title: The influence of percutaneous atrial septal defect closure on the occurrence of migraine.
abstract: OBJECTIVE
  Percutaneous patent foramen ovale closure seems to influence migraine. We wanted to observe the effect of percutaneous atrial septal defect (ASD) closure on migraine.
  
  
  RESULTS
  All patients (>16 years of age) with a percutaneous ASD closure were selected from our database (n=114). A questionnaire about headache before and after closure was sent. According to the criteria of the International Headache Society, two neurologists diagnosed migraine with and without aura (MA+ and MA-, respectively). McNemar paired chi(2) and Wilcoxon signed rank tests were used where applicable. Seventy-five patients (66%, 59 females, mean age 51+/-19 years) responded and were included in the study. An Amplatzer ASD occluder was used in all. Median follow-up time was 29 months (IQ1 and IQ3, 18 and 39 months, respectively). The prevalence of MA- and MA+ changed from 19 (14/75) and 11% (8/75), respectively, before closure to 12 (9/75) and 15% (11/75), respectively, after closure (P=0.18 and P=0.55, respectively, vs. before closure). In 12 patients who suffered from migraine before closure (n=4 and 8, MA+ and MA-, respectively), migraine disappeared. In this subgroup, the frequency of migraine attacks decreased significantly (P=0.01). New-onset migraine was noted in 10 patients (n=7 and 3, MA+ and MA-, respectively).
  
  
  CONCLUSIONS
  Percutaneous ASD closure was not related to a decrease in prevalence of migraine. In a subgroup, patients who suffered from typical migraine before ASD closure, the frequency of migraine attacks decreased significantly. The reason for the new-onset migraine remains unexplained. A larger study sample will be necessary to determine these findings.
authors.affiliation: Department of Cardiology, Internal Medicine, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium.
authors.forename: Katrin
authors.initials: K
authors.lastname: Mortelmans
authors.forename: Martijn
authors.initials: M
authors.lastname: Post
authors.forename: Vincent
authors.initials: V
authors.lastname: Thijs
authors.forename: Luc
authors.initials: L
authors.lastname: Herroelen
authors.forename: Werner
authors.initials: W
authors.lastname: Budts
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D021721:Balloon Occlusion / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome