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| This news site is not sanctioned by, nor part of, the Diamond Headache Foundation, The American Academy of Neurology OR The American Headache Society. |
| News covering selected sessions related to migraine from 2008 medical conferences. |
| Annual Meeting of the American Academy of Neurology |
Chicago, IL April 15-18, 2008 |
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Basilar Artery Flow Patterns Distinquish
Migraine Subtypes |
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BY DON SCHRADER
Contributing Writer |
CHICAGO
(EGMN)— Distinct patterns of cerebral vasomotor
reactivity (CVR) in the basilar artery occur in migraine with
and without aura, suggesting the migraine subtypes have
different underlying pathophysiologic mechanisms, Korean
investigators reported on April 15 at the annual meeting of the
American Academy of Neurology.
Patients who had migraine with aura exhibited significantly
greater basilar artery CVR compared with patients who had
migraine without aura, said Dr. Chin-Sang Chung of Samsung
Medical Center in Seoul. Patients with either type of migraine
differed from a nonmigraine control group with respect to
basilar artery CVR.
“Our data suggest that migraine with aura and migraine without
aura are distinct disorders in terms of vascular responses of
the basilar artery during the interictal period,” said Dr.
Chung. “CVR of the basilar artery may be helpful in delineating
migraine pathophysiology.”
Prior studies of migraine have used transcranial Doppler imaging
to examine vascular response to physiologically induced
hypercapnia. However, the studies excluded the posterior
circulation including functionally important brainstem
structures, noted Dr. Chung.
In an attempt to address limitations of previous studies, the
investigators used power mode Doppler imaging to perform
simultaneous assessment of CVR in the middle cerebral and
basilar arteries. The study included 15 patients who had
migraine with aura, 21 patients who had migraine without aura,
and 29 healthy volunteers.
CVR was evaluated by means of the rebreathing technique, and
two-step transcranial Doppler assessment was performed. First,
the velocity and spectrum of the middle cerebral artery were
monitored simultaneously through the temporal windows. Then the
velocity and spectrum of the middle cerebral artery and basilar
artery were monitored simultaneously.
The migraine patients and volunteers did not differ with respect
to age, sex, and baseline blood pressure and heart rate.
Baseline flow velocity and CVR determined by transcranial
Doppler were also similar between the patients and volunteers.
Measurement of basilar artery CVR revealed significant
differences between the two groups of migraine patients and
between migraine patients and the volunteers. Migraine with aura
was associated with a median basilar artery CVR of 39.4% versus
64.6% among patients who had migraine without aura (P=0.001).
The control group had a median basilar artery CVR of 45.6%,
which differed significantly from the values of migraine
patients (P=0.001).
“The CVR of the basilar artery was entirely different according
to migraine subtype, which suggests that migraine with and
without aura are two distinct disorders,” said Dr. Chung. |
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