title: Longitudinal changes in cerebral blood flow velocities in different clinical courses of migraine.
abstract: Objective To assess longitudinal changes in cerebral blood flow velocities (ΔCBFVs) according to the clinical course of migraine. Methods We retrospectively included migraine patients with two or more attacks per month at baseline who were followed up within 2 years with transcranial Doppler in a tertiary headache clinic. ΔCBFVs were analyzed in relation to clinical courses, defined as remission (0-1 headache days/month), persistence (2-14/month), or progression (≥15/month) in episodic migraine (EM), and conversion to EM (<15/month) and persistence (≥15/month) in chronic migraine (CM). Results A total of 166 patients (90 EM and 76 CM) were included. In EM, the remission group ( n = 30) showed a decrease in CBFV in the middle cerebral artery (MCA) and the basilar artery (BA). The progression group ( n = 10) showed increasing CBFVs in the bilateral MCAs. Patients with the persistence course ( n = 50) showed generally unchanged CBFVs. In CM, ΔCBFVs decreased in the BA and increased in the posterior cerebral artery (PCA) after conversion to EM ( n = 61), whereas they remained unchanged in the persistence group ( n = 15). In all patients, % change in headache days was positively correlated with the %ΔCBFVs of the bilateral MCAs and the BA. Conclusions CBFV changes are associated with the different clinical courses of migraine. The association is more prominent in EM than CM.
authors.affiliation: 1 Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Mi Ji
authors.initials: MJ
authors.lastname: Lee
authors.affiliation: 2 Department of Neurology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Min Kyung
authors.initials: MK
authors.lastname: Chu
authors.affiliation: 3 Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Hanna
authors.initials: H
authors.lastname: Choi
authors.affiliation: 1 Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hyun Ah
authors.initials: HA
authors.lastname: Choi
authors.affiliation: 1 Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Chungbin
authors.initials: C
authors.lastname: Lee
authors.affiliation: 1 Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Chin-Sang
authors.initials: CS
authors.lastname: Chung
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D011446:Prospective Studies; D012189:Retrospective Studies; D017585:Ultrasonography, Doppler, Transcranial / Q000639:trends
keywords: Migraine; cerebral hemodynamics; prognosis; transcranial Doppler