Features of cerebrovascular reactivity in patients of young age with migraine

Abstract

The aim of the study was to Doppler sonography study of cerebrovascular reactivity in young patients with migraine and comparison of autoregulation patterns between groups of migraine patients with aura and migraine without aura. Materials and methods: We conducted the clinical Doppler examination of 124 young patients (18-45 years old), including 55 men and 69 women in the conditions of the clinical base of the Kharkiv Medical Academy of Postgraduate Education in 2017-2019. The criteria for involvement of patients in the study were: migraine without aura (group 1-63 patients), migraine with aura (group 2-61 patients) The control group consisted of 45 patients of the corresponding gender and age. The indicators of CVR were studied using the ultrasound device. Results: A hyperreactive response to tests with CO2 and photoreactivity were more pronounced in the patients with migraine without aura. The patients with migraine with aura showed hyperreactivity in the test with O2, which was an indicator of the tendency to hyperconstriction. The hyperreactivity in the functional nitroglycerin test and the carotid compression test shows the state of the myogenic mechanism of changes in vascular tone. Insignificant hyperreactivity to orthostatic load detected in both groups shows the interest of the neurogenic regulatory link. Conclusions: 1. The most important hemodynamic patterns in the patients with migraine are excessive perfusion with migraine without aura and difficult perfusion with migraine with aura. 2. For the patients with migraine without aura, a characteristic criterion for autoregulation is the pattern of hyperreactivity hypercapnic load and photostimulation. 3. The most important difference in the autoregulatory response in the patients with migraine with aura compared with migraine without aura is the hyperresponse to hyperventilation load, compression carotid and nitroglycerin tests.