Cerebral Hemodynamic Response To Menstrual Cycle In Migraine

Abstract

Objective: Menstrually related migraine (MRM) occurs in relation to menstrual cycles. We investigated the cerebral hemodynamic response to the menstrual cycle in nonmenstrually related migraines (nMRM), MRM and healthy controls. Methods: 22 nMRM, 20 MRM patients in an attack-free interval and 20 healthy volunteers were included in our study. TCD recordings were made during the follicular and luteal phases of the hormonal cycle and mean flow velocity values of middle and posterior cerebral arteries were studied. Cerebral vasomotor reactivity (CVR) was evaluated by breath holding index (BHI) and visually evoked blood flow (VEBF) changes in both phases of the same menstrual cycle. Results: Mean flow veloticities and hormone levels were not different between groups. Right BHI and bilateral VEBF values were significantly lower in both of the migraine groups. The physiological elevation of CVR in the luteal phase was detected in the control and nMRM groups, but not in the MRM group. Conclusion: The cerebral hemaodynamics were affected in both MRM and nMRM. Additionally the physiological CVR to menstrual cycle was impaired in MRM. The impairment in cerebral hemodynamic response to the menstrual cycle in MRM needs further research to discover the underlying pathophysiology.