Journal of Neurology

, Volume 239, Issue 6, pp 338–342 | Cite as

Multimodal tests of cerebrovascular reactivity in migraine: a transcranial Doppler study

  • A. Thie
  • M. Carvajal-Lizano
  • U. Schlichting
  • K. Spitzer
  • K. Kunze
Original Communications

Summary

Altered cerebral vasoreactivity (CVR) has been implicated in migraine. To test this hypothesis, we studied CVR as measured by transcranial Doppler ultrasound (TCD) in 11 migraineurs and 12 healthy controls of similar age. Mean flow velocities (MFV) in the middle cerebral artery (MCA) were recorded during a cognitive and two motor tasks. MFV in the posterior cerebral artery (PCA) were measured during photic stimulation and observation of complex images. The increase of MFV in the MCA during the cognitive task was greater in migraineurs than in controls (9.1% vs 5.0% ;P = 0.06). The increase of MFV in both tests for PCA reactivity was significantly greater in migraineurs than in controls: 17.4% vs 9.9% for photic stimulation (P < 0.05) and 20.3% vs 10.2% for observation of complex images (P<0.05). Owing to overlap of individual results, the discriminative value of both tests was unsatisfactory. The variability of flow velocities as measured by standard deviations of MFV was significantly greater in migraineurs than in controls during all tests of PCA vasoreactivity. Differences in CVR between migraineurs and normal controls may be detected by TCD testing, in particular in the PCA territory. For individual diagnostic purposes, CVR tests proved to be insufficient.

Key words

Migraine Cerebrovascular reactivity Transcranial Doppler ultrasound 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Aaslid R (1987) Visually evoked dynamic blood flow response of the human cerebral circulation. Stroke 18:771–775Google Scholar
  2. 2.
    Caplan LR (1991) Migraine and vertebrobasilar ischemia. Neurology 41:55–61Google Scholar
  3. 3.
    Conrad B, Klingelhöfer J (1989) Dynamics of cerebral blood flow for various visual stimuli. Exp Brain Res 77:437–441Google Scholar
  4. 4.
    Diehl RR, Sitzer M, Hennerici M (1990) Changes of cerebral blood flow velocity during cognitive activity. Stroke 21:1236–1237Google Scholar
  5. 5.
    Droste DW, Harders AG, Rastogi E (1989) A transcranial Doppler study of blood flow velocity in the middle cerebral arteries performed at rest and during mental activities. Stroke 20:1005–1011Google Scholar
  6. 6.
    Friberg L, Olsen TS, Roland PE, Lassen NA (1987) Focal ischaemia caused by instability of cerebrovascular tone during attacks of hemiplegic migraine. Brain 110:917–934Google Scholar
  7. 7.
    Gomez SM, Gomez CR, Hall IS (1990) Transcranial Doppler ultrasonographic assessment of intermittent light stimulation at different frequencies. Stroke 21:1746–1748Google Scholar
  8. 8.
    Harer C, Kummer R von (1991) Cerebrovascular CO2 reactivity in migraine: assessment by transcranial Doppler ultrasound. J Neurol 238:23–26Google Scholar
  9. 9.
    Huber P, Handa J (1967) Effect of contrast material, hypercapnia, hyperventilation, hypertonic glucose and papaverine on the diameter of the cerebral arteries. Invest Radiol 2:17–32Google Scholar
  10. 10.
    Ingvar DH, Risberg J (1967) Increase of regional cerebral blood flow during mental effort in normals and in patients with focal brain disorders. Exp Brain Res 3:195–211Google Scholar
  11. 11.
    Lauritzen M, Olsen TS, Lassen NA, Paulson OB (1983) Changes in regional cerebral blood flow during the course of classic migraine attacks. Ann Neurol 13:633–641Google Scholar
  12. 12.
    Meyer JS, Hata T, Imai A (1987) Evidence supporting a vascular pathogenesis of migraine and cluster headache. In: Blau JN (ed) Migraine. Clinical, therapeutic, conceptual and research aspects. Chapman & Hall, London, pp 265–302Google Scholar
  13. 13.
    Moskowitz M (1984) The neurobiology of vascular head pain. Ann Neurol 16:157–168Google Scholar
  14. 14.
    Olesen J (1971) Contralateral focal increase of cerebral blood flow in man during arm work. Brain 94:635–646Google Scholar
  15. 15.
    Olesen J, Larsen B, Lauritzen M (1981) Focal hyperemia followed by spreading oligemia and impaired activation of rCBF in migraine. Ann Neurol 9:344–352Google Scholar
  16. 16.
    Reinecke M, Wallasch TM, Langohr HD (1989) Autonomic cerebrovascular reactivity in migraine and other headaches. Cephalalgia 9 [Suppl 10]:160–161Google Scholar
  17. 17.
    Risberg J (1986) Regional cerebral blood flow in neuropsychology. Neuropsychologia 24:135–140Google Scholar
  18. 18.
    Rosa R, Bellini V, Filippi MC, Taddei MT, Vitali T, Conigliaro S (1987) Hemodynamic studies by transcranial Doppler in primary headache. Cephalalgia 7 [Suppl 6]:280Google Scholar
  19. 19.
    Thie A (1991) Transcranial Doppler studies during migraine and other headaches. In: Olesen J (ed) Migraine and other headaches: the vascular mechanisms. Raven, New York, pp 263–274Google Scholar
  20. 20.
    Thie A, Spitzer K, Lachenmayer L, Kunze K (1988) Prolonged vasospasm in migraine detected by non-invasive transcranial Doppler ultrasound. Headache 28:183–186Google Scholar
  21. 21.
    Thie A, Fuhlendorf A, Spitzer K, Kunze K (1990) Transcranial Doppler evaluation of common and classic migraine. I. Ultrasonic features during the headache-free period. Headache 30:201–208Google Scholar
  22. 22.
    Thomas TD, Harpold GJ, Troost BT (1990) Cerebral vascular reactivity in migraineurs as measured by transcranial Doppler ultrasound. Cephalalgia 10:95–99Google Scholar
  23. 23.
    Tunis MM, Wolff HG (1953) Studies on headache. Long-term observation on the reactivity of the cranial arteries in subjects with vascular headache of the migraine type. Arch Neurol Psychiatry 70:551–557Google Scholar

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • A. Thie
    • 1
  • M. Carvajal-Lizano
    • 1
  • U. Schlichting
    • 1
  • K. Spitzer
    • 1
  • K. Kunze
    • 1
  1. 1.Neurologische Universitätsklinik EppendorfHamburg 20Germany

Personalised recommendations