Cerebrovascular reactivity in adolescents with migraine and tension-type headache during headache-free interval and attack.
BACKGROUND
Migraine is a common cause of headache in adolescents. Assuming that the cerebral vasculature is involved in the pathophysiology of migraine, we compared cerebral vasoreactivity in adolescents both during a migraine attack and a headache-free interval.


METHODS
A functional transcranial Doppler test utilizing a visual stimulation paradigm was undertaken to measure the evoked flow velocity in the posterior cerebral artery of adolescents suffering from a migraine without aura or a tension-type headache. To serve as a control, data previously obtained from age-matched adolescents with no primary headache disorder were used. The flow curves were evaluated by determining the maximal flow velocity increase and by modeling their time course according to a control system analysis. In that analysis, the main dynamic features of the flow response were described mathematically in terms of a control system model of low order. The parameters were time delay, gain, attenuation, rate time, and natural frequency.


RESULTS
The attenuation parameter (P<.005), indicative of an increased tone of the vessel, and the resting absolute flow velocity (P<.01) both showed a significant increase during an attack in the adolescents with migraine; the gain parameter showed a trend towards similar increase (P =.07). The maximal flow velocity did not increase significantly during an attack.


CONCLUSIONS
The control system approach utilized here appears to be more sensitive for detecting migraine-associated changes in cerebral vasoreactivity than examination of the maximal flow velocities alone.
Rosengarten
Bernhard
B
Department of Neurology, Justus-Liebig University of Giessen, Germany.
Sperner
Jürgen
J
Görgen-Pauly
Ute
U
Kaps
Manfred
M
D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity; D002560:Cerebrovascular Circulation; D006801:Humans; D008881:Migraine Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018781:Tension-Type Headache / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017585:Ultrasonography, Doppler, Transcranial