title: To Be or Not to Be Patent: The Relationship Between Migraine and Patent Foramen Ovale.
abstract: OBJECTIVE
  Migraine is a common neurological disorder with an uncertain pathogenesis. A pathophysiological link has been proposed between the migraine headache and patent foramen ovale (PFO). However, the data about the association of migraine with the presence of PFO are conflicting. The study aims to prospectively investigate the prevalence of PFO in patients with migraine compared with that of control subjects.
  
  
  METHODS
  A total of 203 migraineous patients and 212 control subjects with similar demographic characteristics to that of case subjects regarding age and gender were included in the study. Transthoracic echocardiography with agitated saline injection was used to evaluate the presence of PFO. PFO was judged to be present if any microbubble was seen in the left cardiac chambers within the first 5 cardiac cycles from the maximum right atrial opacification at rest or after provocative maneuvers.
  
  
  RESULTS
  Mean age of the patients was 37.2 ± 9.8 years and 93% were female. Migraine with aura was present in 32% (n = 65) of the patients. The prevalence of PFO was similar in patients with migraine and the control subjects (42% vs 44%; odds ratio 0.90, 95% confidence interval 0.61-1.33, P = .61). Likewise, the prevalence of PFO was similar in migraineurs patients with or without aura (41% vs 42%; odds ratio 0.95, 95% confidence interval 0.51-1.76, P = .87).
  
  
  CONCLUSIONS
  This study suggest that PFO is not more common in patients with migraine compared with healthy subjects. Therefore, our findings suggest that the relationship between migraine headache and the presence of PFO is questionable.
authors.affiliation: Cardiology Department, Izmir Katip Celebi University Ataturk Education and Research Hospital, Izmir, Turkey.
authors.forename: Nihan
authors.initials: N
authors.lastname: Kahya Eren
authors.affiliation: Neurology Department, Izmir Katip Celebi University Ataturk Education and Research Hospital, Izmir, Turkey.
authors.forename: Nazlı G
authors.initials: NG
authors.lastname: Bülbül
authors.affiliation: Cardiology Department, Izmir Katip Celebi University Ataturk Education and Research Hospital, Izmir, Turkey.
authors.forename: Selcen
authors.initials: S
authors.lastname: Yakar Tülüce
authors.affiliation: Cardiology Department, Izmir Katip Celebi University Ataturk Education and Research Hospital, Izmir, Turkey.
authors.forename: Cem
authors.initials: C
authors.lastname: Nazlı
authors.affiliation: Neurology Department, Izmir Katip Celebi University Ataturk Education and Research Hospital, Izmir, Turkey.
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Beckmann
mesh_terms: D000328:Adult; D005260:Female; D054092:Foramen Ovale, Patent / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020325:Migraine with Aura / Q000453:epidemiology*; D020326:Migraine without Aura / Q000453:epidemiology*; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D014463:Ultrasonography
keywords: echocardiography; migraine; patent foramen ovale