Abstract
Migraine affects the autonomous nervous system and a recent investigation has also proposed a severe disturbance of dynamic cerebral blood flow regulation in the middle cerebral artery during spontaneous blood pressure oscillations. This study investigates whether dynamic cerebral autoregulation is impaired in persons with migraine among a normal cohort. Out of 94 adults studied to establish normal values for dynamic autoregulation, 19 suffered from migraine according to IHS criteria (10 of them with aura). Transcranial Doppler sonography and fingerplethysmography were used to determine dynamic autoregulation of both middle cerebral arteries following spontaneous low frequency (0.06–0.12 Hz) blood pressure fluctuations (phase and gain of transfer function, correlation coefficient indices Dx and Mx). No significant differences were found for the low frequency variability of blood pressure (power spectral density) and various indices of dynamic cerebral autoregulation between persons with and without migraine. Moreover, no differences were observed between persons with migraine, with and without aura. This study based on a normal cohort does not support the presence of generally impaired cerebral autoregulation dynamics in persons with migraine. Future studies should focus on posterior circulation and particular cerebellar autoregulation.
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Aaslid R, Lindegaard KF, Sorteberg W, Nornes H (1989) Cerebral autoregulation dynamics in humans. Stroke 20:45–52
Czosnyka M, Smielewski P, Kirkpatrick P, Menon DK, Pickard JD (1996) Monitoring of cerebral autoregulation in head-injured patients. Stroke 27:1829–1834
Dora B, Balkan S (2002) Exaggerated interictal cerebrovascular reactivity but normal blood flow velocities in migraine without aura. Cephalalgia 22:288–290
Dumville J, Panerai RB, Lennard NS, Naylor AR, Evans DH (1998) Can cerebrovascular reactivity be assessed without measuring blood pressure in patients with carotid artery disease? Stroke 29:968–974
Evans RW, Lipton RB, Silberstein SD (2003) The prevalence of migraine in neurologists. Neurology 61:1271–1272
Fiermonte G, Pierelli F, Pauri F, Cosentino FI, Soccorsi R, Giacomini P (1995) Cerebrovascular CO2 reactivity in migraine with aura and without aura. A transcranial Doppler study. Acta Neurol Scand 92:166–169
Haubrich C, Wendt A, Diehl RR, Klotzsch C (2004) Dynamic autoregulation testing in the posterior cerebral artery. Stroke 35:848–852
Heckmann JG, Hilz MJ, Katalinic A, Marthol H, Muck-Weymann M, Neundorfer B (1998) Myogenic cerebrovascular autoregulation in migraine measured by stress transcranial Doppler sonography. Cephalalgia 18:133–137
Hetzel A, Braune S, Guschlbauer B, Dohms K (1999) CO2 reactivity testing without blood pressure monitoring? Stroke 30:398–401
Kastrup A, Thomas C, Hartmann C, Schabet M (1998) Cerebral blood flow and CO2 reactivity in interictal migraineurs: a transcranial Doppler study. Headache 38:608–613
Kruit MC, van Buchem MA, Hofman PA et al (2004) Migraine as a risk factor for subclinical brain lesions. JAMA 291:427–434
Kruit MC, Launer LJ, Ferrari MD, van Buchem MA (2005) Infarcts in the posterior circulation territory in migraine. The population-based MRI CAMERA study. Brain 128:2068–2077
Kuo TB, Chern CM, Sheng WY, Wong WJ, Hu HH (1998) Frequency domain analysis of cerebral blood flow velocity and its correlation with arterial blood pressure. J Cereb Blood Flow Metab 18:311–318
Kuo TB, Chern CM, Yang CC et al (2003) Mechanisms underlying phase lag between systemic arterial blood pressure and cerebral blood flow velocity. Cerebrovasc Dis 16:402–409
Lipsitz LA, Mukai S, Hamner J, Gagnon M, Babikian V (2000) Dynamic regulation of middle cerebral artery blood flow velocity in aging and hypertension. Stroke 31:1897–1903
Müller M, Marziniak M (2005) The linear behavior of the system middle cerebral artery flow velocity and blood pressure in patients with migraine: lack of autonomic control? Stroke 36:1886–1890
Nedeltchev K, Arnold M, Schwerzmann M et al (2004) Cerebrovascular response to repetitive visual stimulation in interictal migraine with aura. Cephalalgia 24:700–706
Panerai RB (1998) Assessment of cerebral pressure autoregulation in humans–a review of measurement methods. Physiol Meas 19:305–338
Park CW, Sturzenegger M, Douville CM, Aaslid R, Newell DW (2003) Autoregulatory response and CO2 reactivity of the basilar artery. Stroke 34:34–39
Pierangeli G, Parchi P, Barletta G, Chiogna M, Lugaresi E, Cortelli P (1997) Power spectral analysis of heart rate and diastolic blood pressure variability in migraine with and without aura. Cephalalgia 17:756–760
Reinhard M, Müller T, Guschlbauer B., Timmer J, Hetzel A (2003a) Transfer function analysis for clinical evaluation of dynamic cerebral autoregulation—a comparison between spontaneous and respiratory-induced oscillations. Physiol Meas 24:27–43
Reinhard M, Roth M, Muller T, Czosnyka M, Timmer J, Hetzel A (2003b) Cerebral autoregulation in carotid artery occlusive disease assessed from spontaneous blood pressure fluctuations by the correlation coefficient index. Stroke 34:2138–2144
Silvestrini M, Baruffaldi R, Bartolini M et al (2004) Basilar and middle cerebral artery reactivity in patients with migraine. Headache 44:29–34
Sliwka U, Harscher S, Diehl RR, van Schayck R, Niesen WD, Weiller C (2001) Spontaneous oscillations in cerebral blood flow velocity give evidence of different autonomic dysfunctions in various types of headache. Headache 41:157–163
Thijs RD, Kruit MC, van Buchem MA, Ferrari MD, Launer LJ, van Dijk JG (2006) Syncope in migraine: the population-based CAMERA study. Neurology 66:1034–1037
Timmer J, Lauk M, Pfleger W, Deuschl G (1998) Cross-spectral analysis of physiological tremor and muscle activity. I. Theory and application to unsynchronized electromyogram. Biol Cybern 78:349–357
Wang X, Krishnamurthy S, Evans J et al (2005) Transfer function analysis of gender-related differences in cerebral autoregulation. Biomed Sci Instrum 41:48–53
Weiller C, May A, Limmroth V et al (1995) Brain stem activation in spontaneous human migraine attacks. Nat Med 1:658–660
Zhang R, Zuckerman JH, Giller CA, Levine BD (1998) Transfer function analysis of dynamic cerebral autoregulation in humans. Am J Physiol 274:H233–H241
Zwetsloot CP, Caekebeke JF, Jansen JC, Odink J, Ferrari MD (1992) Blood flow velocities in the vertebrobasilar system during migraine attacks–a transcranial Doppler study. Cephalalgia 12:29–32
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M. Re. acknowledges support from the Deutsche Forschungsgemeinschaft DFG (He 1949/4-1 and Ti 315/4-1).
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Reinhard, M., Wehrle-Wieland, E., Roth, M. et al. Preserved dynamic cerebral autoregulation in the middle cerebral artery among persons with migraine. Exp Brain Res 180, 517–523 (2007). https://doi.org/10.1007/s00221-007-0879-2
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DOI: https://doi.org/10.1007/s00221-007-0879-2