Measurement of Blood Flow Velocity in the Middle Cerebral Artery During Spontaneous Migraine Attacks: A Systematic Review

TY - JOUR

T1 - Measurement of Blood Flow Velocity in the Middle Cerebral Artery During Spontaneous Migraine Attacks

T2 - A Systematic Review

AU - Shayestagul, Nisar A

AU - Christensen, Casper E

AU - Amin, Faisal Mohammad

AU - Ashina, Sait

AU - Ashina, Messoud

N1 - © 2017 American Headache Society.

PY - 2017/6

Y1 - 2017/6

N2 - OBJECTIVE: To assess the evidence for blood flow velocity changes in the middle cerebral artery during and outside of spontaneous migraine attacks.METHODS: A systematic literature search on PubMed was performed and reference lists of assessed articles to identify studies on spontaneous migraine attacks that used transcranial Doppler on the middle cerebral artery with comparisons to interictal measurements were reviewed. Studies on non-spontaneous attacks and intervention studies were excluded.RESULTS: A total of 17 original articles reporting blood flow velocity values in the middle cerebral artery using transcranial Doppler in migraine patients both with and without aura were identified. A total of 24 subgroups (ie, migraine patients without aura = 11, migraine patients with aura = 9, and mixed = 4) of migraine patients were investigated during and outside spontaneous migraine attacks in the 17 studies. No change was reported in 15 subgroups (63%), while decreased blood flow velocity was found in 8 subgroups (33%) and increased blood flow velocity was found in one study (4%). Exploratory analysis revealed that studies showing decreased blood flow velocity were carried out earlier after onset of attack (mean time, 4.1 h) compared with those showing no change (mean time, 6.0 h).CONCLUSIONS: Overall, spontaneous migraine attacks are not accompanied by blood flow velocity changes in the middle cerebral artery. However, explorative analyses on the time from attack onset to examination revealed side-specific attack-related decrease in blood flow velocity in the early, but not late phases. This is the first systematic review focusing on the flow changes in the middle cerebral artery of spontaneous migraine attacks. Future studies should focus on the early blood flow velocity changes in migraine attacks.

AB - OBJECTIVE: To assess the evidence for blood flow velocity changes in the middle cerebral artery during and outside of spontaneous migraine attacks.METHODS: A systematic literature search on PubMed was performed and reference lists of assessed articles to identify studies on spontaneous migraine attacks that used transcranial Doppler on the middle cerebral artery with comparisons to interictal measurements were reviewed. Studies on non-spontaneous attacks and intervention studies were excluded.RESULTS: A total of 17 original articles reporting blood flow velocity values in the middle cerebral artery using transcranial Doppler in migraine patients both with and without aura were identified. A total of 24 subgroups (ie, migraine patients without aura = 11, migraine patients with aura = 9, and mixed = 4) of migraine patients were investigated during and outside spontaneous migraine attacks in the 17 studies. No change was reported in 15 subgroups (63%), while decreased blood flow velocity was found in 8 subgroups (33%) and increased blood flow velocity was found in one study (4%). Exploratory analysis revealed that studies showing decreased blood flow velocity were carried out earlier after onset of attack (mean time, 4.1 h) compared with those showing no change (mean time, 6.0 h).CONCLUSIONS: Overall, spontaneous migraine attacks are not accompanied by blood flow velocity changes in the middle cerebral artery. However, explorative analyses on the time from attack onset to examination revealed side-specific attack-related decrease in blood flow velocity in the early, but not late phases. This is the first systematic review focusing on the flow changes in the middle cerebral artery of spontaneous migraine attacks. Future studies should focus on the early blood flow velocity changes in migraine attacks.

KW - Blood Flow Velocity

KW - Cerebrovascular Circulation/physiology

KW - Humans

KW - Middle Cerebral Artery/diagnostic imaging

KW - Migraine Disorders/diagnostic imaging

KW - Ultrasonography, Doppler, Transcranial

U2 - 10.1111/head.13106

DO - 10.1111/head.13106

M3 - Review

C2 - 28470726

SN - 0017-8748

VL - 57

SP - 852

EP - 861

JO - Headache

JF - Headache

IS - 6

ER -