Cerebral Hemodynamics, Right-to-Left Shunt and White Matter Hyperintensities in Patients with Migraine with Aura, Young Stroke Patients and Controls

Nicoletta Brunelli, Claudia Altamura, Carlo A. Mallio, Gianguido Lo Vullo, Marilena Marcosano, Marcel Bach-Pages, Bruno Beomonte Zobel, Carlo Cosimo Quattrocchi and Fabrizio Vernieri
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Nicoletta Brunelli: Headache and Neurosonology Unit, Neurology Unit, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy
Claudia Altamura: Headache and Neurosonology Unit, Neurology Unit, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy
Carlo A. Mallio: Radiology Unit, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy
Gianguido Lo Vullo: Radiology Unit, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy
Marilena Marcosano: Headache and Neurosonology Unit, Neurology Unit, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy
Marcel Bach-Pages: Department of Plant Sciences, University of Oxford, Oxford OX1 3RB, UK
Bruno Beomonte Zobel: Radiology Unit, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy
Carlo Cosimo Quattrocchi: Radiology Unit, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy
Fabrizio Vernieri: Headache and Neurosonology Unit, Neurology Unit, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy

IJERPH, 2022, vol. 19, issue 14, 1-10

Abstract: Background: Migraine with aura (MA) patients present an increased risk of cerebrovascular events. However, whether these patients present an increased white matter hyperintensities (WMHs) load compared to the general population is still under debate. Our study aimed to evaluate the relationship between cerebral hemodynamics, right-to-left shunt (RLS) and WMHs in MA patients, young patients with cryptogenic stroke or motor transient ischemic attack (TIA) and controls. Methods: We enrolled 30 MA patients, 20 young (<60 years) patients with cryptogenic stroke/motor TIA, and 10 controls. All the subjects underwent a transcranial Doppler bubble test to detect RLS and cerebral hemodynamics assessed by the breath holding index (BHI) for the middle (MCA) and posterior (PCA) cerebral arteries. Vascular risk factors were collected. The WMHs load on FLAIR MRI sequences was quantitatively assessed. Results: The stroke/TIA patients presented a higher prevalence of RLS (100%) compared with the other groups ( p < 0.001). The MA patients presented a higher BHI compared with the other groups in the PCA ( p = 0.010) and higher RLS prevalence (60%) than controls (30%) ( p < 0.001). The WMHs load did not differ across groups. BHI and RLS were not correlated to the WMHs load in the groups. Conclusions: A preserved or more reactive cerebral hemodynamics and the presence of a RLS are likely not involved in the genesis of WMHs in MA patients. A higher BHI may counteract the risk related to their higher prevalence of RLS. These results need to be confirmed by further studies to be able to effectively identify the protective role of cerebral hemodynamics in the increased RLS frequency in MA patients.

Keywords: cerebral hemodynamics; right-to-left shunt; white matter hyperintensities (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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