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The Journal of Headache and Pain
Published in: The Journal of Headache and Pain 1/2015

Open Access 01-12-2016 | Research article

Autonomous control of cardiovascular reactivity in patients with episodic and chronic forms of migraine

Authors: Oleg V. Mamontov, Laura Babayan, Alexander V. Amelin, Rashid Giniatullin, Alexei A. Kamshilin

Published in: The Journal of Headache and Pain | Issue 1/2015

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Abstract

Background

The autonomous cardiovascular control can contribute to progression of migraine. However, current data on cardiovascular reactivity in migraine, especially severe forms, are essentially contradictory. The main aim of this study was to compare the autonomous regulation of circulation in patients with episodic and chronic migraine and healthy subjects.

Methods

Seventy three migraine patients (mean age 35 ± 10) including episodic migraine (51 patients, 4–14 headache days/months) and chronic migraine (22 patients, ≥15 headache days/month) along with age-match control (71 healthy voluntaries) were examined. The autonomic regulation of circulation was examined with the tilt-table test, a deep breathing and Valsalva Maneuver, handgrip test, cold-stress vasoconstriction, arterial baroreflex and blood pressure variability.

Results

The changes in heart rate induced by deep breathing, Valsalva Maneuver, and blood pressure in tilt-table test in patients with migraine did not differ from the control group. In contrast, the values of cold-stress-vasoconstriction forearm blood-flow reactivity (p <0.001), the increase in diastolic blood pressure in handgrip test (p <0.001), mean blood pressure in the late stage of the second phase of Valsalva Maneuver (p <0.001) and blood pressure variability (p <0.005) were all higher in patients with migraine than in the control group.

