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Platelet dysfunction and stroke in the female migraineur

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Abstract

Some studies suggest that platelet activation and aggregation are associated with migraine, likely secondary to changes occurring during the acute attack. Evidence also suggests that platelet clots can lodge in small cerebral vessels, and that the resultant is chemia and inflammation can induce cortical spreading depression with aura-like symptoms and pulsatile headache. Endothelial dysfunction, a result of numerous vascular, genetic, and environmental risk factors, is more common in women with migraine and leads to altered hemostasis. When associated with other factors, such as oral contraceptive use, there may be an increased tendency for thrombus formation, secondary migraine with aura, transient ischemic attacks, and stroke. Identifying those migraineurs at highest risk of developing endothelial dysfunction and platelet disorders may allow for preventive strategies to avoid the cerebral consequences.

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References and Recommended Reading

  1. Malmgren R, Hasselmark L: The platelet and the neuron: two cells in focus in migraine. Cephalalgia 1988, 8:7–24.

    Article  PubMed  CAS  Google Scholar 

  2. Hanington E, Jones RJ, Amess JA, Wachowicz B: Migraine: a platelet disorder. Lancet 1981, 2:720–723.

    Article  PubMed  CAS  Google Scholar 

  3. Moskowitz MA: Pathophysiology of headache: past and present. Headache 2007, 47(Suppl 1):S58–S63.

    Article  PubMed  Google Scholar 

  4. Tietjen EG: Migraine and ischaemic heart disease and stroke: potential mechanisms and treatment implications. Cephalalgia 2007, 27:981–987.

    Article  PubMed  Google Scholar 

  5. Rendu F, Brohard-Bohn B: The platelet release reaction: granules’ constituents, secretion and functions. Platelets 2001, 12:261–273.

    Article  PubMed  CAS  Google Scholar 

  6. Furie B, Furie BC: Mechanisms of thrombus formation. N Engl J Med 2008, 359:938–949.

    Article  PubMed  CAS  Google Scholar 

  7. Lowe GD: Virchow’s triad revisited: abnormal flow. Pathophysiol Haemost Thromb 2003, 33:455–457.

    Article  PubMed  Google Scholar 

  8. Couch JR, Hassanein RS: Platelet aggregability in migraine. Neurology 1977, 27:843–848.

    PubMed  CAS  Google Scholar 

  9. Manotti C, Quintavalla R, Manzoni GC: Platelet activation in migraine. Thromb Haemost 1983, 50:758.

    PubMed  CAS  Google Scholar 

  10. Hilton BP, Cumings JN: 5-Hydroxytryptamine levels and platelet aggregation responses in subjects with acute migraine headache. J Neurol Neurosurg Psychiatry 1972, 35:505–509.

    Article  PubMed  CAS  Google Scholar 

  11. Jones RJ, Forsythe AM, Amess JA: Platelet aggregation in migraine patients during the headache-free interval. Adv Neurol 1982, 33:275–278.

    PubMed  CAS  Google Scholar 

  12. Lechner H, Ott E, Fazekas F, Pilger E: Evidence of enhanced platelet aggregation and platelet sensitivity in migraine patients. Cephalalgia 1985, 5(Suppl 2):89–91.

    Google Scholar 

  13. Pawlowska Z, Kozubski W, Walkowiak B, Cierniewski CS: Increased platelet glycoprotein IIb reflects an abnormality of the platelet membrane in migraine. Headache 1988, 28:60.

    Article  PubMed  CAS  Google Scholar 

  14. Kozubski W, Walkowiak B, Cierniewski CS, Prusinski A: Platelet fibrinogen receptors in migraine patients. Headache 1987, 27:431.

    Article  PubMed  CAS  Google Scholar 

  15. Kovacs K, Herman F, Filep J, et al.: Platelet aggregation of migraineurs during and between attacks. Cephalalgia 1990, 10:161–165.

    Article  PubMed  CAS  Google Scholar 

  16. Jha S, Varma M, Garg R, Kar AM: Platelet aggregation in migraine. J Assoc Physicians India 1992, 40:153–154.

    PubMed  CAS  Google Scholar 

  17. Deshmukh SV, Meyer JS: Cyclic changes in platelet dynamics and the pathogenesis and prophylaxis of migraine. Headache 1977, 17:101–108.

