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Pavelić AR, Zebenholzer K, Wöber C. Reconceptualizing autonomic function testing in migraine: a systematic review and meta-analysis. J Headache Pain 2024; 25:54. [PMID: 38600467 PMCID: PMC11005222 DOI: 10.1186/s10194-024-01758-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/26/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Autonomic nervous system (ANS) testing has aided in our ability to evaluate autonomic dysfunction in migraine patients. We reviewed the literature in multiple databases which investigate ANS function in migraine patients and healthy subjects. METHODS This systematic review and meta-analysis examined the respective deep breathing, Valsalva manoeuvre, orthostatic and isometric challenge results, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analyses of Observational Studies in Epidemiology (MOOSE) statements. RESULTS Seven articles met all inclusion criteria. Fixed-effects meta-analysis showed migraine patients (n = 424), collectively, had lower interictal autonomic test results compared with healthy controls (n = 268). In detail, this was true for the standardized mean difference (g) of deep breathing (g= -0.32; 95% confidence interval (CI) -0.48, -0.16), orthostatic challenge (g= -0.28; 95% CI -0.44, -0.13) and isometric challenge (g= -0.55; 95% CI -0.71, -0.39) and for the difference of means (MD) of the Valsalva ratio (MD = -0.17; 95% CI -0.23, -0.10). CONCLUSIONS Interictal ANS dysfunction can be identified in migraine patients when compared to healthy controls. These findings indicate the importance to evaluate ANS function in migraine patients - especially, as migraine-specific prophylactic therapies (such as anti-calcitonin gene-related peptide (CGRP) antibodies) may affect the function of the ANS.
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Affiliation(s)
- Antun R Pavelić
- Department of Neurology, University Hospital Tulln, Alter Ziegelweg 10, Tulln, 3430, Austria
- Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Austria
| | - Karin Zebenholzer
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, 1090, Austria.
- Medical University of Vienna Comprehensive Center for Clinical Neurosciences & Mental Health, Vienna, 1090, Austria.
| | - Christian Wöber
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, 1090, Austria
- Medical University of Vienna Comprehensive Center for Clinical Neurosciences & Mental Health, Vienna, 1090, Austria
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Mueller B. Episodic Migraine and POTS. Curr Pain Headache Rep 2023; 27:757-763. [PMID: 37804458 DOI: 10.1007/s11916-023-01173-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 10/09/2023]
Abstract
PURPOSE OF REVIEW Migraine is prevalent in patients with postural orthostatic tachycardia syndrome (POTS). The purpose of this review is to summarize and interpret studies that examine stress response systems in patients with migraine, focusing on their relevance to the pathologies associated with POTS. Important structural and functional components of the stress response network are also reviewed. RECENT FINDINGS In patients with migraine, studies examining the autonomic nervous system have demonstrated interictal sympathetic hypofunction and ictal sympathetic hyperfunction, while those focusing on the hypothalamic-pituitary-adrenal axis have demonstrated elevated responsivity. There is evidence that activation of these stress response systems during a migraine episode may exacerbate vascular dysfunction and play a role in the development of central sensitization. Activation of the stress response systems during an episode of migraine has the potential to exacerbate the pathology of POTS. Treatment approaches for the patient with comorbid episodic migraine and POTS should consider the etiology of POTS.
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Affiliation(s)
- Bridget Mueller
- Department of Neurology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, Box 1139, New York, NY, 10029, USA.
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Mueller BR, Ray C, Benitez A, Robinson-Papp J. Reduced cardiovagal baroreflex sensitivity is associated with postural orthostatic tachycardia syndrome (POTS) and pain chronification in patients with headache. Front Hum Neurosci 2023; 17:1068410. [PMID: 36992793 PMCID: PMC10040804 DOI: 10.3389/fnhum.2023.1068410] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/24/2023] [Indexed: 03/16/2023] Open
Abstract
BackgroundNon-cephalgic symptoms including orthostatic intolerance, fatigue, and cognitive impairment, are common in patients with chronic headache disorders and may result from alterations in the autonomic nervous system. However, little is known about the function of autonomic reflexes, which regulate cardiovascular homeostasis and cerebral perfusion in patients with headache.MethodsAutonomic function testing data from patients with headache collected between January 2018 and April 2022 was retrospectively analyzed. Through review of EMR we determined headache pain chronicity and patient self-report of orthostatic intolerance, fatigue, and cognitive impairment. Composite Autonomic Severity Score (CASS), CASS subscale scores, and cardiovagal and adrenergic baroreflex sensitivities were used to quantify autonomic reflex dysfunction. Descriptive analyses (Mann-Whitney-U or χ2, as appropriate) determined associations between autonomic reflex dysfunction and POTS as well as chronic headache. Binomial logistic regression adjusted for age and sex. Spearman’s rank correlation determined the association between the total CASS score and the number of painless symptoms reported by each participant.ResultsWe identified 34 patients meeting inclusion criteria, of whom there were 16 (47.0%) with orthostatic intolerance, 17 (50.0%) with fatigue, 11 (32.4%) with cognitive complaints, and 11 (32.4%) with Postural Orthostatic Tachycardia Syndrome (POTS). The majority of participants had migraine (n = 24, 70.6%), were female (n = 23, 67.6%) and had a chronic (>15 headache days in a month) headache disorder (n = 26, 76.5%). Reduced cardiovagal baroreflex sensitivity (BRS-V) independently predicted chronic headache [aOR: 18.59 (1.16, 297.05), p = 0.039] and POTS [aOR: 5.78 (1.0, 32.5), p = 0.047]. The total CASS was correlated with the total number of non-painful features in the expected direction (r = 0.46, p = 0.007).ConclusionAbnormal autonomic reflexes may play an important role in pain chronification and the development of POTS in patients with headache.
