Increased Cerebrovascular _pCO₂ Reactivity in Migraine with Aura- a Transcranial Doppler Study During Hyperventilation

Abstract

Cerebrovascular reactivity during hypocapnia was tested in 20 migraineurs (8 with aura, 12 without aura) and 30 sex- and age-matched healthy subjects, and during nitroglycerin-induced headache in 12 healthy subjects. Before and during hyperventilation, mean blood-flow velocity (Vmean) in the middle cerebral artery was measured with transcranial Doppler. In each subject a pCO2 reactivity index (RI) was calculated as (delta Vmean/baseline Vmean)/delta pCO2. Interictally, patients with migraine with aura showed higher RI (p < 0.05 ANOVA and multiple range test) than controls, whereas migraineurs without aura did not differ from healthy subjects. Ictal and interictal RIs were similar in 9 patients suffering from migraine without aura. No side-to-side differences were detected in RI. During nitroglycerin-induced headache, the RIs were no different from those recorded during migraine attacks and in non-nitroglycerin-provoked healthy controls (p > 0.05, ANOVA and multiple range test). The exaggerated response in migraine with aura might predispose for the characteristic changes in rCBF seen during attacks.

Endothelial Function in Migraine With Aura – A Systematic Review

“…101,102 Others suggest a decreased CVR in migraineurs compared with controls, 103 one being restricted to the posterior circulation in MA. 104 When investigating CVR in response to hypocapnia, Thomsen et al and Fiermonte et al reported increased reactivity in MA compared with MO and controls, 105,106 whereas Totaro et al found no difference between migraineurs and controls. 103 The contrasting results may be due to the variations in methods (eg, hypercapnia or hypocapnia, middle or posterior cerebral vasculature) and patient characteristics.…”

Clinical correlates of phosphene perception in migraine without aura: An Asian study

“…This was supported by a population-based twin survey [15]. Other studies have demonstrated differences in regional cerebral blood flow [16], carbon dioxide cerebrovascular reactivity [17], oestrogen profile [18], amino acid metabolism [19], platelet content and serotonin secretion [20].…”

Alterations in default-mode network connectivity may be influenced by cerebrovascular changes within 1 week of sports related concussion in college varsity athletes: a pilot study

“…The finding of increased CVR is unusual given that CVR is usually decreased in the majority of pathologic conditions in which cerebrovascular physiology is altered with the exception of migraine headaches (Thomsen et al 1995). This exception is particularly interesting given that headache is a commonly reported symptom in patients following concussion.…”