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Published on: June 2, 2014
Autonomic function in migraine patients: ictal and interictal pupillometry
Melissa Cambron1, Heidi Maertens, Koen Paemeleire
1Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Department of Neurology, Universitair Ziekenhuis Brussel, Jette, Belgium.
Headache
|July 2, 2013
Summary
Migraine patients show subtle sympathetic nervous system dysfunction, evidenced by a delayed light reflex after apronicidine administration. This pupillary response is more pronounced during migraine attacks, suggesting a link between autonomic disturbance and migraine pathogenesis.
Area of Science:
- Neuroscience
- Autonomic Nervous System Research
- Ophthalmology
Background:
- Migraine pathogenesis may involve autonomic disturbances, specifically sympathetic hypofunction.
- Previous pupillometric studies suggest sympathetic involvement, but findings are controversial due to subtle or transient effects.
- Assessing sympathetic function during both symptom-free and attack phases is crucial.
Purpose of the Study:
- To investigate sympathetic function in migraine patients compared to controls.
- To evaluate autonomic function during both interictal and ictal phases.
- To use apraclonidine to unmask subtle changes in autonomic function.
Main Methods:
- Infrared pupillometry used to measure pupillary parameters.
- Study included 37 controls and 46 migraine patients in the interictal phase.
- Patients were tested with and without apraclonidine, and some during migraine attacks.
Main Results:
- No significant differences in pupillometry between migraine patients and controls in the interictal phase or during attacks.
- Apraclonidine administration revealed a longer latency of the light reflex in migraine patients compared to controls.
- This prolonged latency was more pronounced during migraine attacks (ictal phase) than in the symptom-free phase (interictal phase).
Conclusions:
- Evidence suggests a subtle pupillary sympathetic hypofunction in migraine patients.
- This hypofunction is identified by a prolonged light reflex latency after apraclonidine.
- The findings support the role of autonomic dysfunction in migraine pathophysiology.
