title: Patients with migraine with aura have increased flow mediated dilation.
abstract: BACKGROUND
  Endothelium-derived nitric oxide (NO) mediates the arterial dilation following a flow increase (i.e. flow-mediated dilation, FMD), easily assessed in the brachial artery. NO is also involved in cerebral hemodynamics and it is supposed to trigger vascular changes occurring during migraine. This study aimed at investigating whether migraine patients present an altered response to NO also in the peripheral artery system.
  
  
  METHODS
  We enrolled 21 migraineurs (10 with aura [MwA], 11 without aura [MwoA]), and 13 controls. FMD was evaluated with ultrasound in all subjects by measuring the percentage increase of the brachial artery diameter induced by hyperaemia reactive to sustained cuff inflation around the arm above systolic pressure. FMD values were then normalized for shear stress.
  
  
  RESULTS
  Normalized FMD values were higher in patients with MwA (28.5 10-2%.s) than in controls (9.0 10-2%.s) and patients with MwoA (13.7 10-2%.s) (p < 0.001). FMD was over the median value (19%) in 23.1% of controls, in 45.5% of the MwoA patients, and in 90% of the MwA patients.
  
  
  CONCLUSIONS
  Migraineurs with aura present an excessive arterial response to hyperaemia, likely as an effect of an increased sensitivity to endothelium-derived nitric oxide. This phenomenon observed peripherally might reflect similar characteristics in the cerebral circulation.
authors.affiliation: Neurologia Clinica, Università Campus Bio-Medico, Roma, Italy. f.vernieri@unicampus.it
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Vernieri
authors.forename: Leo
authors.initials: L
authors.lastname: Moro
authors.forename: Claudia
authors.initials: C
authors.lastname: Altamura
authors.forename: Paola
authors.initials: P
authors.lastname: Palazzo
authors.forename: Raffaele
authors.initials: R
authors.lastname: Antonelli Incalzi
authors.forename: Paolo Maria
authors.initials: PM
authors.lastname: Rossini
authors.forename: Claudio
authors.initials: C
authors.lastname: Pedone
mesh_terms: D000328:Adult; D000367:Age Factors; D001783:Blood Flow Velocity; D001794:Blood Pressure; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D020325:Migraine with Aura / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D020326:Migraine without Aura / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D012039:Regional Blood Flow; D013314:Stress, Mechanical; D014463:Ultrasonography