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Published on: June 2, 2014
Cerebrovascular Function in Hormonal Migraine: An Exploratory Study
Jemima S A Dzator1, Peter R C Howe1,2, Lyn R Griffiths3
1School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia.
Insights
Hormonal migraine is linked to poorer cerebrovascular function, specifically reduced blood flow and impaired neurovascular coupling in the left middle cerebral artery. This finding suggests potential links between migraine, brain blood flow, and quality of life.
Area of Science:
- Neurology
- Vascular Biology
- Neuroscience
Background:
- Migraineurs, especially young women, face higher risks of cerebrovascular disease.
- Limited evidence exists on the link between hormonal migraine and cerebrovascular function.
- Hormonal migraine may impact brain blood flow and neurological health.
Purpose of the Study:
- To investigate the association between cerebrovascular function and hormonal migraine.
- To determine if cerebrovascular abnormalities in hormonal migraineurs correlate with disability and quality of life.
- To explore the relationship between migraine characteristics and cerebrovascular parameters.
Main Methods:
- Cross-sectional study of 50 hormonal migraineurs and 29 controls during the inter-ictal period.
- Transcranial Doppler ultrasound to measure middle cerebral artery (MCA) blood flow velocity and cerebrovascular responsiveness (CVR).
- Assessment of neurovascular coupling via cognitive stimulation and hypercapnia; validated questionnaires for migraine impact and quality of life.
Main Results:
- Hormonal migraineurs exhibited lower resting mean blood flow velocity (MBFV) and impaired neurovascular coupling in the left MCA compared to controls.
- No significant differences in the right MCA or CVR to hypercapnia were observed between groups.
- Headache frequency correlated negatively with CVR, and impaired neurovascular coupling was linked to reduced quality of life in migraineurs.
Conclusions:
- This study is the first to demonstrate poorer cerebrovascular function in hormonal migraineurs, characterized by reduced resting MBFV and impaired neurovascular coupling in the left MCA.
- These findings highlight a potential link between hormonal migraine and cerebrovascular health.
- Further research is warranted to explore therapeutic strategies targeting cerebrovascular function to potentially alleviate migraine and improve patient quality of life.
Abstract:
Background: Migraineurs, particularly young premenopausal women, are at increased risk of cerebrovascular disease; however, there is currently limited evidence as to whether hormonal migraine is associated with poor cerebrovascular function. Objectives: The objectives of this study were to: (1) investigate the potential association of cerebrovascular function with hormonal migraine and (2) determine whether abnormalities of cerebrovascular function in hormonal migraineurs are associated with migraine-related disability and/or quality of life. Method: A cross-sectional study was undertaken in 50 hormonal migraineurs (mean age: 38.7 ± 1.2 years) and 29 controls (mean age: 35.6 ± 1.8 years). Data were collected at a single point in time from all participants during the inter-ictal period when they were free from migraine and not menstruating. Transcranial Doppler ultrasound was used to measure resting blood flow velocity and cerebrovascular responsiveness (CVR) to hypercapnia and cognitive stimulation (neurovascular coupling) in the left and right middle cerebral artery (MCA). Additionally, hormonal migraineurs completed three questionnaires to assess migraine-related disability and quality of life as well as migraine frequency and intensity: Headache Impact Test-6™, Migraine-Specific Quality of Life and Migraine Disability Assessment. Results: Hormonal migraineurs had lower resting mean blood flow velocity (MBFV) (P = 0.009) and neurovascular coupling during cognitive stimulation (P = 0.010) in the left MCA than controls. No such differences were found in the right MCA. Additionally, heart rate (P = 0.004) was higher in hormonal migraineurs than controls. However, no differences in CVR to hypercapnia were found between hormonal migraineurs and controls. Multi-variate analysis revealed age to be a significant (P = 0.012) predictor of MBFV in the left MCA. Negative correlations between headache frequency and CVR to hypercapnia in the left (P = 0.026) and right MCA (P = 0.044) were found. Additionally, negative correlations between neurovascular coupling during the 2-Back 1.5 s task in the right MCA and the MSQoL emotional (P = 0.013) and role-function restrictive (P = 0.039) domains were found. Conclusions: This is the first study to show that hormonal migraineurs have poorer cerebrovascular function, as represented by lower resting MBFV and impaired neurovascular coupling in the left MCA. Future studies should investigate whether improving cerebrovascular function can prevent hormonal migraine and improve quality of life. Clinical Trial Registration: ACTRN12618001230246.
