Cerebrovascular reactivity to l-arginine in the anterior and posterior cerebral circulation in migraine patients

Perko, Denis; Oblak, Janja Pretnar; Šabovič, Mišo; Žvan, Bojana; Zaletel, Marjan

doi:10.1111/j.1600-0404.2010.01468.x

Cited by 37 publications

(49 citation statements)

References 32 publications

(65 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In conformity with prior studies, AIS patients with migraine more often presented symptoms from the posterior circulation and had more occipital and cerebellar infarctions (5,6,31). Our findings suggest that areas of the brain associated with migraine symptoms, for example, visual symptoms from the occipital cortex, might also be more susceptible to infarction in patients with migraine, or that cerebral ischaemia in the posterior region is especially prone to induce CSD in patients with migraine.…”

Section: Discussionsupporting

confidence: 76%

Diffusion-weighted lesions in acute ischaemic stroke patients with migraine

et al. 2014

View full text Add to dashboard Cite

Objectives -There is increasing knowledge about an association between migraine and ischaemic stroke. Cortical spreading depression (CSD) is the probable biological substrate of migrainous aura. To investigate the influence of CSD on the apparent stroke -migraine association, we hypothesized that magnetic resonance (MR) diffusion weighted images of acute ischaemic stroke patients would reveal an association between small cortical infarctions and migraine. Methods -We included all patients admitted to the Bergen stroke unit between 2006 and 2012 with verified acute ischaemic stroke by MR imaging. Patients were grouped in a migraine and a no-migraine group. Baseline data and clinical characteristics were analysed between the groups. Imaging data were analysed with respect to infarct location and size. Multivariate analyses were performed to adjust for confounders and provide risk estimates for observed associations. Results -A total of 1703 subjects were enrolled, 787 subjects were excluded due to uncertain or unobtainable migraine diagnosis, leaving 196 and 720 subjects in the migraine and nomigraine group, respectively. The migraine group was younger and included a higher proportion of females. There were more infarctions due to cardio-embolism (P = 0.015) and fewer due to small vessel disease (P = 0.018) in the migraine group. A higher rate of patients in the migraine group presented symptoms from the posterior circulation (P = 0.008). Migraine was associated with cortical infarctions (OR 1.8 CI: 1.3-2.5, P = 0.001). Migraine was also associated with small infarctions (OR 1.9 CI: 1.04-3.5, P = 0.038). Conclusions -Migraine was associated with small cortical infarctions. This association may be due to cortical spreading depression.

show abstract

Section: Discussionsupporting

confidence: 76%

Diffusion-weighted lesions in acute ischaemic stroke patients with migraine

et al. 2014

View full text Add to dashboard Cite

show abstract

“…A study involving 30 patients with migraine found reduced mean BHI in the BA in patients with migraine with aura (0.83) compared to controls (1.39) and migraine without aura (1.42; p<0.001) 13. In another study, cerebral VMR to l-arginine was significantly impaired in the PCAs of patients with migraine (without aura: 14.4, with aura: 14.3) compared to controls (21.3; p=0.002) 24. These findings are quite similar to ours.…”

Section: Discussionmentioning

confidence: 90%

“…A study on silent posterior circulation infarcts in migraine proposed a combination of hypoperfusion during migraine attack and artery to artery embolism to account for these lesions 26. In migraine with aura, cortical spreading depression is thought to alter blood–brain barrier permeability and result in local ischaemia which aggravates the post ictal hypoperfusion 24. Migraineurs do not have increased predisposition to atherosclerosis, which makes artery to artery embolism less likely 27.…”

Section: Discussionmentioning

confidence: 99%

Interictal cerebral and systemic endothelial dysfunction in patients with migraine: a case–control study

Rajan

Khurana

Lal

2014

J Neurol Neurosurg Psychiatry

View full text Add to dashboard Cite

BackgroundAlthough systemic endothelial function is unimpaired in migraine, it is unknown whether cerebral endothelial function impairment exists in migraineurs.Materials and methodsWe conducted a prospective study to assess endothelial function in migraineurs (n=45) and healthy volunteers (n=44). Cerebral endothelial function was assessed by Breath Holding Index (BHI) on transcranial Doppler in bilateral middle cerebral artery (MCA at 30–60 mm), posterior cerebral artery (PCA at 60–80 mm) and basilar artery (BA at 80–120 mm) using bilateral monitoring probes fixed on headband. Brachial artery flow-mediated dilation (FMD) was used as measure of systemic endothelial function.ResultsThere was no difference in baseline mean velocities of MCA, PCA, BA among migraineurs and controls. Mean BHI was significantly lower in PCA (p<0.001) and BA (p<0.001) in patients with migraine with no difference in MCA (p=0.909, 0.450). Cerebral endothelial dysfunction (BHI<1.15) was present in 62.2% of migraineurs in the right PCA (p<0.001), 57.8% in left PCA (p<0.001) and 77.8% in BA (BHI <0.83, p<0.001). There was no difference in BHI among migraineurs without and with aura (n=15). Cerebral and systemic endothelial function had no correlation in migraineurs. Increasing BMI was identified as a predictor of impaired BHI in the BA in migraineurs (p=0.020). Age, sex, presence of aura, lateralisation of headache, headache frequency, time to last attack and impaired FMD were not associated with impaired PCA and BA BHI in migraineurs.ConclusionsMigraineurs may have isolated cerebral endothelial dysfunction restricted to the posterior circulation in the absence of systemic endothelial dysfunction.

show abstract

“…65 Transcranial Doppler Decreased reactivity to L-arginine in the posterior cerebral artery. 68 Voxel-based morphometry Decreased grey matter density in the frontal, parietal, and temporal lobes; 82 increased in the periaqueductal grey. 71,72 Decreased grey matter density in chronic vs episodic migraine: bilaterally in the anterior cingulate cortex, left amygdala, left parietal operculum, left middle and inferior frontal gyri, right inferior frontal gyrus, and insula.…”

Section: Modality Findingsmentioning

confidence: 99%

“…Most animal studies, however, suggest that the posterior cerebral circulation is subject to more basal vasomotor control to nitric oxide than the anterior cerebral circulation. 67 Perko and colleagues 68 used transcranial Doppler sonography to determine the posterior cerebral endothelial function in migraine patients. Mean arterial velocity in the MCA and the posterior cerebral artery (PCA) of migraineurs was measured before and after infusion of L-arginine (precursor to nitric oxide, a potent vasodilator), and cerebrovascular reactivity to L-arginine was then calculated.…”

Section: 91111mentioning

confidence: 99%

Structural and Functional Neuroimaging in Migraine: Insights From 3 Decades of Research

Lakhan

Avramut

Tepper³

2012

Headache

View full text Add to dashboard Cite

Modern imaging methods provide unprecedented insights into brain structure, perfusion, metabolism, and neurochemistry, both during and between migraine attacks. Neuroimaging investigations conducted in recent decades bring us closer to uncovering migraine as a multifaceted, primarily central nervous system disorder. Three main categories of structural and functional brain changes are described in this review, corresponding to the migrainous aura, ictal headache, and interictal states. (Headache 2013;53:46-66)

show abstract

Cerebrovascular reactivity to l-arginine in the anterior and posterior cerebral circulation in migraine patients

Cited by 37 publications

References 32 publications

Diffusion-weighted lesions in acute ischaemic stroke patients with migraine

Diffusion-weighted lesions in acute ischaemic stroke patients with migraine

Interictal cerebral and systemic endothelial dysfunction in patients with migraine: a case–control study

Structural and Functional Neuroimaging in Migraine: Insights From 3 Decades of Research

Contact Info

Product

Resources

About