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Rossi DM, de Souza HCD, Bevilaqua-Grossi D, Vendramim ACC, Philbois SV, Carvalho GF, Dach F, Mascarenhas S, de Oliveira AS. Impairment on Cardiovascular Autonomic Modulation in Women with Migraine. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:763. [PMID: 36613082 PMCID: PMC9819790 DOI: 10.3390/ijerph20010763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Autonomic dysfunction, such as reduced vagally mediated heart rate variability, has been suggested in headache patients but is still uncertain when considering primary headache disorders. This study aims to compare the heart rate and blood pressure variability and baroreflex sensitivity between women with migraine and controls. A migraine (n = 20) and a control group (n = 20) of age-matched women without headache were evaluated. Heart rate variability was analyzed through frequency-domain using spectral analysis presenting variance, low-frequency (LF; 0.04-0.15 Hz) and high-frequency (HF; 0.15-0.4 Hz) bands and by time domain (root mean square of successive R-R interval differences, RMSSD). Blood pressure variability was analyzed with spectral analysis and baroreflex sensitivity with the sequence method. Migraine group had lower heart rate variability characterized by a reduction in total variance, LF oscillations (sympathetic/vagal modulation) and HF oscillations (vagal modulation), and a reduction in SD and RMSSD compared to control group. No difference was found in the blood pressure variability analysis. Regarding baroreflex sensitivity, migraine group had decreased values of total gain, gain down and up compared to control group. Women with migraine exhibited autonomic modulation alterations, expressed by decreased values of heart rate variability and baroreflex sensitivity, but not by differences in blood pressure variability.
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Affiliation(s)
- Denise Martineli Rossi
- Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Uberaba 38025-180, MG, Brazil
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto 14049-900, SP, Brazil
| | - Hugo Celso Dutra de Souza
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto 14049-900, SP, Brazil
| | - Débora Bevilaqua-Grossi
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto 14049-900, SP, Brazil
| | - Ana Carolina Carmona Vendramim
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto 14049-900, SP, Brazil
| | - Stella Vieira Philbois
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto 14049-900, SP, Brazil
| | | | - Fabíola Dach
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto 14049-900, SP, Brazil
| | - Sérgio Mascarenhas
- São Carlos Institute of Physics, University of São Paulo, Sao Carlos 13566-590, SP, Brazil
| | - Anamaria Siriani de Oliveira
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto 14049-900, SP, Brazil
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5
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Mueller BR, Robinson‐Papp J. Postural orthostatic tachycardia syndrome and migraine: A narrative review. Headache 2022; 62:792-800. [DOI: 10.1111/head.14365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Bridget R. Mueller
- Department of Neurology Icahn School of Medicine at Mount Sinai, Center for Headache and Facial Pain New York New York USA
| | - Jessica Robinson‐Papp
- Department of Neurology Icahn School of Medicine at Mount Sinai New York New York USA
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Rausa M, Spada GE, Patron E, Pierangeli G, Palomba D. Do catastrophizing and autonomic-reduced flexibility mediate pain outcomes in chronic headache? Neurol Sci 2022; 43:3283-3295. [PMID: 34799749 DOI: 10.1007/s10072-021-05732-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 11/09/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Maladaptive cognitive strategies and reduced autonomic flexibility have been reported in chronic pain conditions. No study to date addressed the effects of maladaptive coping and reduced autonomic flexibility, as indexed by heart rate variability (HRV), in chronic headaches. The present study aimed to assess the mediating role of pain catastrophizing and HRV on pain outcomes in patients with chronic headache. METHODS Thirty-two chronic headache patients and 28 healthy controls were recruited. Self-reported pain severity, pain interference on daily activity, and pain catastrophizing were assessed through the Multidimensional Pain Inventory and the Pain-Related Self Statements Scale. HRV was recorded at rest. Correlations and mediation analysis between self-report, HRV, and pain outcomes were run. RESULTS Patients with chronic headache reported significantly higher pain severity (p < .001; d = - 1.98), pain interference on daily activity (p < .001; d = - 1.81), and pain catastrophizing (p < .001; d = - 0.96) compared to controls. They also presented significantly lower HRV (p < .05; d = 0.57). Both pain catastrophizing and HRV were associated with pain interference on daily activity. However, from mediation analysis, pain catastrophizing only emerged as the mediator for pain severity (p < .001; b = 0.30) and pain interference (p < .001; b = 0.14). CONCLUSION Present results showed that chronic headache patients are characterized by high catastrophizing and lower physiological adaptability. Pain catastrophizing emerged as the only mediator of pain outcomes, suggesting that cognitive factors might have a major influence on the severity of pain and its interference on daily activities. Further studies are needed to evaluate these autonomic-cognitive interactions in chronic pain.
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Affiliation(s)
- Marialuisa Rausa
- Centro Gruber, Diagnosis and Treatment Outpatient Center for Eating and Weight Disorders, Anxiety and Psychosomatic Disorders, Via Santo Stefano, 10 40125, Bologna, Italy.
