The pathogenesis of migraine is still unknown, the hemodynamics and vascular hypothesis had been tested by many investigators using different methods including angiography, isotopes scan, PET and SPECT scans. In this study, we are assessing the use of TCD to determine cerebral blood flow and vasoreactivity response by using breath-holding test among Iraqi migraine patients. Study group included a total of 57 patients diagnosed with migraine; 42 female patients and 15 male patients, they ranged in age from 15 to 37 years. Migraine of twenty patients were accompanied with aura and thirty-seven patients had no aura. We found no significant difference in peak systolic velocity, diastolic velocity, resistive index, and pulsatility index between the study and the control groups and between the patients with and without aura. Using breath holding index, we found a significant difference between the study and the control group but no significant difference between patients with and without aura and no difference in gender. For the best of our knowledge, this is the first study that supports the role of neurovascular changes via assessment of cerebral blood flow and breath hold vasoreactivity using TCD testing.
Keywords: Transcranial doppler ultrasound; Cerebral blood flow; Breath-holding vasoreactivity
Copyright © 2018 by The American Society for BioMedicine and BM-Publisher, Inc.
1. Hagen K, Jensen R, Stovner L, et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia 2007;27:193-210.
2. Allan H. Ropper, Martin A. Samuels, Joshua P. Klein, Adams and Victor's - Principle of Neurology 10th Ed, 2014; Version 1.0, 978-0-07-180091-4.
3. Headache Classification Committee of the International Headache Society, The International Classification of Headache Disorders, 3nd edition (beta version), Cephalgia 2013;33(9):629-808.
4. Disease GBD, Injury I, Prevalence C. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the global burden of disease study 2016. Lancet 2017;390:1211-1259.
5. Selby G, Lance JW. Observations on 500 cases of migraine and allied vascular headaches. J Neurol. Neurosurg Psychiatry 1960;23:23Y32.
6. Bigal ME, Lipton RB, Stewart WF. The epidemiology and impact of migraine. Curr Neurol Neurosci Rep 2004;4:98-104.
7. Lipton RB, Bigal ME. The epidemiology of migraine. Am J Med 2005;118(Suppl 1):3S-10S.
8. Burch RC, Loder S, Loder E, Smitherman TA. The prevalence and burden of migraine and severe headache in the United States: updated statistics from government health surveillance studies. Headache 2015; 55:21-34.
9. Rasmussen BK, Jensen R, Schroll M, Olesen J. Epidemiology of headache in a general population--a prevalence study. J Clin Epidemiol 1991;44:1147-57.
10. Stewart WF, Wood C, Reed ML, et al. Cumulative lifetime migraine incidence in women and men. Cephalalgia 2008;28(11):1170Y1178.
11. Wolff HG. Headache and other head pain, Oxford University Press, New York 1963.
12. Leaõ AA. Spreading depression of activity in the cerebral cortex. J Neurophysiol 1944;7:359-390.
13. Russell MB, Iselius L, Olesen J. Migraine without aura and migraine with aura are inherited disorders. Cephalalgia 996;16:305-309.
14. Schumacher G, Wolff H. Experimental studies on headache: A. Contrast of histamine headache with the headache of migraine and that associated with hypertension. B. Contrast of vascular mechanisms in pre-headache and in headache phenomena of migraine. Arch Neurol Psychiatry1941;45:199-214.
15. Arjona A, Perula de Torres LA, Serrano-Castro PJ, et al. A transcranial Doppler study in interictal migraine and tension- type headache. J Clin Ultrasound 2007;35:372-375.
16. Kastrup A, Thomas C, Hartmann C, Schabet M. Cerebral blood flow and CO2 reactivity in interictal migraineurs: a transcranial Doppler study. Headache 1998;38:608-613.
17. Valikovics A, Oláh L, Fülesdi B et al. Cerebrovasular reactivity measured by transcranial Doppler in migraine. Headache 1996;36:323-328.
18. Thie A, Fuhlendorf A, Spitzer K, Kunze K. Transcranial Doppler evaluation of common and classic migraine. Part I. Ultrasonic features during the headache-free period. Headache 1990;30:201-208.
19. Abernathy M, Donnelly G, Kay G et al. Transcranial Doppler sonography in headache-free migraineurs. Headache 1994;34:198-203.
20. Heckmann JG, Hilz MJ, Katalinic A, Marthol H, Mück-Weymann M, Neundörfer B. Myogenic cerebrovascular autoregulation in migraine measured by stress transcranial Doppler sonography. Cephalalgia1998;18:133-137.
