Cardiovascular Autonomic Dysfunction in Migraine Attack

J Korean Neurol Assoc > Volume 29(2); 2011 > Article

Journal of the Korean Neurological Association 2011;29(2): 101-105.

편두통 발작기에 관찰되는 심혈관 자율신경장애

김성혁, 신동진 정욱진a 설승원b

가천의과학대학교 신경과학교실, 순환기내과학교실a, 의학전문대학원b

Cardiovascular Autonomic Dysfunction in Migraine Attack

Sung-Hyouk Kim

Department of Neurology; Division of Cardiology, Department of Internal Medicinea, Graduate School of Medicineb, Gachon University of Medicine and Science, Incheon, Korea

Abstract

Background: There has been proposing reports that the autonomic nervous system (ANS) is involved in the pathophysiological mechanism of migraine. However, previous reports suggesting ANS dysfunction during migraine attack was not consistent and were focused mainly on comparison between migraine patients in interictal period and normal controls. The current study is designed to evaluate quantitative evidence of ANS dysfunction by comparing patients in ictal period with those in interictal period.
Methods: We prospectively included 30 migraineurs in ictal period and 30 migraineurs in interictal period from August 2008 to August 2009. Sympathetic function was evaluated by blood pressure response to standing and isometric exercise. Parasympathetic function was evaluated by heart rate response to deep breathing, standing and the Valsalva maneuver.
Results: In orthostatic test, falling of systolic blood pressure (SBP) after standing was prominent in ictal group. Although both groups showed elevation of diastolic blood pressure (DBP) after standing, the change was smaller in ictal group than intercital group. Elevation of DBP after isometric exercise was lower in ictal group without statistical significance. Results of parasympathetic function test were not significantly different between ictal and interictal patients.
Conclusions: This study suggests that subjects with migraine had sympathetic hypofunction during migraine attack. KeyWords:Migraine, Ictal, Interictal, Autonomic nervous system