| | - Gea Elena Spada
- Centro Gruber, Diagnosis and Treatment Outpatient Center for Eating and Weight Disorders, Anxiety and Psychosomatic Disorders, Via Santo Stefano, 10 40125, Bologna, Italy
| | - Elisabetta Patron
- Department of General Psychology, University of Padova, Padova, Italy
| | - Giulia Pierangeli
- Department of Biomedical and Neuromotor Sciences DIBINEM, University of Bologna, Bologna, Italy
- IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Daniela Palomba
- Department of General Psychology, University of Padova, Padova, Italy
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Shi M, Luo D, Guo J, Yang D, Li Z, Zhao H. The Function of the Autonomic Nervous System in Asian Patients With Chronic Migraine. Front Neurosci 2022; 16:773321. [PMID: 35495060 PMCID: PMC9047659 DOI: 10.3389/fnins.2022.773321] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 03/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background The pathogenic mechanisms underlying the autonomic nervous system (ANS) dysfunction in patients with chronic migraine (CM) remain unclear. This study investigated the pathogenesis of ANS dysfunction in this population. Methods A total of 60 patients diagnosed with CM and 60 healthy subjects were recruited to participate in this study. The pupil diameter, pupil contraction velocity, latency, amplitude, and the maximum gradient recovery time were examined before, at 2 min and at 5 min after the cold pressor test, which was combined with the pupillary light reflex method. A brain 3D T1-weighted structural imaging scan, resting-state functional magnetic resonance imaging scan, and diffusion tensor imaging (DTI) scan were also acquired. Results Patients with CM exhibited a longer recovery time to the maximum gradient at 2 min and at 5 min after cold pressing compared with the control group (P < 0.01 and P < 0.05, respectively). There was no significant difference in the pupil diameter, pupillary contraction velocity, latency, amplitude, blood pressure, or heart rate between the two groups (all P > 0.05). In the CM group, the regional homogeneity (ReHo) values of the left amygdala and left lateral hypothalamic area were significantly higher than those of other brain areas (P < 0.001, Alphasim corrected). The DTI scan of the whole brain area showed a lack of significant difference in DTI indices, including FA, MD, AD, and RD values between the two groups (P > 0.05, Alphasim corrected). Conclusion The dysfunction of the left amygdala and left lateral hypothalamic area may be related to ANS dysfunction in patients with CM.
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Affiliation(s)
- Min Shi
- Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Danqing Luo
- Department of Rehabilitation, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jun Guo
- Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dongdong Yang
- Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhaoying Li
- Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Huan Zhao
- Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Huan Zhao,
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8
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Stubberud A, Buse DC, Kristoffersen ES, Linde M, Tronvik E. Is there a causal relationship between stress and migraine? Current evidence and implications for management. J Headache Pain 2021; 22:155. [PMID: 34930118 PMCID: PMC8685490 DOI: 10.1186/s10194-021-01369-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 12/01/2021] [Indexed: 12/13/2022] Open
Abstract
Background The purpose of this narrative review is to examine the literature investigating a causal relationship between stress and migraine and evaluate its implications for managing migraine. Methods PubMed, PsycINFO and CINAHL were searched from 1988 to August 2021, identifying 2223 records evaluating the relationship between stress and migraine. Records were systematically screened. All potentially relevant records were thematically categorized into six mechanistic groups. Within each group the most recent reports providing new insights were cited. Results First, studies have demonstrated an association of uncertain causality between high stress loads from stressful life events, daily hassles or other sources, and the incidence of new-onset migraine. Second, major stressful life events seem to precede the transformation from episodic to chronic migraine. Third, there is some evidence for changes in levels of stress as a risk factor for migraine attacks. Research also suggests there may be a reversed causality or that stress-trigger patterns are too individually heterogeneous for any generalized causality. Fourth, migraine symptom burden seems to increase in a setting of stress, partially driven by psychiatric comorbidity. Fifth, stress may induce sensitization and altered cortical excitability, partially explaining attack triggering, development of chronic migraine, and increased symptom burden including interictal symptom burden such as allodynia, photophobia or anxiety. Finally, behavioral interventions and forecasting models including stress variables seem to be useful in managing migraine. Conclusion The exact causal relationships in which stress causes incidence, chronification, migraine attacks, or increased burden of migraine remains unclear. Several individuals benefit from stress-oriented therapies, and such therapies should be offered as an adjuvant to conventional treatment and to those with a preference. Further understanding the relationship between stress, migraine and effective therapeutic options is likely to be improved by characterizing individual patterns of stress and migraine, and may in turn improve therapeutics.
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Affiliation(s)
- Anker Stubberud
- Department of Neuromedicine and Movement Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway. .,National Advisory Unit on Headaches, Department of Neurology, St. Olavs Hospital, Trondheim, Norway.
| | - Dawn C Buse
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Espen Saxhaug Kristoffersen
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway.,Department of General Practice, University of Oslo, Oslo, Norway
| | - Mattias Linde
- Department of Neuromedicine and Movement Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,National Advisory Unit on Headaches, Department of Neurology, St. Olavs Hospital, Trondheim, Norway
| | - Erling Tronvik
- Department of Neuromedicine and Movement Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,National Advisory Unit on Headaches, Department of Neurology, St. Olavs Hospital, Trondheim, Norway
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Zhang L, Qiu S, Zhao C, Wang P, Yu S. Heart Rate Variability Analysis in Episodic Migraine: A Cross-Sectional Study. Front Neurol 2021; 12:647092. [PMID: 33833731 PMCID: PMC8021769 DOI: 10.3389/fneur.2021.647092] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 02/16/2021] [Indexed: 01/24/2023] Open
Abstract
Objective: It has been reported that autonomic nervous dysfunction is more prevalent in migraineurs. Heart rate variability (HRV) is a commonly used method to evaluate the cardiac autonomic nervous function modulation. However, HRV changes in migraine are still contradictory. The main objective of this study was to explore the potential HRV change patterns in episodic migraine (EM) and whether there were differences in HRV between EM ictal period and the interictal period. Patients and Methods: We conducted a cross-sectional study including 18 patients with EM and 18 age- and sex-matched controls. The characteristics of demographics, some lifestyle factors, and psychological conditions were assessed at baseline. HRVs including time-domain analysis and frequency-domain analysis were performed in all participants. HRV analyses in migraine were recorded not only in the interictal period but also in the ictal period. Results: All the HRV parameters showed a decreased trend in migraine than controls. Time-domain parameters standard deviation of all NN intervals in 24 h (SDNN) and triangular index were significantly lower in the migraine ictal period than controls separately (SDNN, 56.94 ± 22.09 ± 7.76 vs. 135.78 ± 35.16, p < 0.001; triangular index, 12.61 ± 3.20 vs. 22.11 ± 6.90, p < 0.001). Frequency-domain parameter low-frequency power was also lower in the migraine ictal period than controls (351.28 ± 206.71 vs. 559.61 ± 281.24, p = 0.02). SDNN was much lower in the migraine ictal period than migraine interictal period (56.94 ± 22.09 vs. 115.94 ± 46.88, p < 0.001). HRV changes during migraine interictal period did not differ from the control group. The correlation analysis revealed a negative correlation between visual analog scale and HRV parameters in the migraine ictal period (p = 0.04). Conclusions: The present cross-sectional study indicates that HRV was significantly decreased in EM population especially during the migraine ictal period, which means unbalance of autonomic system in EM. Perhaps larger prospective cohort studies are wanted to validate these findings.
