Transcranial Doppler evaluation of cerebral hemodynamics in migraineurs during prophylactic treatment with flunarizine.
Transcranial Doppler (TCD) recording was used to evaluate the mean flow velocity (MFV) and cerebrovascular reactivity to CO2 in 21 migraineurs during the interictal phase. Nine were affected by migraine with aura (MwA) and 12 by migraine without aura (MwoA). During each session the middle cerebral artery (MCA) flow velocity was examined in basal conditions, in hypocapnia after a 3-min period of hyperventilation, in basal conditions a second time, and in hypercapnia after breath-holding. The same procedure was followed in a group of 21 age- and sex-matched volunteers. Recordings were performed before (T1), during (T2), and after (T3) prophylactic treatment with flunarizine (10 mg/day for 2 months) to assess the possible effect of this drug on cerebral hemodynamics. In basal condition, increased MFV values were found in both MwA and MwoA patients. In MwA patients the reactivity index (RI) to hypocapnia was significantly increased in T1 (p < 0.05). This abnormal cerebrovascular reactivity disappeared during flunarizine treatment (T2) and in the post-therapy period (T3).
Istituto di Clinica delle Malattie Nervose e Mentali Università La Sapienza, Rome, Italy. Fiermonte@uniromal.it
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D000328:Adult; D001783:Blood Flow Velocity / Q000187:drug effects; D001921:Brain / Q000098:blood supply*; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D002245:Carbon Dioxide; D005260:Female; D005444:Flunarizine / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000000981:diagnostic imaging / Q000188:drug therapy*; D017585:Ultrasonography, Doppler, Transcranial / Q000187:drug effects*; D014655:Vascular Resistance / Q000187:drug effects
D002121:Calcium Channel Blockers; D002245:Carbon Dioxide; D005444:Flunarizine