    Article  PubMed  CAS  Google Scholar 

  18. Herman F, Magyar K, Kovacs K, Filep J: Decreased sensitivity of platelets to platelet-activating factor in migraine patients during the headache free interval. Thromb Haemost 1989, 62:818.

    PubMed  CAS  Google Scholar 

  19. D’Andrea G, Cananzi AR, Perini F, et al.: Decreased collagen induced platelet aggregation and increased platelet arginine levels in migraine: a possible link with the NO pathway. Cephalalgia 1994, 14:352–356.

    Article  PubMed  Google Scholar 

  20. MacGregor EA, Bird N, Ridler C, Wilkinson MIP: Handling of 5-hydroxytryptamine by platelets in migraine. Headache 1992, 32:68–72.

    Article  Google Scholar 

  21. Tietjen GE, Al Qasmi MM, Athanas K, et al.: Altered hemostasis in migraineurs studied with a dynamic flow system. Thromb Res 2007, 119:217–222.

    Article  PubMed  CAS  Google Scholar 

  22. Crassard I, Conard J, Bousser MG: Migraine and haemostasis. Cephalalgia 2001, 21:630–636.

    Article  PubMed  CAS  Google Scholar 

  23. Peatfield RC: Can transient ischaemic attacks and classical migraine always be distinguished? Headache 1987, 27:240–243.

    Article  PubMed  CAS  Google Scholar 

  24. Overell JR, Bone I, Lees KR: Interatrial septal abnormalities and stroke: a meta-analysis of case-control studies. Neurology 2000, 55:1172–1179.

    PubMed  CAS  Google Scholar 

  25. Schwedt TJ, Demaerschalk BM, Dodick DW: Patent foramen ovale and migraine: a quantitative systematic review. Cephalalgia 2008, 28:531–540.

    Article  PubMed  CAS  Google Scholar 

  26. Wilmshurst PT, Nightingale S, Walsh KP, Morrison WL: Clopidogrel reduces migraine with aura after transcatheter closure of persistent foramen ovale and atrial septal defects. Heart 2005, 91:1173–1175.

    Article  PubMed  CAS  Google Scholar 

  27. Martin VT, Behbehani M: Ovarian hormones and migraine headache: understanding mechanisms and pathogenesis: part 2. Headache 2006, 46:365–386.

    Article  PubMed  Google Scholar 

  28. Gillum LA, Mamidipudi SK, Johnston SC: Ischemic stroke risk with oral contraceptives: a meta-analysis. JAMA 2000, 284:72–78.

    Article  PubMed  CAS  Google Scholar 

  29. Allais G, Gabellari IC, Mana O, et al.: Migraine and stroke: the role of oral contraceptives. Neurol Sci 2008, 29(Suppl 1):S12–S14.

    Article  Google Scholar 

  30. Michiels JJ, Berneman Z, Schroyens W, et al.: Plateletmediated erythromelalgic, cerebral, ocular and coronary microvascular ischemic and thrombotic manifestations in patients with essential thrombocythemia and polycythemia vera: a distinct aspirin-responsive and coumadin-resistant arterial thrombophilia. Platelets 2006, 17:528–544.

    Article  PubMed  CAS  Google Scholar 

  31. Bonetti PO, Lerman LO, Lerman A: Endothelial dysfunction: a marker of atherosclerotic risk. Arterioscler Thromb Vasc Biol 2003, 23:168–175.

    Article  PubMed  CAS  Google Scholar 

  32. Vischer UM: von Willebrand factor, endothelial dysfunction, and cardiovascular disease. J Thromb Haemost 2006, 4:1186–1193.

    Article  PubMed  CAS  Google Scholar 

  33. Tietjen GE, Al-Qasmi M, Athanas K, et al.: Increased von Willebrand factor in migraine. Neurology 2001, 57:334–336.

    PubMed  CAS  Google Scholar 

  34. Tietjen GE, Herial NA, White LM, et al.: Migraine and biomarkers of endothelial activation in young women. Stroke 2009 (in press).