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Affiliation(s)
- Lvming Zhang
- Department of Neurology, Medical School of Chinese People's Liberation Army, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Shi Qiu
- Department of Neurology, Aerospace Center Hospital, Beijing, China
| | - Chunxia Zhao
- Department of Neurology, Aerospace Center Hospital, Beijing, China
| | - Peifu Wang
- Department of Neurology, Aerospace Center Hospital, Beijing, China
| | - Shengyuan Yu
- Department of Neurology, Medical School of Chinese People's Liberation Army, Chinese People's Liberation Army General Hospital, Beijing, China
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Zelenina TA, Salukhov VV, Zemlianoi AB, Zheleznjak SG, Klitsenko OA. Impairment of microvascular blood flow in patients with type 2 diabetes and cardiovascular autonomic neuropathy. DIABETES MELLITUS 2021. [DOI: 10.14341/dm12372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND: Diabetic autonomic neuropathy is the reason for early morbidity and mortality on diabetic patients. The pathology not only cardiac innervation but microvascular is presented.AIMS: We estimated the parameters of skin microvascular blood flow in accordance with cardiovascular autonomic neuropathy (CAN) staging in diabetic patients. We also assessed other risk factors of CAN in patients with diabetes.MATERIALS AND METHODS: We included 76 patients with type 2 diabetes in the study (24 patients with resent-onset diabetes and/or diabetes without microvascular complications, 26 with diabetic sensorimotor neuropathy (SMN) and 26 with SMN and previous history of diabetic foot amputation). The SMN was diagnosed on the basis of patients complaints, anamnesis and data of clinical neurological examinations. CAN was detected using several cardiovascular autonomic reflex tests (CART) as a gold standard of diagnosis: the tilt-table test, a deepbreathing and Valsalva Maneuver, handgrip test, cold-stress vasoconstriction. According to the Toronto Diabetic Neuropathy Expert Group Recommendation all patients was separated on the groups: CAN 0 (all CARTs were normal), CAN 1 (possible/early CAN — one abnormal CART was presented), CAN 2 (definite/confirmed CAN –at least two abnormal CARTs were found), CAN 3 (severe/advanced CAN — in the cases of orthostatic hypotension in addition to CARTs abnormalities). Microvascular blood flow of skin at the nail roller of fingers skin was valuated at rest as well as in functional cold test by the method of High-frequency Ultrasonic Dopplerography using the “Minimax Doppler K” device (LLC JV “Minimax”, St. Petersburg, Russia).RESULTS: CAN 1 was found in 8% diabetic patients without microvascular complications, 42 and 21% patients with SMN and diabetic foot amputations respectively. CAN 2 was diagnosed in 27% patients with SMN and 58% patients history of diabetic foot amputations. CAN 3 in 8% and 19% cases in patients with SMN and history of diabetic foot amputations respectively. The parameters of microvascular blood flow at rest were significantly decreased in patients with confirmed/severe CAN in comparison with early staging of CAN and patients without CAN (Vm=2.5±0.66 sm/sec vs. 4.4±0.54 sm/sec and 5.1±1.01 sm/sec respectively; p=0.0033). The abnormal result of cold test was detected in 94% patients with confirmed/ severe CAN and 26% patients with CAN 1.CONCLUSIONS: This investigation has demonstrated in a cohort with type 2 diabetes patients with/without SMN and with/ without history of previously foot amputations that decrease the Vm (the variable of microvascular blood flow assessed by High-frequency Ultrasonic Dopplerography) lower than 2.4 sm/sec is associated with 6.4 times increased likelihood of confirmed/severe CAN as well as positive cold test result. That the patients with positive cold test results were 28.6 times more likely have confirmed/severe CAN.
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Affiliation(s)
| | | | | | | | - O. A. Klitsenko
- North-Western State Medical University named after I. I. Mechnikov
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11
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Linstra KM, Fronczek R, Terwindt GM. Response to: migraine symptoms and the role of the autonomic dysfunction. Eur J Neurol 2020; 27:e96. [DOI: 10.1111/ene.14374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 12/01/2022]
Affiliation(s)
- K. M. Linstra
- Department of Neurology Leiden University Medical Center Leiden The Netherlands
- Division of Pharmacology and Vascular Medicine Department of Internal Medicine Erasmus University Medical Center Rotterdam The Netherlands
| | - R. Fronczek
- Department of Neurology Leiden University Medical Center Leiden The Netherlands
- Sleep‐Wake Centre SEIN Heemstede The Netherlands
| | - G. M. Terwindt
- Department of Neurology Leiden University Medical Center Leiden The Netherlands
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12
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Yılmaz S, Özlü SG, Kurt ANÇ. Ambulatory blood pressure abnormalities in children with migraine. Pediatr Nephrol 2020; 35:2157-2162. [PMID: 32556954 DOI: 10.1007/s00467-020-04640-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/29/2020] [Accepted: 06/02/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although there are data showing that the frequency of hypertension increases in adults with migraine, there has been no study on this subject in children. In this study, we aimed to evaluate the presence of hypertension in children with migraine by performing ambulatory blood pressure monitoring (ABPM). METHODS Thirty-seven children diagnosed with migraine and 30 healthy controls were evaluated between January 2015 and March 2016. Demographic data, clinical and laboratory features, and physical examination findings were recorded for both groups. Office blood pressure was measured for all children, and each also underwent ABPM. The two groups were compared in terms of ambulatory blood pressure parameters. RESULTS The mean age was 13.3 and 13.1 years and the proportion of females was 73% and 60% in the migraine and control groups, respectively. Although the frequency of hypertension was not higher, abnormal ABPM patterns were found to be significantly more frequent in the migraine group (migraine, 45.9%; control, 16.7%; p, 0.018). Nighttime mean arterial blood pressure, nighttime diastolic blood pressure, and non-dipping pattern were higher in children with migraine than those in the control group (p < 0.05). CONCLUSIONS These results suggest that ambulatory blood pressure abnormalities may be present in almost half of patients with migraine. Therefore, we suggest that ABPM should be performed even if the office blood pressure measurements of children diagnosed with migraine are normal.
