Transcranial Doppler Evaluation of the Cerebral Vasculature in Women Patients who Have Migraine with Aura

Abstract

Background: Previous studies suggest that increased cerebrovascular reactivity might be a feature of patients who have migraine with aura (MwA). The correlation between the clinical presentation of migraine with aura and transcranial Doppler parameters remains unclear.

Objective: The main aim of this study was to explore cerebral blood flow, vascular resistance, and cerebrovascular reactivity in women MwA. Also, the relationships between hemodynamic conditions and aura characteristics are examined.

Design: Cross-sectional study.

Setting: Headache Center, Neurology Clinic, Clinical Center of Serbia.

Subjects: Fifty-four women MwA and 49 healthy controls (HCs).

Methods: Transcranial Doppler sonography examination was used to determine blood flow mean velocity (MV) and pulsatility index (PI), as well as breath-holding index (BHI), in 15 arterial segments comprising the circle of Willis.

Results: A total of 54 women MwA and 49 HCs were studied. The PIs of all segments of the left and right middle cerebral arteries and the left and right anterior cerebral arteries were significantly higher in MwA with regards to HCs. Also, both the left and right BHIs were significantly higher in MwA than HCs. In addition, MVs of the right vertebral artery and the first segment of the basilar artery were significantly lower in MwA than HCs. Longer duration of migraine aura showed a weak negative correlation with the PI of the left posterior cerebral artery.

Conclusions: Our findings suggest increased vessel pulsatility, abnormal cerebrovascular reactivity, and decreased cerebral blood flow velocity in several arterial segments of the Willis circle in women MwA.

Keywords: Blood Flow Mean Velocity; Cerebrovascular Reactivity; Pulsatility Index; Sex Phenotype; Transcranial Doppler.