Conclusion

Thus, both episodic and chronic migraine are associated with significant disturbances in autonomous control resulting in enhanced vascular reactivity whereas the cardiac regulation remains largely unchanged.
Literature
1.
2.
Amelin AV, Ignatov YD, Skoromets AA, Migraine SAU (2014) The pathogenesis, clinical features, pharmacotherapy:a guide for physicians. MEDpress-Inform, Moscow (in Russian)
3.
Silberstein SD (2004) Migraine pathophysiology and its clinical implications. Cephalalgia 24(Suppl 2):2–7CrossRefPubMed
4.
Brennan KC, Beltrán-Parrazal L, López-Valdés HE, Theriot J, Toga AW, Charles AC (2007) Distinct vascular conduction with cortical spreading depression. J Neurophysiol 97:4143–4151CrossRefPubMed
5.
Goadsby PJ (2007) Recent advances in understanding migraine mechanisms, molecules and therapeutics. Trends Mol Med 13:39–44CrossRefPubMed
6.
7.
Zakharov A, Vitale C, Kilinc E, Koroleva K, Fayuk D, Shelukhina I, Naumenko N, Skorinkin A, Khazipov R, Giniatullin R (2015) Hunting for origins of migraine pain:cluster analysis of spontaneous and capsaicin-induced firing in meningeal trigeminal nerve fibers. Front Cell Neurosci 9:287CrossRefPubMedPubMedCentral
8.
Aurora SK, Kulthia A, Barrodale PM (2011) Mechanism of chronic migraine. Curr Pain Headache Rep 15:57–63CrossRefPubMed
9.
Drummond PD (1990) Disturbances in ocular sympathetic function and facial blood flow in unilateral migraine headache. J Neurol Neurosurg Psychiatry 53:121–125CrossRefPubMedPubMedCentral
10.
Zaproudina N, Lipponen JA, Karjalainen PA, Kamshilin AA, Giniatullin R, Närhi M (2014) Acral coldness in migraineurs. Auton Neurosci 180:70–73CrossRefPubMed
11.
Tietjen GE (2009) Migraine as a systemic vasculopathy. Cephalalgia 29:989–996
12.
Shechter A, Stewart WF, Silberstein SD, Lipton RB (2002) Migraine and autonomic nervous system function:a population-based, case-control study. Neurology 58:422–427CrossRefPubMed
13.
Kisan R, Sujan M, Adoor M, Rao R, Nalini A, Kutty BM, Chindanda Murthy B, Raju T, Sathyaprabha T (2014) Effect of Yoga on migraine: A comprehensive study using clinical profile and cardiac autonomic functions. Int J Yoga 7:126–132CrossRefPubMedPubMedCentral
14.
Matei D, Constantinescu V, Corciova C, Ignat B, Matei R, Popescu CD (2015) Autonomic impairment in patients with migraine. Eur Rev Med Pharmacol Sci 19:3922–3927PubMed
15.
16.
Zaproudina N, Narhi M, Lipponen JA, Tarvainen MP, Karjalainen PA, Karhu J, Airaksinen O, Giniatullin R (2013) Nitroglycerin-induced changes in facial skin temperature: ‘cold nose’ as a predictor of headache? Clin Physiol Funct Imaging 33:409–417. doi:10.​1111/​cpf.​12042 PubMed
17.
Zaproudina N, Teplov V, Nippolainen E, Lipponen JA, Kamshilin AA, Närhi M, Karjalainen PA, Giniatullin R (2013) Asynchronicity of facial blood perfusion in migraine. PLoS One 8:e80189CrossRefPubMedPubMedCentral
18.
Gotoh F, Komatsumoto S, Araki N, Gomi S (1984) Noradrenergic nervous activity in migraine. Arch Neurol 41:951–955CrossRefPubMed
19.
Havanka-Kanniainen H, Tolonen U, Myllyla VV (1986) Autonomic dysfunction in adult migraineurs. Headache 26:425–430CrossRefPubMed
20.
Boccuni M, Alessandri M, Fuscof BM, Cangi F (1989) The pressor hyperresponsiveness to phenylephrine unmasks sympathetic hypofunction in migraine. Cephalalgia 9:239–245CrossRefPubMed
21.
Lalande S, Sawicki CP, Baker JR, Shoemaker JK (2014) Effect of age on the hemodynamic and sympathetic responses at the onset of isometric handgrip exercise. J Appl Physiol 116:222–227CrossRefPubMedPubMedCentral
22.
Mosek A, Novak V, Opfer-Gehrking TL, Swanson JW, Low PA (1999) Autonomic dysfunction in migraineurs. Headache 39:108–117CrossRefPubMed
23.
Micieli G, Tassorelli C, Bosone D, Cavallini A, Bellantonio P, Rossi F, Nappi G (1995) Increased cerebral blood flow velocity induced by cold pressor test in migraine:a possible basis for pathogenesis? Cephalalgia 15:494–498CrossRefPubMed
24.
Napoli R, Guardasole V, Zarra E, Sena AD, Saccà F, Ruvolo A, Grassi S, Giugliano S, Michele GD, Cittadini A, Carrieri PB, Saccà L (2013) Migraine attack restores the response of vascular smooth muscle cells to nitric oxide but not to norepinephrine. World J Cardiol 5:375–381. doi:10.​4330/​wjc.​v5.​i10.​375 PubMedPubMedCentral
25.
Modesti PA, Polidori G, Bertolozzi I, Vanni S, Cecioni I (2004) Impairment of cardiopulmonary receptor sensitivity in the early phase of heart failure. Heart 90:30–36CrossRefPubMedPubMedCentral
26.
Rizzo MR, Sasso FC, Marfella R, Siniscalchi M, Paolisso P, Carbonara O, Capoluongo MC, Lascar N, Pace C, Sardu C, Passavanti B, Barbieri M, Mauro C, Paolisso G (2015) Autonomic dysfunction is associated with brief episodes of atrial fibrillation in type 2 diabetes. J Diabetes Complications 29:88–92CrossRefPubMed
