Clinical features of right‐to‐left shunt in the different subgroups of migraine

Ling, Yanyan; Wang, Min; Pan, Xudong; Zhao, Hongqin

doi:10.1002/brb3.1553

Cited by 8 publications

(6 citation statements)

References 26 publications

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“…Some studies have found that RLS grades are related to the severity of migraine [ 28 ], but our study did not find a correlation between RLS and HIT-6 scores. The possible reason may be that the sample size of our study is small.…”

Section: Discussioncontrasting

confidence: 99%

Calcitonin gene-related peptide: a possible biomarker in migraine patients with patent foramen ovale

Li,

Yu,

et al. 2024

BMC Neurol

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Background Serum CGRP has been found to increase during migraine attack. However, whether CGRP can identify MA with PFO subtypes in MA remains unknown. This study aimed to investigate the differential expression of calcitonin gene-related peptide (CGRP) between migraine (MA) patients with and without patent foramen ovale (PFO), and to evaluate the predictive value of CGRP for MA with PFO. Methods A total of 153 patients with MA, 51 patients with PFO and 102 patients without. Venous blood was drawn and HIT-6 score was calculated during the onset of MA, and blood routine, inflammatory indexes and serum CGRP were detected. The differences in serum markers and HIT-6 scores were compared between the two groups, and the risk factors of MA with PFO were determined by univariate and multivariate logistics regression. Furthermore, the correlation between CGRP level with right-to-left shunt (RLS) grades and headache impact test-6 (HIT-6) score in MA patients with PFO were assessed. Independent risk factors were screened out by multivariate Logistic regression analysis. We used the receiver operating characteristic (ROC) curve to analyze the diagnostic value of these risk factors in MA complicated with PFO. Results The serum CGRP level and HIT-6 scores in the MA with PFO group were significantly higher than those in the MA group (P < 0.001). Multivariate regression analysis showed that CGRP was an independent risk factor for MA with PFO (OR = 1.698, 95% CI = 1.325–2.179, P < 0.001). CGRP values increased with the increase of RLS grade(Spearmen rho = 0.703, P < 0.001). Furthermore, a positive correlation between CGRP and HIT-6 scores was found (Spearmen rho = 0.227; P = 0.016). ROC curve showed that the optimal cut-off value for diagnosing MA with PFO was 79 pg/mL, the area under the curve (AUC) for predicting MA with PFO was 0.845, with 72.55% sensitivity and 78.43% specificity. Conclusions MA patients with PFO have higher serum CGRP level. elevated CGRP concentration was associated with higher RLS grade and increased HIT-6 score. Higher serum CGRP level has certain clinical value in predicting PFO in MA patients. Trial registration This study was approved by the Ethics Committee of Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine (Ethics batch number: 20,201,215,005).

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Section: Discussioncontrasting

confidence: 99%

Calcitonin gene-related peptide: a possible biomarker in migraine patients with patent foramen ovale

Li,

Yu,

et al. 2024

BMC Neurol

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“…Beside, the blood flow velocity of the middle cerebral artery is also suggested to be correlated with the development and prognosis of migraine. Therefore, the detection and analysis of intracranial hemodynamics in patients with migraine is the main concern of many researchers ( 46 , 48 – 51 ). Given the importance of hemodynamic changes in migraine and the usefulness of their detection for the diagnosis and evaluation of this condition, changes in blood flow velocity detected by TCD were analyzed.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta-analysis of the Therapeutic Effect of Acupuncture on Migraine

Fan

Sun

et al. 2020

Front. Neurol.

