title: The increased distensibility of the wall of cerebral arterial network may play a role in the pathogenic mechanism of migraine headache.
abstract: The aim was to evaluate whether patients with episodic migraine with (MA+) and without aura (MA-), during the interictal period of migraine would have an altered distensibility of the wall of cerebral arterial network and whether it would play a role in migraine headache. To evaluate the distensibility of the wall of cerebral arterial network, we measured the time-delay in milliseconds (ms) between the R-wave of an electrocardiogram and the arterial pulse wave of cerebral microcirculation (R-APWCMtd) on the frontal cortex detected by near-infrared spectroscopy (NIRS) in 10 patients with MA+ (age 39.5 ± 12.2 years), in 10 with MA- (age 40.3 ± 10.2 years), according to ICHD-3 criteria 2012, during the interictal period of migraine, and in 15 age-, sex- and height-matched healthy control subjects. The patients with migraine had a significantly longer R-APWCMtd than the control subjects F = 13.4, p < 0.001: MA+:+38.3 ms; MA-:+34.7 ms indicating an increased distensibility of the wall of cerebral arterial network. In multiple regression analysis, R-APWCMtd was significantly associated with migraine (R (2) = 0.50, p < 0.0001) but not with age, gender, height, migraine attack frequency and disease duration. The increased distensibility leads to an increased flow pulsatility into intracranial dural meningeal vessels that may lead to a mechanical stimulation of the nociceptors that innervate the dural vasculature. This condition may play a role in promoting the sensitization of trigeminovascular afferents and sterile inflammation within the dura mater that are fundamental to the pathogenesis of migraine headache.
authors.affiliation: Department of Neurology, Headache Center, Via C. De Lellis, 66054, Vasto (CH), Italy, stefano.viola@email.it.
authors.forename: S
authors.initials: S
authors.lastname: Viola
authors.forename: P
authors.initials: P
authors.lastname: Viola
authors.forename: M P
authors.initials: MP
authors.lastname: Buongarzone
authors.forename: L
authors.initials: L
authors.lastname: Fiorelli
authors.forename: P
authors.initials: P
authors.lastname: Litterio
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D002536:Cerebral Arteries / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology; D004562:Electrocardiography; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000503:physiopathology*; D020326:Migraine without Aura / Q000503:physiopathology; D019265:Spectroscopy, Near-Infrared; D013997:Time Factors