title: Peripheral endothelial function and arterial stiffness in women with migraine with aura: a case-control study.
abstract: BACKGROUND
  Vascular dysfunction may be involved in migraine pathophysiology and contribute to the increased risk of ischemic stroke in migraine, particularly in women with migraine with aura (MA). However, data on endothelial function in MA are controversial. Here, we investigated whether systemic endothelial function and arterial stiffness are altered in women with MA, using a novel peripheral arterial tonometry device for the first time.
  
  
  METHODS
  Twenty-nine female MA patients without comorbidities and 30 healthy women were included, and carotid intima-media thickness was assessed by a standardized procedure. Endothelial function was assessed using peripheral arterial tonometry. Reactive hyperaemic response of digital pulse amplitude was measured following 5 minutes of forearm occlusion of the brachial artery. Arterial stiffness was assessed by fingertip tonometry derived and heart-rate-adjusted augmentation index.
  
  
  RESULTS
  No differences were found in peripheral arterial tonometry ratio (2.3 ± 0.6 vs 2.2 ± 0.8; p = 0.58) and left carotid intima-media thickness (in µm: 484 ± 119 vs 508 ± 60; p = 0.37). Women with MA had higher heart-rate-averaged augmentation index [median (interquartile range, IQR) of 5 (IQR 0.5 to 18) vs -5 (IQR -16.8 to 8.3), p = 0.005] and heart-rate-adjusted augmentation index [1 (IQR -6 to 12.5) vs -8 (IQR -20.3 to 2.5), p = 0.008] than healthy controls.
  
  
  CONCLUSIONS
  Peripheral endothelial function is not impaired in women with MA, but they have greater arterial stiffness. This may contribute to the increased stroke risk in women with MA.
authors.affiliation: Charité-Universitätsmedizin Berlin, Germany. thomas.liman@charite.de
authors.forename: T G
authors.initials: TG
authors.lastname: Liman
authors.forename: L
authors.initials: L
authors.lastname: Neeb
authors.forename: J
authors.initials: J
authors.lastname: Rosinski
authors.forename: I
authors.initials: I
authors.lastname: Wellwood
authors.forename: U
authors.initials: U
authors.lastname: Reuter
authors.forename: W
authors.initials: W
authors.lastname: Doehner
authors.forename: P U
authors.initials: PU
authors.lastname: Heuschmann
authors.forename: M
authors.initials: M
authors.lastname: Endres
mesh_terms: D000328:Adult; D001158:Arteries / Q000503:physiopathology*; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008365:Manometry; D020325:Migraine with Aura / Q000503:physiopathology*; D059289:Vascular Stiffness / Q000502:physiology*; D014664:Vasodilation / Q000502:physiology