Endothelial repair capacity and migraine: The fix is in
[Show abstract] [Hide abstract] ABSTRACT: White matter hyperintensities (WMH) have been associated with mood disorders in psychiatric patients. In the present study, we aimed to assess whether WMHs are associated with depressive symptoms and different sensitivity of the behavioral inhibition (BIS), and activation (BAS) systems in patients with chronic headache. Participants were 85 adult outpatients (16 men and 69 women) with a diagnosis of chronic headache. All of the patients underwent brain magnetic resonance imaging (MRI) and were administered the BIS/BAS scales and the Center for Epidemiologic Studies Depression Scale. Above 40 % of patients had periventricular WMHs (PWMHs) and almost 98 % had deep WMHs (DWMHs). Patients with PWMHs reported fewer depressive symptoms than patients without PWMHs. Patients with more severe DWMHs (compared with patients with mild or without DWMH lesions) were older and reported lower scores on the drive dimension of the BIS/BAS scales. In multivariate analyses, patients with PWMHs were 1.06 times more likely to report fewer depressive symptoms than patients without PWMHs. WMH lesions in patients with chronic headache were associated with less depression severity.0Comments 10Citations
- "It has been suggested that recurrent migraine attacks may affect vulnerable deep tissues penetrating arteries and contributing to local critical hypoperfusion leading to minor brain injury observed as white matter abnormalities. Other proposed mechanisms have been suggested including atherosclerotic insults associated with the presence of cardiovascular risk factors [55, 56], endothelial dysfunction (e.g., both endothelial activation and impaired vascular reactivity) [57–59], genetic risk factors which are common in migraine and stroke , drugs commonly used to treat headache, having vasoconstrictor activity , and cardiac dysfunctions such as patent foramen ovale. In addition, irrespective of whether endothelial dysfunction is linked to platelet aggregation, recurrent endothelial insults may lead to microvascular brain damage contributing to white matter lesions . "
[Show abstract] [Hide abstract] ABSTRACT: Migraine is a common neurological disorder and can be severely disabling during attacks. The highest prevalence occurs between the ages of 25 and 55 years, potentially the most productive period of life. Migraine leads to a burden not only for the individual, but also for the family and society in general. Prior studies have found that migraine occurs together with other illnesses at a greater coincidental rate than is seen in the general population. These occurrences are called "comorbidities," which means that these disorders are interrelated with migraine. To delineate the comorbidities of migraine is important, because it can help improve treatment strategies and the understanding of the possible pathophysiology of migraine. The comorbid illnesses in patients with migraine include stroke, sub-clinical vascular brain lesions, coronary heart disease, hypertension, patent foramen ovale, psychiatric diseases (depression, anxiety, bipolar disorder, panic disorder, and suicide), restless legs syndrome, epilepsy and asthma. In this paper, we review the existing epidemiological and hospital-based studies, and illustrate the connections between these illnesses and migraine.0Comments 42Citations
- "Second, the proinflammatory or vasoactive peptide released during migraine attacks may damage the vascular endothelium and result in stroke or other vascular events (Kurth et al., 2006; Tietjen, 2007). Third, lower levels of endothelial progenitor cells in migraineurs indicated a reduced endothelial repair capacity, particularly in migraine with aura, which may contribute to the association between migraine and vascular diseases (Elkind, 2008; Lee et al., 2008). Fourth, the genetic risk factors are possible shared mechanisms between migraine and cardiovascular diseases (Scher et al., 2006; Schürks et al., 2008). "
- [Show abstract] [Hide abstract] ABSTRACT: The purpose of this article is to review the latest concepts regarding migraine and ischemic stroke. In addition, focal neurological deficits and MRI changes in migraine patients will be reviewed. A PubMed search of neurological literature pertaining to this study was conducted using specific keyword search terms pertaining to migraine and ischemic stroke. Migraine, especially with aura, is a relative risk factor for stroke. Neuroimaging demonstrates the posterior circulation as being most vulnerable, although the reason for this distribution is unclear. Factors that may contribute to stroke in migraine include changes during cortical spreading depression with hyper- or hypoperfusion of neural tissue, vasospasm and endothelial dysfunction. Estrogen affects migraine expression as well as cerebral circulation, yet most women with migraine without aura are not at increased risk. Co-morbidity with patent foramen ovale can be mechanism of both disorders via presumed lack of filtration of microemboli or toxic substances; however, closure with reversal of right to left shunt seems to be more beneficial for cryptogenic stroke than migraine. Migraine and stroke are found in specific genetic disorders such as CADASIL, HERNS and MELAS giving clues to genetic factors. Stroke associated with migraine treatments such as ergots or triptans is rare, and usually associated with special circumstances such as overuse or concomitant thrombogenic conditions. Although true migrainous infarction is rare, our understanding of the subtle associations between migraine and cerebrovascular behavior is expanding.0Comments 28Citations
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