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Migraine and autonomic nervous system function: a population-based, case-control study.

Aaron Shechter1, Walter F Stewart, Stephen D Silberstein

  • 1Department of Epidemiology, the Johns Hopkins School of Hygiene and Public Health, Baltimore, MD, USA. ashechter@hotmail.com

Neurology
|February 13, 2002
PubMed
Summary
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Migraineurs with disabling attacks show signs of autonomic nervous system (ANS) hypofunction, indicated by lower heart rate variability. This suggests ANS dysfunction may be linked to migraine causes or consequences.

Area of Science:

  • Neurology
  • Cardiovascular Physiology
  • Autonomic Nervous System Function

Background:

  • Clinic-based studies suggest a link between migraine and abnormal autonomic nervous system (ANS) function.
  • This study aimed to confirm these findings in a population-based cohort.

Purpose of the Study:

  • To investigate differences in autonomic nervous system (ANS) function between migraineurs and controls.
  • To explore whether ANS function varies within the migraine population, specifically between those with and without disabling attacks.

Main Methods:

  • A population study compared 80 migraine cases with 85 matched controls.
  • Autonomic nervous system (ANS) function was assessed using resting blood pressure, Valsalva maneuver, heart rate variability (pulse rate [RR] variation) during deep breathing, and cardiovascular reactivity.

Related Experiment Videos

  • Migraineurs were categorized into those with disabling attacks (n=28) and without (n=52).

    • Main Results:

    • Elevated resting diastolic blood pressure was observed in disabled migraineurs compared to nondisabled migraineurs and controls.
    • Significantly lower pulse rate (RR) variation was found in disabled migraineurs compared to both nondisabled migraineurs and controls.
    • While the Valsalva ratio and mean circular resultant were lower in disabled migraineurs, these differences were not statistically significant.

    Conclusions:

    • Migraineurs experiencing disabling attacks may exhibit autonomic nervous system (ANS) hypofunction.
    • ANS dysfunction could be a risk factor for migraine or a consequence of frequent, disabling attacks.
    • Shared neural substrates may underlie both ANS dysfunction and migraine.