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Affiliation(s)
- Songül Yılmaz
- Department of Pediatric Nephrology, Ankara Yıldırım Beyazıt University Yenimahalle Education and Research Hospital, Ankara, Turkey.
| | - Sare Gülfem Özlü
- Department of Pediatric Nephrology, Ankara Yıldırım Beyazıt University Yenimahalle Education and Research Hospital, Ankara, Turkey
| | - Ayşegül Neşe Çıtak Kurt
- Department of Pediatric Neurology, Ankara Yıldırım Beyazıt University Yenimahalle Education and Research Hospital, Ankara, Turkey
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Cortez MM, Theriot JJ, Rea NA, Gowen FE, Brennan KC. Low-frequency facial hemodynamic oscillations distinguish migraineurs from non-headache controls. CEPHALALGIA REPORTS 2019; 2. [PMID: 34046553 DOI: 10.1177/2515816319888216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background Surface imaging is a promising, noninvasive approach to assess regional perfusion in craniovascular disorders such as migraine. Methods We used optical imaging to examine differences in facial blood volume at baseline and in response to ammonia inhalation (a noxious stimulus), as well as standardized measures of cardiovascular autonomic function, in healthy, non-headache controls (n = 43) and in interictal migraine subjects (n = 22). Results Resting facial cutaneous oscillation (FCO) frequency was significantly different in migraine compared to healthy controls. Following ammonia inhalation, healthy controls showed a significant increase in resting FCO frequency, whereas this response was not significant in the migraine group. Standardized autonomic reflex parameters did not differ significantly between study groups, and facial cutaneous activity did not correlate with standardized cardiovascular autonomic reflex parameters, suggesting potentially different regulation. Conclusions This approach to the assessment of craniofacial hemodynamic function appears to exhibit differing mechanisms from previously available techniques, and represents a promising new physiological biomarker for the study of craniofacial vascular function in migraine and potentially other craniovascular disorders.
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Affiliation(s)
- Melissa M Cortez
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Jeremy J Theriot
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Natalie A Rea
- School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Forrest E Gowen
- School of Medicine, University of Nevada, Reno, NV, USA.,School of Chiropractic Medicine, University of Western States, Portland, OR, USA
| | - K C Brennan
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
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Lee S, Gong M, Lai RWC, Liu FZ, Lam MHS, Chang D, Xia Y, Liu T, Tse G, Li KHC. Electrographic indices in migraine patients: A systematic review and meta-analysis. J Electrocardiol 2019; 57:63-68. [PMID: 31514014 DOI: 10.1016/j.jelectrocard.2019.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/18/2019] [Accepted: 05/31/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIM Migraine patients can exhibit autonomic dysregulation, in turn leading to cardiac conduction and repolarization abnormalities. This systematic review and meta-analysis evaluated the electrocardiographic changes in migraineurs. METHOD PubMed and Embase databases were searched for human studies using the search terms 'migraine' and 'electrocardiogram' until 15th December 2018, identifying 108 and 131 studies. RESULTS Thirteen studies involving 667 migraineurs and 208 normal subjects included (mean age=30.7, total male percentage=19.8%) were included. A longer mean QTc interval (standard mean difference=7.89, 95% confidence interval=[3.29, 12.49], p=0.0008) and higher frequency of QTc prolongation (risk ratio [RR]=6.23, [2.86-13.58], p<0.00001), but no difference in PR-interval (SMD=4.33, [-3.90-12.56], p=0.30) were observed during migraine attacks compared to pain-free periods. P-wave dispersion was higher in migraine patients compared to controls (mean difference=3.62, [1.03-6.21], p=0.006). RR-interval were statistically indistinguishable between migraine patients and controls (SMD=0.08, [-0.65-0.81], p=0.83), or between migraineurs with and without aura (SMD=-0.03, [-0.44-0.38], p=0.89). Deep breathing ratio was significantly lower in migraineurs compared to controls (SMD=-0.27, 95% CI=[-0.46, -0.08], p=0.006) but similar between migraineurs with and without aura (SMD=-0.04, [-0.27-0.19], p=0.74). No significant difference in Valsalva ratio is found between migraineurs and controls (SMD=0.10, [-0.32-0.53], p=0.63) or between migraineurs with and without aura (SMD=-0.17, [-0.40-0.06], p=0.14). Root mean square of successive differences (RMSSD) (SMD=-0.07, [-1.10-0.95], p=0.89) and standard deviation of NN intervals (SDNN) (SMD=-0.10, [-0.61-0.41], p=0.71) did not significantly differ between migraine patients and controls. CONCLUSION Electrocardiographic alterations are observed in migraine patients compared to controls, especially during migraine attacks.