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Background: Migraine is an intractable headache disorder, manifesting as periodic attacks. It is highly burdensome for patients and society. Acupuncture treatment can be beneficial as a supplementary and preventive therapy for migraine. Objectives: This systematic review and meta-analysis aimed to investigate the efficacy and safety of acupuncture for migraine, and to examine transcranial doppler changes after acupuncture. Methods: Reports, conference, and academic papers published before March 15, 2019 in databases including PubMed, Cochrane library, Embase, China National Knowledge Infrastructure, WANFANG Database, Chinese journal of Science and Technology, and China Biomedical were searched. Randomized controlled trials (RCTs) involving acupuncture, sham acupuncture, and medication in migraine were included. The Cochrane Collaboration software, RevMan 5.3, was used for data processing and migration risk analysis. Results: Twenty-eight RCTs were included. 15 RCTs included medication only, 10 RCTs included sham acupuncture only, and 3 RCTs included both. The study included 2874 patients, split into 3 groups: acupuncture treatment group (n = 1396), medication control group (n = 865), and sham acupuncture control group (n = 613). The results showed that treatment was more effective in the acupuncture group than in the sham acupuncture group (MD = 1.88, 95% CI [1.61, 2.20], P < 0.00001) and medication group (MD = 1.16, 95% CI [1.12, 1.21], P < 0.00001). Improvement in visual analog scale (VAS) score was greater in the acupuncture group than in the sham acupuncture group (MD = −1.00, 95% CI [-1.27,−0.46], P < 0.00001; MD = −0.59, 95% CI [-0.81,−0.38], P < 0.00001), and their adverse reaction rate was lower than that of the medication group (RR = 0.16, 95% CI [0.05, 0.52], P = 0.002). The improvement of intracranial blood flow velocity by acupuncture is better than that by medication, but the heterogeneity makes the result unreliable. Conclusions: Acupuncture reduced the frequency of migraine attacks, lowered VAS scores, and increased therapeutic efficiency compared with sham acupuncture. Ou et al. Meta-analysis of Acupuncture and Migraine Compared with medication, acupuncture showed higher effectiveness with less adverse reactions and improved intracranial blood circulation. However, owing to inter-study heterogeneity, a prospective, multicenter RCT with a large sample is required to verify these results.

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“…35 Migraine is characterised by a left-right distribution of pain, and there are also left-right differences in its pathogenesis. Some studies have shown left-right vascular shunting in migraine, 36 left-right asymmetries in substances involved in pain, such as dimethylarginine, 37 and differences in the left-right functional response of the central hemisphere. 38 Whether there is modulation of the central brain mechanisms around acupuncture for migraine has not been confirmed by studies, but as a verification of the efficacy of CAT, migraine is certainly a good vehicle for the disease.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Efficacy of contralateral acupuncture in women with migraine without aura: protocol for a randomised controlled trial

Feng

Zhang

et al. 2022

BMJ Open

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IntroductionMigraine is a common neurological disorder with a higher prevalence occurring in women. Migraine without aura (MwoA) is the most common type of migraine. In recent years, the safety and effectiveness of acupuncture for migraines have been internationally recognised. Contralateral acupuncture (CAT) (Jùcì) is an ancient classic acupuncture technique from Huang Di Nei Jing that refers to the acupoints on the right side (healthy side) selected for diseases on the left (affected side) and vice versa. Some studies have shown that efficacy of CAT on the painful disorder is even better than ipsilateral acupuncture (IAT), but there remains a lack of high-quality evidence to support it.Methods and analysisThis is a single-centre, randomised and sham-controlled clinical trial in China with three parallel groups that aim to evaluate the efficacy of CAT in women with unilateral MwoA. 243 participants will be randomly divided into the experimental group (CAT group), control group 1 (IAT group) and control group 2 (sham acupuncture group) (1:1:1 allocation ratio). Each group will be given 30-minute treatment sessions, once every other day, approximately three times per week, for a total of 24 treatments and follow-up visits two times. The primary outcome is the changes in days of migraine attacks. The secondary outcomes are frequency of migraine attacks, intensity of migraine, migraine duration, the dose of intake of acute medication, the Migraine-Specific Quality of Life Questionnaire, the Migraine Disability Assessment Score, the Headache Impact Test-6 and the Pittsburgh Sleep Quality Index. The data will be collected at the baseline time (week 0), end of treatment (week 4–8) and the follow-up time (week 12–16). Adverse events will be collected and recorded during each treatment.Ethics and disseminationEthics approval was obtained from the Ethics Committee of the Sports Trauma Specialist Hospital of Yunnan Province (2021-01). All participants will provide written informed consent before randomisation. The results of this study will be published in a peer-reviewed journal and presented at conferences.Trial registration numberChinese Clinical Trial Registration Center (ChiCTR2100051479).

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Clinical features of right‐to‐left shunt in the different subgroups of migraine

Cited by 8 publications

References 26 publications

Calcitonin gene-related peptide: a possible biomarker in migraine patients with patent foramen ovale

Calcitonin gene-related peptide: a possible biomarker in migraine patients with patent foramen ovale

A Systematic Review and Meta-analysis of the Therapeutic Effect of Acupuncture on Migraine

Efficacy of contralateral acupuncture in women with migraine without aura: protocol for a randomised controlled trial

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