ArticlePloS one2019
Right-to-left shunts and hormonal therapy influence cerebral vasomotor reactivity in patients with migraine with aura.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Profiling cerebrovascular function in migraine: A systematic review and meta-analysis.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2021Pooled it
- Ultrasound assessment of cerebrovascular risk via breath-holding index in migraine patients treated with anti-CGRP monoclonal antibodies: a pilot study.Journal of ultrasonography · 2026Article
- Clinical characteristics and short-term outcomes of migraine with patent foramen ovale: a comparative study.European journal of medical research · 2025Article
- Exploring the effects of resveratrol supplementation on cerebrovascular function in hormonal migraineurs: A pilot study.IBRO neuroscience reports · 2023Article
- Connection between right-to-left shunt and photosensitivity: a community-based cross-sectional study.Frontiers in neurology · 2023Article
- Bibliometric Analysis of Research on Migraine-Stroke Association from 2013 to 2023.Journal of pain research · 2023Article
- Stroke territory and atherosclerosis in ischemic stroke patients with a history of migraine with aura.Frontiers in neurology · 2023Article
- The Patent Foramen Ovale and Migraine: Associated Mechanisms and Perspectives from MRI Evidence.Brain sciences · 2022Review
- Cerebral Hemodynamics, Right-to-Left Shunt and White Matter Hyperintensities in Patients with Migraine with Aura, Young Stroke Patients and Controls.International journal of environmental research and public health · 2022Article
- Shorter visual aura characterizes young and middle-aged stroke patients with migraine with aura.Journal of neurology · 2022Article
- Can aura migraine be elicited by isolated pulmonary arteriovenous fistula?-A case report.Frontiers in neurology · 2022Article
- The Role of Endothelial Dysfunction in the Pathophysiology and Cerebrovascular Effects of Migraine: A Narrative Review.Journal of clinical neurology (Seoul, Korea) · 2021Review
- Cerebrovascular Function in Hormonal Migraine: An Exploratory Study.Frontiers in neurology · 2021Article
- Pathophysiological Bases of Comorbidity in Migraine.Frontiers in human neuroscience · 2021Review
- Commentary: Enhanced Hemodynamic and Clinical Response to αCGRP in Migraine Patients-A TCD Study.Frontiers in neurology · 2021Article
- Enhanced Hemodynamic and Clinical Response to αCGRP in Migraine Patients-A TCD Study.Frontiers in neurology · 2021Article
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Patent Foramen Ovale and impaired cerebral hemodynamics were proposed among the pathophysiological mechanisms explaining the increased risk for stroke in patients with Migraine with Aura (MA). Our study aimed at comparing the vasomotor reactivity (VMR) of the anterior and the posterior cerebral circulation in patients with Migraine with Aura, in patients with acute vascular ischemic accidents, and in controls. We hypothesized that VMR in MA patients is preserved in the anterior circulation and reduced in the posterior circulation. We prospectively assessed with Transcranial Doppler the vasomotor reactivity to breath holding of the Middle and Posterior Cerebral Arteries (MCA, PCA) in MA patients, in acute vascular patients and healthy controls. We also evaluated the possible effect of clinical characteristics of MA (attack frequency, aura length or type, disease history), vascular factors and the presence of right-to-left shunt on VMR. Diverging from our hypothesis, MA patients displayed a higher breath-holding index (BHI) than controls in the MCA (1.84±0.47%/s vs 1.53±0.47%/s, p = .001) as well as in the PCA (1.87±0.65%/s vs 1.47±0.44%/s, p < .001). In MA patients, MCA BHI was higher in those with large right-to-left shunts (2.09±0.42 vs 1.79±0.47, p = .046) and lower in those taking estrogens (1.30±0.30%/s vs 1.9±0.45%/s, p = .009). We did not observe an effect of MA characteristics on BHI. The increased BHI in MA patients with large right-to-left shunts could be explained by the vasoactive effect in the cerebral circulation of substances bypassing the deactivating pulmonary filters or by a constitutional trait of the vascular system associating persistent right-to-left shunts and hyper-reactive hemodynamics. Our results discourage the hypothesis that altered hemodynamics contribute to increasing the stroke risk in all MA patients. However, estrogens can lower VMR, curtailing the hemodynamic resources of MA patients.
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