Patients with migraine with aura have increased flow mediated dilation

Area of Science:

• Vascular Physiology
• Neurology
• Cardiovascular Research

Background:

• Endothelium-derived nitric oxide (NO) regulates arterial dilation in response to blood flow (flow-mediated dilation, FMD).
• NO plays a role in cerebral hemodynamics and is implicated in migraine-related vascular changes.
• Investigating peripheral NO response in migraine patients can offer insights into central vascular mechanisms.

Purpose of the Study:

• To determine if migraine patients exhibit an altered peripheral arterial response to nitric oxide.
• To compare flow-mediated dilation (FMD) in migraineurs with and without aura against healthy controls.

Main Methods:

• Utilized ultrasound to measure brachial artery diameter changes during reactive hyperemia in 21 migraineurs (10 with aura [MwA], 11 without aura [MwoA]) and 13 controls.
• Calculated FMD by assessing the percentage increase in brachial artery diameter post-occlusion.
• Normalized FMD values for shear stress to account for variations in blood flow dynamics.

Main Results:

• Normalized FMD was significantly higher in migraineurs with aura (28.5 x 10^-2 %.s) compared to controls (9.0 x 10^-2 %.s) and migraineurs without aura (13.7 x 10^-2 %.s) (p < 0.001).
• A higher proportion of migraineurs with aura (90%) exhibited FMD above the median (19%) compared to MwoA patients (45.5%) and controls (23.1%).

Conclusions:

• Migraineurs with aura demonstrate an excessive arterial hyperemic response, likely due to increased sensitivity to endothelium-derived nitric oxide.
• This enhanced peripheral vascular reactivity may reflect similar alterations in cerebral circulation during migraine attacks.
• The findings suggest a potential link between peripheral endothelial function and migraine pathophysiology.