27.
Thomsen LL, Iversen HK, Boesen F, Olesen J (1995) Transcranial Doppler and cardiovascular responses during cardiovascular autonomic tests in migraineurs during and outside attacks. Brain 118:1319–1327CrossRefPubMed
28.
Riesco N, Pérez-Alvarez AI, Verano L, García-Cabo C, Martínez-Ramos J, Sánchez-Lozano P, Cernuda-Morollón E, Pascual J (2015) Prevalence of cranial autonomic parasympathetic symptoms in chronic migraine: Usefulness of a new scale. Cephalalgia. doi:10.​1177/​0333102415593087​
29.
Koenig J, Williams DP, Kemp AH, Thayer JF (2016) Vagally mediated heart rate variability in headache patients-a systematic review and meta-analysis. Cephalalgia 36:265–78CrossRefPubMed
30.
Cernuda-Morollón E, Martínez-Camblor P, Alvarez R, Larrosa D, Ramón C, Pascual J (2015) Increased VIP levels in peripheral blood outside migraine attacks as a potential biomarker of cranial parasympathetic activation in chronic migraine. Cephalalgia 35:310–316CrossRefPubMed
31.
Headache Classification Committee of the International Headache Society (2013) The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia 33:629–808. doi:10.​1177/​0333102413485658​ CrossRef
32.
Fagernæs CF, Heuch I, Zwart JA, Winsvold BS, Linde M, Hagen K (2015) Blood pressure as a risk factor for headache and migraine:a prospective population-based study. Eur J Neurol 22:156–162CrossRefPubMed
33.
Pierpont GL, Voth EJ (2004) Assessing autonomic function by analysis of heart rate recovery from exercise in healthy subjects. Am J Cardiol 94:64–68CrossRefPubMed
34.
35.
Furlan R, Jacob G, Snell M, Robertson D, Porta A, Harris P (1998) Chronic orthostatic intolerance. A disorder with discordant cardiac and vascular sympathetic control. Circulation 98:2154–2159CrossRefPubMed
36.
37.
Taylor JA, Myers CW, Halliwill JR, Seidel H, Eckberg DL (2001) Sympathetic restraint of respiratory sinus arrhythmia:implications for vagal-cardiac tone assessment in humans. Am J Physiol Heart Circ Physiol 280:2804–14
38.
Lu K, Clark JW Jr, Ghorbel FH, Ware DL, Bidani A (2001) A human cardiopulmonary system model applied to the analysis of the Valsalva maneuver. Am J Physiol Heart Circ Physiol 281:H2661–H2679PubMed
39.
Ewing DJ, Irving JB, Kerr F, Wildsmith JA, Clarke BF (1974) Cardiovascular responses to sustained handgrip in normal subjects and in patients with diabetes mellitus:a test of autonomic function. Clin Sci Mol Med 46:295–306. doi:10.​1042/​cs0460295 PubMed
40.
Imaizumi T, Takeshita A, Makino N, Ashihara T, Yamamoto K, Nakamura M (1984) Impaired baroreflex control of vascular resistance and heart rate in acute myocardial infarction. Br Heart J 52:418–421CrossRefPubMedPubMedCentral
41.
Wehrwein EA, Joyner MJ (2013) Regulation of blood pressure by the arterial baroreflex and autonomic nervous system. Handb Clin Neurol 117:89–102CrossRefPubMed
42.
Parati G, Ochoa JE, Lombardi C, Salvi P, Bilo G (2013) Assessment and interpretation of blood pressure variability in a clinical setting. Blood Press 22:345–354CrossRefPubMed
43.
44.
Cady RK, Schreiber CP, Farmer KU (2004) Understanding the patient with migraine: the evolution from episodic headache to chronic neurologic disease. A proposed classification of patients with headache. Headache 44:426–435CrossRefPubMed
45.
Allena M, Steiner TJ, Sances G, Carugno B, Balsamo F, Nappi G, Andrée C, Tassorelli C (2015) Impact of headache disorders in Italy and the public-health and policy implications: a population-based study within the Eurolight Project. J Headache Pain 16:100CrossRefPubMedPubMedCentral
46.
Wada N, Singer W, Gehrking TL, Sletten DM, Schmelzer JD, Low PA (2014) Comparison of baroreflex sensitivity with a fall and rise in blood pressure induced by the Valsalva manoeuvre. Clin Sci (Lond) 127:307–313CrossRef
47.
Shepherd JT, Rusch NJ, Vanhoutte PM (1983) Effect of cold on the blood vessel wall. Gen Pharmacol 14:61–64CrossRefPubMed
48.
Vanhoutte PM, Shepherd JT (1985) Adrenergic pharmacology of human and canine peripheral veins. Fed Proc 44:337–340PubMed
49.
Yerdelen D, Acil T, Goksel B, Karatas M (2008) Heart rate recovery in migraine and tension-type headache. Headache 48:221–225CrossRefPubMed
50.
Metadata
Title
Autonomous control of cardiovascular reactivity in patients with episodic and chronic forms of migraine
Authors
Oleg V. Mamontov
Laura Babayan
Alexander V. Amelin
Rashid Giniatullin
Alexei A. Kamshilin
Publication date
01-12-2016
Publisher
Springer Milan
Published in
The Journal of Headache and Pain / Issue 1/2015
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI
https://doi.org/10.1186/s10194-016-0645-6

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