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Affiliation(s)
- Sharen Lee
- Laboratory of Cardiovascular Physiology, Li Ka Shing Institute of Health Sciences, Hong Kong S.A.R., P.R. China
| | - Mengqi Gong
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China
| | - Rachel W C Lai
- Laboratory of Cardiovascular Physiology, Li Ka Shing Institute of Health Sciences, Hong Kong S.A.R., P.R. China
| | - Fang Zhou Liu
- Department of Cardiovascular, Guangdong Cardiovascular Institute, Guangdong General Hospital Affiliated to South China University of Technology, Guangzhou, China
| | | | - Dong Chang
- Xiamen Cardiovascular Hospital Affiliated to Xiamen University, Xiamen, China
| | - Yunlong Xia
- Department of Cardiovascular Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China
| | - Gary Tse
- Laboratory of Cardiovascular Physiology, Li Ka Shing Institute of Health Sciences, Hong Kong S.A.R., P.R. China; Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China.
| | - Ka Hou Christien Li
- Laboratory of Cardiovascular Physiology, Li Ka Shing Institute of Health Sciences, Hong Kong S.A.R., P.R. China; Faculty of Medicine, Newcastle University, United Kingdom.
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15
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Huang Q, Yu H, Zhang N, Guo B, Feng C, Wang S, Liang X. Body Mass Index and Primary Headache: A Hospital-Based Study in China. BIOMED RESEARCH INTERNATIONAL 2019; 2019:4630490. [PMID: 31119170 PMCID: PMC6500676 DOI: 10.1155/2019/4630490] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/08/2019] [Accepted: 03/31/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Primary headache and obesity are highly prevalent disorders in the general population. Although many studies have reported an association between the two, there is still no overall comprehension about this relationship. To gain a more accurate understanding in this regard, we analyzed data from a 2011 cross-sectional study in Chongqing, China. METHODS Patients with a chief complaint of headache were administered a headache questionnaire and diagnosed by neurology doctors in accordance with the International Classification of Headache Disorders 2nd Edition (ICHD-II) criteria. Patients aged < 18 years or diagnosed with secondary headache were excluded. RESULTS Of 1327 patients who cited headache as the chief complaint, 16 were excluded for missing data, while 396 were diagnosed with chronic headache (177 chronic migraine [CM], 186 chronic tension-type headache [CTTH], and 33 other chronic headache) and 915 with episodic headache (369 episodic migraine [EM], 319 episodic tension-type headache [ETTH], and 227 other episodic headache). Chronic headache patients had a higher number of headache days per month, longer duration of headache history, and greater tendency to overuse analgesics than episodic headache patients. The CM and ETTH patients were more apt to be overweight and had a significantly greater body mass index (BMI; p < 0.05) than the EM and CTTH patients. Overweight (odds ratio [OR] = 3.64; 95% confidence interval (CI), 1.19-8.81) and obesity (OR = 28.63; 95% CI, 2.96-276.6) were independently associated with CM but not with other headaches, and this association was not influenced by other factors such as medication overuse. CONCLUSIONS The relationship between headache and overweight/obesity varies depending on the type of primary headache. CM patients are more likely to have a higher body mass index than EM patients, while ETTH patients are more likely to be overweight/obese than CTTH patients.
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Affiliation(s)
- Qingqing Huang
- Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, China
| | - Huiqing Yu
- Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, China
| | - Ningning Zhang
- Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, China
| | - Bingling Guo
- Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, China
| | - Changyan Feng
- Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, China
| | - Shiqiang Wang
- Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, China
| | - Xiping Liang
- Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, China
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16
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Kamshilin AA, Volynsky MA, Khayrutdinova O, Nurkhametova D, Babayan L, Amelin AV, Mamontov OV, Giniatullin R. Novel capsaicin-induced parameters of microcirculation in migraine patients revealed by imaging photoplethysmography. J Headache Pain 2018; 19:43. [PMID: 29915934 PMCID: PMC6005996 DOI: 10.1186/s10194-018-0872-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 06/13/2018] [Indexed: 01/03/2023] Open
Abstract
Background The non-invasive biomarkers of migraine can help to develop the personalized medication of this disorder. In testing of the antimigraine drugs the capsaicin-induced skin redness with activated TRPV1 receptors in sensory neurons associated with the release of the migraine mediator CGRP has already been widely used. Methods Fourteen migraine patients (mean age 34.6 ± 10.2 years) and 14 healthy volunteers (mean age 29.9 ± 9.7 years) participated in the experiment. A new arrangement of imaging photoplethysmography recently developed by us was used here to discover novel sensitive parameters of dermal blood flow during capsaicin applications in migraine patients. Results Blood pulsation amplitude (BPA) observed as optical-intensity waveform varying synchronously with heartbeat was used for detailed exploration of microcirculatory perfusion induced by capsicum patch application. The BPA signals, once having appeared after certain latent period, were progressively rising until being saturated. Capsaicin-induced high BPA areas were distributed unevenly under the patch, forming “hot spots.” Interestingly the hot spots were much more variable in migraine patients than in the control group. In contrast to BPA, a slow component of waveforms related to the skin redness changed significantly less than BPA highlighting the latter parameter as the potential sensitive biomarker of capsaicin-induced activation of the blood flow. Thus, in migraine patients, there is a non-uniform (both in space and in time) reaction to capsaicin, resulting in highly variable openings of skin capillaries. Conclusion BPA dynamics measured by imaging photoplethysmography could serve as a novel sensitive non-invasive biomarker of migraine-associated changes in microcirculation.
