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The persistent foramen ovale and migraine

P T Wilmshurst1

  • 1The Royal Shrewsbury Hospital, Shrewsbury, United-Kingdom. peter.wilmshurst@rsh.nhs.uk

Revue Neurologique
|September 6, 2005
PubMed

Insights

Migraine, especially with aura, is linked to large heart openings called persistent foramen ovale (PFO). Closing a PFO can improve migraine symptoms, suggesting a causal role for these shunts.

Area of Science:

  • Cardiology
  • Neurology
  • Genetics

Background:

  • Migraine, particularly migraine with aura, is a debilitating neurological condition.
  • A potential link between migraine and cardiac shunts, such as persistent foramen ovale (PFO), has been observed.

Purpose of the Study:

  • To investigate the association between migraine and large right-to-left shunts, specifically PFO.
  • To explore the potential causal role of PFO in migraine with aura.
  • To examine the impact of PFO closure on migraine symptoms.

Main Methods:

  • Observational studies correlating migraine prevalence with the presence of PFO and other right-to-left shunts.
  • Analysis of migraine improvement following PFO closure procedures.
  • Family studies investigating the inheritance patterns of migraine and atrial shunts.

Main Results:

  • A significant association exists between migraine, especially migraine with aura, and large PFOs or other right-to-left shunts.
  • PFO closure has been shown to improve migraine symptoms in many patients with large shunts.
  • In some families, migraine inheritance is linked to the inheritance of large atrial shunts.

Conclusions:

  • Persistent foramen ovale (PFO) may play a causal role in the etiology of migraine with aura in a subset of patients.
  • These findings may also offer insights into the underlying causes of migraine in individuals without a detectable shunt.
  • PFO closure represents a potential therapeutic strategy for migraine patients with large shunts.

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