Volume 24, Issue 101, January - February, 2020

Cardiovascular sympathetic nervous system response to cold pressor test among patients with migraine

Mohamed Saad¹, Wael Gabr^2,3♦, Osama El-Azouni^4,5, Asmaa Farouk Enein⁶

¹Professor of neurology, Neurology department, Mansoura University, Mansoura, Egypt
²Associate professor of neurology, Neurology department, Mansoura University, Mansoura, Egypt
³Associate professor of neurology, Internal medicine department, Tiabah University, Madina, KSA
⁴Associate professor of neurology, Neurology department, Zagazig University, Zagazig, Egypt
⁵Consultant of neurology, Mouwasat Hospital, KSA
⁶Associate professor Internal Medicine Department, Faculty of Medicine, Mansoura University, Egypt

^♦Corresponding author
Department of Neurology, Faculty of Medicine, University of Mansoura, Mansoura, Egypt Email: waaael@yahoo.com / wael_gabr@mans.edu.eg

ABSTRACT

Context: Autonomic nervous system (ANS) dysfunction is one of the main characteristics of migraine; however, the exact relationship between migraine and ANS is not clear. Moreover, researches in this field yielded inconclusive and conflicting results. Aims: We tried to evaluate sympathetic autonomic cardiovascular response to cold stress in migraine patients and compare it to control group. Methods and Material: Cardiovascular responses to cold pressor test was evaluated in 91 participants, 61 participants were migraineurs (53 females and 8 males, average age 28.42±3.85 years) and 30 subjects were age and sex matched healthy controls (26 females and 4 males, average ages of 28.79±2.99 years). Results: Patient with migraine showed higher systolic and diastolic blood pressure in response to cold stress compared to controls (P<0.05), there were no differences between migraine patient with and without aura (P>0.05). Also, our data revealed a direct relationship between migraine duration and sympathetic response. Conclusions: Migraineurs have higher sympathetic tone compared to controls; Sympathetic hyperactivity is not significantly different between migraineurs with aura and without aura. A direct relationship between sympathetic over-activity and migraine duration was observed in patients group. Key message: Migraineurs have a higher sympathetic tone making patients more vulnerable to cerebrovascular disease (CVD). So, clinicians should take care that some medications used in migraine management may affect cardiovascular system, and should try to prevent the modifiable CVD risk factors among migraineurs.

Keywords: Headache, migraine, autonomic dysfunction, cerebrovascular disease, cold pressor test.

Medical Science, 2020, 24(101), 26-36

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