title: Altered cardiovascular reactivity to mental stress but not to cold pressure test in migraine.
abstract: OBJECTIVE
  This study assessed cardiovascular reactivity to mental stress and cold pressure test in migraineurs and controls. It compared the cardiovascular reactivity between patients with migraine with aura and patients with migraine without aura.
  
  
  BACKGROUND
  Several studies have assessed the autonomic nervous system functioning and cardiovascular responses to stressor stimuli in migraine. Cold pressure test and sustained attention tasks are distinct forms of induced stress. It is still unknown if patients with migraine have distinct patterns of response to sustained attention tasks and cold pressure test, since no previous studies have evaluated the cardiovascular responses to these 2 distinct types of stress in the same population of migraine patients.
  
  
  METHODS
  Two distinct protocols were used to induce cardiovascular reactivity. Mental stress was induced by using a Stroop test card, a procedure involving the maintenance of the attention control. The other protocol was the cold pressure test. The blood pressure and heart rate were digitally recorded in rest and test phases. The mean elevation and the variance of blood pressure and heart rate were compared between groups.
  
  
  RESULTS
  Patients with migraine had higher rest systolic blood pressure and lower heart rate induced by mental stress than controls. There were no differences between migraineurs and controls with cold pressure test. There were no differences between migraineurs with and without aura.
  
  
  CONCLUSIONS
  There was a significantly different pattern of cardiovascular reactivity between migraineurs and controls with mental stress but not with cold pressure test. Distinct central nervous system structures are involved in these 2 types of stress. A distinct pattern of activation of the prefrontal cortex-periaqueductal gray matter circuit in migraine may explain a singular autonomic reactivity to mental stress in this disease.
authors.affiliation: Headache Clinic, Department of Pathology, Escola Superior de Ciências da Santa Casa de Misericórdia (EMESCAM) - Vitória-ES, Brazil.
authors.forename: Renan B
authors.initials: RB
authors.lastname: Domingues
authors.forename: Kelly B
authors.initials: KB
authors.lastname: Fonseca
authors.forename: Luciene F
authors.initials: LF
authors.lastname: Ziviane
authors.forename: Simone A
authors.initials: SA
authors.lastname: Domingues
authors.forename: Dalton
authors.initials: D
authors.lastname: Vassalo
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology; D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000503:physiopathology*; D017776:Autonomic Pathways / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D002319:Cardiovascular System / Q000503:physiopathology; D003080:Cold Temperature / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000150:complications / Q000503:physiopathology*; D009483:Neuropsychological Tests; D010487:Periaqueductal Gray / Q000502:physiology; D017397:Prefrontal Cortex / Q000502:physiology; D011312:Pressure / Q000009:adverse effects; D013315:Stress, Psychological / Q000150:complications / Q000503:physiopathology*; D013564:Sympathetic Nervous System / Q000503:physiopathology; D014661:Vasoconstriction / Q000502:physiology; D055815:Young Adult