Evaluation of carotid intima-media thickness in children with migraine: a marker of subclinical atherosclerosis

Abstract

Migraine is a commonly seen neurovascular disorder during childhood. Inflammation induced by the activation of cytokines and neuropeptides is implied in its pathophysiology. There is an association between inflammation and atherosclerosis in patients with migraine. In addition, there is a strong correlation between early atherosclerotic wall lesions and carotid intima-media thickness (CIMT). The study population consisted of 57 migraine patients aged 5-17 years, as well as 47 healthy children who served as the control group. Those migraine patients who were not receiving any medications at the interictal period were compared to healthy controls in terms of their measured lipid levels, thyroid function, vitamin B12 levels, serum iron levels, iron binding capacity, complete blood count, C-reactive protein (CRP) levels, and carotid intima-media thickness (CIMT) scores, which may comprise risk factors for atherosclerosis. When children in the migraine and control groups were compared in terms of those risk factors that are known to be related to vascular changes, no significant differences were found. However, a significant difference was detected in CIMT values (P < 0.05). Atherosclerosis commences in childhood, and there is a long period of time before the onset of ischemic symptoms occurs. In children with migraine, an evaluation of CIMT can be used as a non-invasive imaging modality to detect atherosclerosis, which develops in the context of chronic inflammation. In this way, measures to reduce morbidity and mortality, which may result from cardiovascular diseases, can be implemented.

Migraine Modulation and Debut after Percutaneous Atrial Septal Defect Closure: A Review

“…Several other vascular risk factors have been reported as associated with migraine: experimental hypoxia (100); altered brachial and femoral artery compliance as well as decreased brachial artery diameter (41); increased carotid artery media thickness, a subclinical marker of early atherosclerosis (43, 44), has been reported as heightened in pediatric migraineurs (45) and adult migraineurs (42). Migraineurs (particularly women) with MA have two times the risk of ischemic stroke (38), and MA and migraine in general, in an unadjusted population-based analysis, have been associated with stroke, myocardial infarction and claudication (34).…”

“…Elevated vascular risk factors have been found in migraineurs, including vasoactive plasma endothelin (ET-1), a marker for atherosclerosis and endothelia injury (42). Increased carotid artery media thickness, a subclinical marker of early atherosclerosis (43, 44), has been reported as heightened in pediatric migraineurs (45) and in adult migraineurs (42). …”

Migraine and Ischemic Stroke in Women. A Narrative Review

“…In migraineurs with subclinical infarction in the CAMERA study, the clinical and radiological features of the multiple, small lesions found predominantly in the deep arterial border zone of the cerebellum suggested hypoperfusion or embolism rather than atherosclerosis 38 . In contrast, there are 7 studies reporting evidence of subclinical atherosclerosis in adults with migraine, 136‐142 including in those with episodic migraine and those with aura 136‐139 . One recent study also reported an independent association of carotid wall thickening with triptan and ergotamine consumption, suggesting that repeated use of these vasoconstrictive agents may have lasting effects 137 .…”

“…A 2019 meta‐analysis of ultrasonic assessment of CIMT in participants from 7 studies reported significantly greater CIMT in patients with migraine compared to controls, but no differences in CIMT between patients with MWA and controls, or MWoA and controls 140 . This analysis included 2 studies of children showing increased CIMT in migraine, even when of recent onset 141,142 …”

Increased Epicardial Adipose Tissue Thickness: A new Indicator of Subclinical Atherosclerosis in Non-Fat Children with Migraine

“…Several studies have investigated these mechanisms in migraine and obesity [4][5][6] . Some adult and pediatric studies have showed the link between migraine and vascular events such as ischemic stroke and atherosclerosis as well 7,8 .…”