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Affiliation(s)
- Alexei A Kamshilin
- Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg, Russia.
| | - Maxim A Volynsky
- Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg, Russia
| | - Olga Khayrutdinova
- Department of Neurology and Rehabilitation, Kazan State Medical University, Kazan, Russia
| | - Dilyara Nurkhametova
- Laboratory of Neurobiology, Kazan Federal University, Kazan, Russia.,Department of Neurobiology, University of Eastern Finland, Kuopio, Finland
| | - Laura Babayan
- Department of Neurology and Neurosurgery, Pavlov First Saint Petersburg State Medical University, St. Petersburg, Russia
| | - Alexander V Amelin
- Department of Neurology and Neurosurgery, Pavlov First Saint Petersburg State Medical University, St. Petersburg, Russia
| | - Oleg V Mamontov
- Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg, Russia.,Department of Circulation Physiology, Almazov National Medical Research Centre, St. Petersburg, Russia
| | - Rashid Giniatullin
- Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg, Russia.,Laboratory of Neurobiology, Kazan Federal University, Kazan, Russia.,Department of Neurobiology, University of Eastern Finland, Kuopio, Finland
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17
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Association between Body Mass Index and Migraine: A Survey of Adult Population in China. Behav Neurol 2018; 2018:6585734. [PMID: 29849812 PMCID: PMC5933061 DOI: 10.1155/2018/6585734] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Accepted: 01/11/2018] [Indexed: 12/24/2022] Open
Abstract
Both migraine and obesity are prevalent disorders in the general population, which are characterized by disability and impaired quality of life. Although so many researches had studied the association between migraine and obesity, there are still no full knowledge of the relationship between body mass index (BMI) and migraine, especially chronic migraine (CM). In this study, we analyzed a previous epidemiological survey data of primary headache patients in Chongqing, which surveyed consecutive neurological outpatients through face-to-face interview with physicians using a headache questionnaire. 166 episodic migraine (EM) patients and 134 chronic migraine (CM) patients were included in the study out of 1327 primary headache patients. And 200 healthy adults from the physical examination center were included as a control group. Finally, we found that the patients with migraine (EM and CM) were more likely to be overweight, obese, or morbidly obese compared to those in the healthy group. Significant difference was found between BMI and frequency of migraine attacks but not severity or duration of headache onset. And no significant difference was found in severity and duration of headache onset between episodic and chronic migraine among different BMI classifications. Such may update our knowledge about the clinical features of migraine and BMI, revealing that the frequency of attacks may be associated with being overweight, obese, or morbidly obese in patients with migraine and that the extent of being overweight, obese, or morbidly obese in CM patients was lower than that in EM patients.
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18
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Abstract
PURPOSE OF REVIEW Symptoms of autonomic dysfunction are common in patients with migraine, both during and between migraine attacks. Studies evaluating objective autonomic testing in patients have found significant, though somewhat conflicting results. The purposes of this review are to summarize and interpret the key findings of these studies, including those evaluating heart rate variability, autonomic reflex testing, and functional imaging in patients with migraine. The neuroanatomy of the central autonomic network as it relates to migraine is also reviewed. RECENT FINDINGS Several studies have evaluated autonomic balance in migraineurs, with conflicting results on the magnitude of sympathetic versus parasympathetic dysfunction. Most studies demonstrate sympathetic impairment, with a lesser degree of parasympathetic impairment. Three trends have emerged: (1) migraine with aura tends to produce more significant autonomic dysfunction than migraine without aura, (2) sympathetic impairment is more common than parasympathetic impairment, and (3) sympathetic impairment is common in the interictal period, with increased sympathetic responsiveness during the ictal period, suggesting adrenoreceptor hypersensitivity.
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19
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Kamshilin AA, Zaytsev VV, Mamontov OV. Novel contactless approach for assessment of venous occlusion plethysmography by video recordings at the green illumination. Sci Rep 2017; 7:464. [PMID: 28352083 PMCID: PMC5428721 DOI: 10.1038/s41598-017-00552-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 03/06/2017] [Indexed: 11/09/2022] Open
Abstract
Occlusion plethysmography is an important method for assessment of the status of the cardiovascular system, which provides valuable information concerning arterial and venous blood flow, including mechanisms of their regulation. All up-to-date systems estimate change of the limb's volume during occlusion by contact-type sensors. The objective of the research is demonstration of feasibility of the novel approach to measuring the blood flow during venous occlusion by using imaging photoplethysmography (PPG). Twenty healthy individuals participated in the experiment. We used four synchronized video cameras to record all-around view of the forearm illuminated by the green light. After the recording, the PPG waveform was calculated in more than 4000 non-overlapping Regions of Interest (ROI). In the most of the ROIs, the waveform shape was typical for classical plethysmography with the distinctive linear growth of the signal. Speed of the signal change was the same along the forearm but it varied along the forearm's circumference. These findings allows us to hypothesize that the PPG waveform is the direct consequence of the forearm blood flow. Therefore, the novel technique could be applied to the same medical examinations as the classical plethysmography, but it is more advantageous because of non-contact nature and easiness in implementation.
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Affiliation(s)
- Alexei A Kamshilin
- Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg, 197101, Russia.
| | - Valeriy V Zaytsev
- Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg, 197101, Russia
| | - Oleg V Mamontov
- Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg, 197101, Russia.,Federal Almazov North-West Medical Research Centre, Department of Circulation Physiology, St. Petersburg, 197341, Russia
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20
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Babayan L, Mamontov OV, Amelin AV, Bogachev M, Kamshilin AA. Arterial hypertension in migraine: Role of familial history and cardiovascular phenotype. Auton Neurosci 2017; 203:103-107. [PMID: 28143709 DOI: 10.1016/j.autneu.2017.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 01/10/2017] [Accepted: 01/23/2017] [Indexed: 01/03/2023]
Abstract
Recent studies indicate that migraine is associated with increased risk of cardiovascular diseases. However, links between autonomic cardiovascular regulation, arterial hypertension (AH) and migraine are still little explored. In this study, we evaluated autonomic regulation in migraine patients with and without hypertension. We studied 104 patients with migraine, aged 34±10 y, including 28 with and 76 without hypertension (M+AH and M-AH groups, respectively). The control group consisted of 88 healthy volunteers matched by age and sex. The autonomic regulation of circulation was examined with the tilt-table test, deep-breathing and Valsalva Maneuver, handgrip test, cold-stress induced vasoconstriction, arterial baroreflex, and blood pressure variability measurements. We found that migraine patients with concomitant hypertension demonstrated reduced arterial baroreflex, whereas other parameters of cardiac autonomic regulation were unchanged. In contrast, most indicators of vasomotor reactivity (blood pressure response to the hand-grip, Valsalva maneuver and cold vasoconstriction) were enhanced in migraine patients with no significant differences between migraine patients with and without hypertension. Patients from both M+AH and M-AH groups more commonly had a family history of cardiovascular disorders. Our data revealed increased vasomotor reactivity in migraine patients, with or without concomitant hypertension. This was associated with the family history of cardiovascular diseases.
