Cerebrovascular reactivity to hypercapnia in migraine patients measured with near-infrared spectroscopy

Abstract

Migraine pain is considered to manifest itself as a result of an impaired cerebrovascular reactivity. Hence, proper quantification and diagnosis of this problem without causing more disturbance has always been a challenge in investigating migraine pathogenesis. Functional near-infrared spectroscopy system (fNIRS) is being proposed as an inexpensive, rapid, safe and accurate technique to monitor cerebrovascular dynamics. We have developed NIROXCOPE 201, a novel multi source and detector device of fNIRS, and attempted to investigate the cerebrovascular reactivity of migraine patients to a breath hold task which produces a metabolic perturbation. Six normals and six migraine patients performed four consecutive breath holding task. A typical brain hemodynamic response (BHR) is observed both for controls and migraineurs with an initial phase, main response and a recovery phase. Hence, fitting to a sum of three sequentially arranged gaussian curves proved that amplitudes of [Hb] and [HbO2] signals acquired by fNIRS are approximately two to five times higher in controls than migraine patients (P<0.01) for all phases. Moreover, amplitude change between successive breath holds tends to converge to a steady value for controls whereas an uncontrolled percent change is observed for migraineurs. Our results confirm an impaired cerebrovascular reactivity in the frontal cortex of migraine patients interictally.