Interictal cerebral and systemic endothelial dysfunction in patients with migraine: a case-control study

Area of Science:

• Neurology
• Vascular Biology
• Neuroimaging

Background:

• Systemic endothelial function is typically normal in migraineurs.
• The status of cerebral endothelial function in migraine remains largely unexplored.

Purpose of the Study:

• To investigate cerebral endothelial function in individuals with migraine.
• To compare cerebral endothelial function between migraineurs and healthy controls.

Main Methods:

• A prospective study involving 45 migraineurs and 44 healthy volunteers.
• Cerebral endothelial function assessed using Breath Holding Index (BHI) via transcranial Doppler in middle cerebral (MCA), posterior cerebral (PCA), and basilar arteries (BA).
• Systemic endothelial function evaluated by brachial artery flow-mediated dilation (FMD).

Main Results:

• Migraineurs exhibited significantly lower BHI in the PCA and BA compared to controls, indicating impaired cerebral endothelial function.
• Cerebral endothelial dysfunction was observed in a high percentage of migraineurs (PCA: 62.2% right, 57.8% left; BA: 77.8%).
• No significant difference in MCA BHI was found, and no correlation existed between cerebral and systemic endothelial function in migraineurs. Higher BMI predicted impaired BA BHI.

Conclusions:

• Migraineurs may experience isolated cerebral endothelial dysfunction, particularly affecting the posterior circulation.
• This dysfunction occurs independently of systemic endothelial function.
• Cerebral endothelial dysfunction in migraine is not associated with aura, headache characteristics, or systemic endothelial function.