presymptomatic Changes in Fabry Disease

Functional Transcranial Doppler: Presymptomatic Changes in Fabry Disease

Sildenafil Improves Dynamic Vascular Function in the Brain: Studies in Patients with Pulmonary Hypertension

Ethnic Influences on Neurovascular Coupling

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