Patients with migraine with aura have increased flow mediated dilation.
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.
Vernieri
Fabrizio
F
Neurologia Clinica, Università Campus Bio-Medico, Roma, Italy. f.vernieri@unicampus.it
Moro
Leo
L
Altamura
Claudia
C
Palazzo
Paola
P
Antonelli Incalzi
Raffaele
R
Rossini
Paolo Maria
PM
Pedone
Claudio
C
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