  35. Cesar JM, Garcia-Avello A, Vecino AM, et al.: Increased levels of plasma von Willebrand factor in migraine crisis. Acta Neurol Scand 1995, 91:412–413.

    Article  PubMed  CAS  Google Scholar 

  36. Sarchielli P, Alberti A, Baldi A, et al.: Proinflammatory cytokines, adhesion molecules, and lymphocyte integrin expression in the internal jugular blood of migraine patients without aura assessed ictally. Headache 2006, 46:200–207.

    Article  PubMed  Google Scholar 

  37. Leira R, Sobrino T, Rodriguez-Yanez M, et al.: MMP-9 immunoreactivity in acute migraine. Headache 2007, 47:698–702.

    Article  PubMed  Google Scholar 

  38. Lee ST, Chu K, Jung KH, et al.: Decreased number and function of endothelial progenitor cells in patients with migraine. Neurology 2008, 70:1510–1517.

    Article  PubMed  Google Scholar 

  39. Dreier JP, Kleeberg J, Petzold G, et al.: Endothelin-1 potently induces Leao’s cortical spreading depression in vivo in the rat: a model for an endothelial trigger of migrainous aura? Brain 2002, 125(Pt 1):102–112.

    Article  Google Scholar 

  40. Vanmolkot FH, van Bortel LM, de Hoon JN: Altered arterial function in migraine of recent onset. Neurology 2007, 68:1563–1570.

    Article  PubMed  Google Scholar 

  41. Scher AI, Terwindt GM, Picavet HS, et al.: Cardiovascular risk factors and migraine: the GEM population-based study. Neurology 2005, 64:614–620.

    PubMed  CAS  Google Scholar 

  42. Bushnell CD, Jamison M, James AH: Migraines during pregnancy are associated with stroke and vascular diseases: data from the nationwide inpatient sample [abstract]. Neurology 2007, 68(Suppl 1):A130.

    Google Scholar 

  43. Lisi V, Garbo G, Battistella P, et al.: Endothelin receptor A -231 G>A polymorphism: no linkage to primary pediatric headache. Headache 2006, 46:486–491.

    Article  PubMed  Google Scholar 

  44. Butler R, Morris AD, Burchell B, Struthers AD: DD angiotensin-converting enzyme gene polymorphism is associated with endothelial dysfunction in normal humans. Hypertension 1999, 33:1164–1168.

    PubMed  CAS  Google Scholar 

  45. Kowa H, Fusayasu E, Ijiri T, et al.: Association of the insertion/deletion polymorphism of the angiotensin I-converting enzyme gene in patients of migraine with aura. Neurosci Lett 2005, 374:129–131.

    Article  PubMed  CAS  Google Scholar 

  46. Schurks M, Zee RY, Buring JE, Kurth T: ACE D/I polymorphism, migraine, and cardiovascular disease in women. Neurology 2009, 72:650–656.

    Article  PubMed  CAS  Google Scholar 

  47. Hassan A, Hunt BJ, O’sullivan M, et al.: Homocysteine is a risk factor for cerebral small vessel disease, acting via endothelial dysfunction. Brain 2004, 127(Pt 1):212–219.

    Article  Google Scholar 

  48. Scher AI, Terwindt GM, Verschuren WM, et al.: Migraine and MTHFR C677T genotype in a population-based sample. Ann Neurol 2006, 59:372–375.

    Article  PubMed  CAS  Google Scholar 

  49. Tietjen GE, Herial NA, Utley C, et al.: Association of von Willebrand factor activity with ACE I/D and MTHFR C677T polymorphisms in migraine. Cephalalgia 2009 Feb 27 (Epub ahead of print).

  50. Tietjen GE: Migraine as a systemic vasculopathy. Headache 2009 (in press).

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Authors and Affiliations

  1. Department of Neurology, The University of Toledo, 3000 Arlington Avenue, MS 1195, Toledo, OH, 43614, USA

    Gretchen E. Tietjen

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  1. Gretchen E. Tietjen
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  2. Jagdish Khubchandani
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Correspondence to Gretchen E. Tietjen.

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Tietjen, G.E., Khubchandani, J. Platelet dysfunction and stroke in the female migraineur. Current Science Inc 13, 386–391 (2009). https://doi.org/10.1007/s11916-009-0063-4

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