21. Silvestrini M, Matteis M, Troisi E, Cupini LM, Bernardi G. Cerebrovascular reactivity in migraine with and without aura. Headache 1996;36:37-40.
22. Totaro R, De Matteis G, Marini C, Prencipe M. Cerebral blood flow in migraine with aura: a transcranial Doppler sonography study. Headache 1992;32:446-451.
23. Vernieri F, Tibuzzi F, Pasqualetti P, et al. Increased cerebral vasomotor reactivity in migraine with aura: an autoregulation disorder? A transcranial Doppler and near-infrared spectroscopy study. Cephalalgia 2008;28:689-695.
24. Bäcker M, Sander D, Hammes MG et al. Altered cerebrovascular response pattern in interictal migraine during visual stimulation. Cephalalgia 2001;21:611-616.
25. Fiermonte G, Pierelli F, Pauri F, Cosentino FI, Soccorsi R, Giacomini P. Cerebrovascular CO2 reactivity in migraine with aura and without aura. A transcranial Doppler study. Acta NeurolScand 1995;92:166-169.
26. Micieli G, Tassorelli C, Bosone D et al. Increased cerebral blood flow velocity induced by cold pressor test in migraine: a possible basis for pathogenesis? Cephalalgia1995;15:494-498.
27. Nowak A, Gergont A, Steczkowska M. Assessment of cerebral blood flow after visual stimulation in children with a migraine and chronic tension-type headache-preliminary reports. Dlekarski 2008;65:777-782.
28. Totaro R, Marini C, De Matteis G, Di Napoli M, Carolei A. Cerebrovascular reactivity in migraine during headache free intervals. Cephalalgia 1997;17:191-194.
29. Thomsen LL, I versen HK, Olesen J. Increased cerebrovascular pCO2 reactivity in migraine with aura – a transcranial Doppler study during hyperventilation. Cephalalgia 1995;15:211-215.
30. Markus, H.S. and Harrison, Estimation of cerebrovascular Reactivity Using Transcranial Doppler, Including the use of breath-Holding as the Vasodilatory Stimulus, Stroke 1992;23:668-673.
31. Liu HL, Huang JC, Wu CT, Hsu YY. Detectability of blood oxygenation level-dependent signal changes during short breath hold duration. Magn. Reson. Imaging 2002;20:643-648.
32. Nowak A, Kaci M. Transcranial Doppler evaluation in migraineurs, Neurologiai Neurochirurgia Polska 2009;(2):162-172.
33. De Benedittis G, Ferrari Da Passano C, Granata G, Lorenzetti A. CBF changes during headache-free periods and spontaneous/induced attacks in migraine with and without aura: a TCD and SPECT comparison study, J Neurosurgical Science 1999;43(2):141-6.
34. Reinhard M, Wehrle-Wieland E, Roth M, et al. Preserved dynamic cerebral autoregulation in the middle cerebral artery among persons with migraine, Exp Brain Res 2007;180:517-523.
35. Kastrup A, Thomas C, Hartmann C, Schabet M. Cerebral Blood Flow and CO, Reactivity in Interictal Migraineurs: A Transcranial Doppler Study. Headache 1998;38(8):608-13.
36. Wallasch TM, Beckmann P, Kropp P. Cerebrovascular reactivity during the Valsalva maneuver in migraine, tension-type headache and medication overuse headache, Functional Neurology 2011;26(4):223-227.
37. Chana S, Tama Y, Laia C, et al. Transcranial Doppler study of cerebrovascular reactivity: Aremigraineurs more sensitive to breath-hold challenge? Brain Research, 2009;1291:53-59.
38. Harer C, von Kummer R. Cerebrovascular CO2 reactivity in migraine: assessment by transcranial Doppler ultrasound, Neurol 1991;238:23-26.
For any technique error please contact us and will be response to sending purchase article by email.
Who Can Become a Reviewer?
Any expert in the article's research field can become a reviewer with American Journal of BioMedicine. Editors might ask you to look at a specific aspect of an article.
Thank you for visiting American Journal of BioMedicine. * = Required fields
[contact-form-7 404 "Not Found"]
American Journal of BioMedicine Volume 6, Issue 8, pages 648-660
Received July 15, 2018; accepted October 12, 2018; published October 18, 2018
How to cite this article
Hassoun HK, Almudhafar A, Allebban Z, Altemimi S, AlSafar HA, Rhadi M. Cerebral blood flow and vasomotor reactivity assessment by using transcranial Doppler among Iraqi migraineurs-case control study. American Journal of BioMedicine 2018;6(10):648-660.
Case report outline