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Affiliation(s)
- Laura Babayan
- Pavlov First Saint Petersburg State Medical University, St. Petersburg, Russia; ITMO University, St. Petersburg, Russia
| | - Oleg V Mamontov
- Pavlov First Saint Petersburg State Medical University, St. Petersburg, Russia; ITMO University, St. Petersburg, Russia; Federal Almazov North-West Medical Research Centre, St. Petersburg, Russia
| | - Alexander V Amelin
- Pavlov First Saint Petersburg State Medical University, St. Petersburg, Russia; ITMO University, St. Petersburg, Russia
| | - Mikhail Bogachev
- Saint-Petersburg Electrotechnical University, St. Petersburg, Russia
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21
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Mikhailov N, V. Mamontov O, A. Kamshilin A, Giniatullin R. Parasympathetic Cholinergic and Neuropeptide Mechanisms of Migraine. Anesth Pain Med 2016; 7:e42210. [PMID: 28920040 PMCID: PMC5554415 DOI: 10.5812/aapm.42210] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 10/19/2016] [Accepted: 11/21/2016] [Indexed: 12/24/2022] Open
Abstract
Context Migraine mechanisms remain largely uncovered for various reasons including a very high complexity of the neurophysiological mechanisms implicated in this disorder and a plethora of endogenous biologically active compounds involved in the pathological process. The functional role of parasympathetic innervation of meninges and cholinergic mechanisms of migraine are among little explored issues despite multiple evidence indirectly indicating the role of acetylcholine (ACh) and its analogues in migraine and other types of headache. In the current short review, we discuss morphological, functional, and clinical issues related to the role of ACh and its analogues such as carbachol and nicotine in this most common neurological disorder. Evidence Acquisition In the present work, studies published from 1953 to 2016 were investigated. Literature was searched with following keywords: acetylcholine (ACh), carbachol, nicotine, parasympathetic, mast cells, vasoactive intestinal polypeptide (VIP), and pituitary adenylate cyclase-activating polypeptide (PACAP). Results Parasympathetic fibers originated from SPG and trigeminal nerves can interact at the level of meninges which is considered to be the origin site of migraine pain. Here, in dura mater, ACh, VIP, and PACAP released by parasympathetic afferents can both affect mast cells provoking its degranulation and additional release of neurotransmitters, or they can directly affect trigeminal nerves inducing nociception. Conclusions In summary, cholinergic mechanisms in migraine and other types of headache remain little elucidated and future studies should clarify the role of parasympathetic nerves and molecular mechanisms of cholinergic modulation within the nociceptive system.
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Affiliation(s)
- Nikita Mikhailov
- Department of Neurobiology, University of Eastern Finland, 70210 Kuopio, Finland
| | - Oleg V. Mamontov
- Department of Circulation Physiology, Federal Almazov North-West Medical Research Centre, St. Petersburg, 197341, Russia
- Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg, 197101, Russia
| | - Alexei A. Kamshilin
- Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg, 197101, Russia
- Corresponding author: Alexei A. Kamshilin, Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg, 197101, Russia, E-mail:
| | - Rashid Giniatullin
- Department of Neurobiology, University of Eastern Finland, 70210 Kuopio, Finland
- Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg, 197101, Russia
- Laboratory of Neurobiology, Kazan Federal University, Kazan, Russia
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Kamshilin AA, Sidorov IS, Babayan L, Volynsky MA, Giniatullin R, Mamontov OV. Accurate measurement of the pulse wave delay with imaging photoplethysmography. BIOMEDICAL OPTICS EXPRESS 2016; 7:5138-5147. [PMID: 28018731 PMCID: PMC5175558 DOI: 10.1364/boe.7.005138] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 10/22/2016] [Accepted: 10/31/2016] [Indexed: 05/30/2023]
Abstract
Assessment of the cardiovascular parameters using noncontact video-based or imaging photoplethysmography (IPPG) is usually considered as inaccurate because of strong influence of motion artefacts. To optimize this technique we performed a simultaneous recording of electrocardiogram and video frames of the face for 36 healthy volunteers. We found that signal disturbances originate mainly from the stochastically enhanced dichroic notch caused by endogenous cardiovascular mechanisms, with smaller contribution of the motion artefacts. Our properly designed algorithm allowed us to increase accuracy of the pulse-transit-time measurement and visualize propagation of the pulse wave in the facial region. Thus, the accurate measurement of the pulse wave parameters with this technique suggests a sensitive approach to assess local regulation of microcirculation in various physiological and pathological states.
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Affiliation(s)
- Alexei A. Kamshilin
- Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg 197101, Russia
| | - Igor S. Sidorov
- Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg 197101, Russia
| | - Laura Babayan
- Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg 197101, Russia
- Department of Neurology and Neurosurgery, Pavlov First Saint Petersburg State Medical University, St. Petersburg 197022, Russia
| | - Maxim A. Volynsky
- Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg 197101, Russia
| | - Rashid Giniatullin
- Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg 197101, Russia
- Department of Neurobiology, University of Eastern Finland, 70210 Kuopio, Finland
- Laboratory of Neurobiology, Kazan Federal University, Kazan 7208, Russia
| | - Oleg V. Mamontov
- Department of Computer Photonics and Videomatics, ITMO University, St. Petersburg 197101, Russia
- Department of Circulation Physiology, Federal Almazov North-West Medical Research Centre, St. Petersburg 197341, Russia
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