Cerebrovascular reactivity to hypercapnia in patients with migraine: A dual‐echo arterial spin labeling MRI study

Abstract

AbstractObjectiveThis study aimed to compare cerebrovascular reactivity between patients with migraine and controls using state‐of‐the‐art magnetic resonance imaging (MRI) techniques.BackgroundMigraine is associated with an increased risk of cerebrovascular disease, but the underlying mechanisms are still not fully understood. Impaired cerebrovascular reactivity has been proposed as a link. Previous studies have evaluated cerebrovascular reactivity with different methodologies and results are conflicting.MethodsIn this single‐center, observational, case–control study, we included 31 interictal patients with migraine without aura (aged 19–66 years, 17 females) and 31 controls (aged 22–64 years, 18 females) with no history of vascular disease. Global and regional cerebrovascular reactivities were assessed with a dual‐echo arterial spin labeling (ASL) 3.0 T MRI scan of the brain which measured the change in cerebral blood flow (CBF) and BOLD (blood oxygen level dependent) signal to inhalation of 5% carbon dioxide.ResultsWhen comparing patients with migraine to controls, cerebrovascular reactivity values were similar between the groups, including mean gray matter CBF‐based cerebrovascular reactivity (3.2 ± 0.9 vs 3.4 ± 1% ΔCBF/mmHg CO2; p = 0.527), mean gray matter BOLD‐based cerebrovascular reactivity (0.18 ± 0.04 vs 0.18 ± 0.04% ΔBOLD/mmHg CO2; p = 0.587), and mean white matter BOLD‐based cerebrovascular reactivity (0.08 ± 0.03 vs 0.08 ± 0.02% ΔBOLD/mmHg CO2; p = 0.621).There was no association of cerebrovascular reactivity with monthly migraine days or migraine disease duration (all analyses p > 0.05).ConclusionCerebrovascular reactivity to carbon dioxide seems to be preserved in patients with migraine without aura.