Abstract

Background
Transcranial Doppler(TCD), a safe non-invasive method, can evaluate cerebrovascular reac- tivity. Although the vascular theory has many controversies, the patients with migraine show the changes of cerebral blood flow, which seems to contribute the pathophysiology and development of the migraine. In this study, we investigated cerebraovascular reactivity to hypoventilation in migraineurs, and compared their findings with those of normal controls. Methods: According to International Headache Society criteria and a headache paperweight, a total of 46 subjects, including 23 migraineurs and 23 controls were studied. The doppler signals from the middle cerebral artery(MCA) and posterior cerebral artery(PCA) at a depth of 6.0cm and 7.2cm were selected for the evaluation. After the resting baseline mean flow velocities(mFVs) were obtained, all subjects were instructed to hyperventilate for at least 2 minutes, to obtain the mFV in hyperventilation. Then, the subjects were allowed to breathe normally, and returning to the baseline mFV was confirmed. After mean flow velocities(mFVs) as a baseline were obtained, all subjects were instructed to hold breath al least for 30 seconds, and 3rd mFVs were recorded. Results: The significant differences in cerebrovascular reactivity of MCA between normal controls and migraineurs were observed during hypoventilation(40.64±13.20cm/sec vs. 56.58±11.50cm/sec, p<0.01 on Mann-Whitney test). The differences of cerebrovascular reactivity of PCA between normal controls and migraine groups were not significant. Conclusion: The cerebrovascular reactivity(CVR) of MCA in migraineurs was more increased than that in normal controls. Our studies suggest that vasoreactivity to hypoventilation measured by TCD can be an aid for the understanding of the pathophysiology of the migraine and the differentiation from normal subjects. Korean Journal of Headache 6(1):82-88, 2005