Peripheral Arterial Tonometry (EndoPAT)-measured Endothelial Dysfunction in Migraine with Aura children

Alice Bonuccelli; Claudia  Sciarrotta; Maria Grazia Esposito; Vanessa Bianchi; Mario Miccoli; Pasquale  Striano; Riccardo  D'angelo; Margherita  Valiani; Emioli Randazzo; Thomas Foiadelli; Diego Peroni; Giovanni Federico; Alessandro Orsini

doi:10.23750/abm.v92iS4.12674

Peripheral Arterial Tonometry (EndoPAT)-measured Endothelial Dysfunction in Migraine with Aura children

Authors

Alice Bonuccelli Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa
Claudia Sciarrotta Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa
Maria Grazia Esposito Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa
Vanessa Bianchi Pediatric Diabetology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa
Mario Miccoli Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
Pasquale Striano Pediatric Neurology Unit, Dinogmi, Giannina Gaslini’s. Istitute, University of Genoa
Riccardo D'angelo Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa
Margherita Valiani Pediatric Diabetology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa
Emioli Randazzo Pediatric Diabetology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Italy
Thomas Foiadelli Pediatric Clinic, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
Diego Peroni Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Italy
Giovanni Federico Pediatric Diabetology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Italy
Alessandro Orsini Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Italy

DOI: https://doi.org/10.23750/abm.v92iS4.12674

Keywords:

Migraine with aura, endothelial dysfunction, EndoPAT, arterial stiffness

Abstract

Background. The association between Migraine with Aura (MA) and vascular disease has been previously reported. We investigated whether pre-clinical vascular alterations, such as Endothelial Dysfunction, are already present in children and adolescents with Migraine with Aura.

Methods. We retrospectively enrolled 27 patients having Migraine with Aura, aged9 -18 years, and 31 age matched healthy control subjects to evaluateEndothelial Function by Peripheral Arterial Tonometry. This technique measures finger pulse wave amplitude, before and during reactive hyperaemia, and calculates the Augmentation Index (AI) and the Reactive Hyperaemia Index (RHI). We also set-up an Aura Severity Scale to assess disease severity and its relationship with AI and RHI alterations.

Results. Also if the case-control study resulted only partially as significant, we found there is an inversely proportional relationship between the severity of the migraine measured with Aura Severity Scale and the values of the endoscore (a significantly reduced levels of AI (p-value <0,03) and a marginal reduction of RHI levels (p-value <0,07).

Conclusion. Further studies should explore the impact of pre-clinical vascular alterations in children and adolescents with Migraine with Aura.

References

Foiadelli T, Piccorossi A, Sacchi L, De Amici M, Tucci M, Brambilla I, et al. Clinical characteristics of headache in Italian adolescents aged 11-16 years: a cross-sectional questionnaire school-based study. Ital J Pediatr. 2018;44(1):44.

Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211.

Butt JH, Franzmann U, Kruuse C. Endothelial function in migraine with aura - a systematic review. Headache. 2015;55(1):35-54.

Olesen J. International Classification of Headache Disorders. Lancet Neurol. 2018;17(5):396-7.

Eidlitz-Markus T, Zeharia A. Symptoms and clinical parameters of pediatric and adolescent migraine, by gender - a retrospective cohort study. J Headache Pain. 2017;18(1):80.

Viana M, Tronvik EA, Do TP, Zecca C, Hougaard A. Clinical features of visual migraine aura: a systematic review. J Headache Pain. 2019;20(1):64.

Cordelli DM, Marra C, Ciampoli L, Barbon D, Toni F, Zama D, et al. Posterior Reversible Encephalopathy Syndrome in infants and young children. Eur J Paediatr Neurol. 2021;30:128-33.

Luzzi S, Gragnaniello C, Marasco S, Lucifero AG, Del Maestro M, Bellantoni G, et al. Subaxial Vertebral Artery Rotational Occlusion Syndrome: An Overview of Clinical Aspects, Diagnostic Work-Up, and Surgical Management. Asian Spine J. 2020.

Luzzi S, Gragnaniello C, Giotta Lucifero A, Marasco S, Elsawaf Y, Del Maestro M, et al. Anterolateral approach for subaxial vertebral artery decompression in the treatment of rotational occlusion syndrome: results of a personal series and technical note. Neurol Res. 2021;43(2):110-25.

Luzzi S, Gragnaniello C, Giotta Lucifero A, Del Maestro M, Galzio R. Microneurosurgical management of giant intracranial aneurysms: Datasets of a twenty-year experience. Data Brief. 2020;33:106537.

Luzzi S, Gragnaniello C, Giotta Lucifero A, Del Maestro M, Galzio R. Surgical Management of Giant Intracranial Aneurysms: Overall Results of a Large Series. World Neurosurg. 2020;144:e119-e37.

Luzzi S, Giotta Lucifero A, Del Maestro M, Marfia G, Navone SE, Baldoncini M, et al. Anterolateral Approach for Retrostyloid Superior Parapharyngeal Space Schwannomas Involving the Jugular Foramen Area: A 20-Year Experience. World Neurosurg. 2019;132:e40-e52.

Tfelt-Hansen PC. History of migraine with aura and cortical spreading depression from 1941 and onwards. Cephalalgia. 2010;30(7):780-92.

Bigal ME, Kurth T, Hu H, Santanello N, Lipton RB. Migraine and cardiovascular disease: possible mechanisms of interaction. Neurology. 2009;72(21):1864-71.

Giotta Lucifero A, Baldoncini M, Bruno N, Galzio R, Hernesniemi J, Luzzi S. Shedding the Light on the Natural History of Intracranial Aneurysms: An Updated Overview. Medicina (Kaunas). 2021;57(8).

Reriani MK, Lerman LO, Lerman A. Endothelial function as a functional expression of cardiovascular risk factors. Biomark Med. 2010;4(3):351-60.

Savioli G, Ceresa IF, Macedonio S, Gerosa S, Belliato M, Iotti GA, et al. Trauma Coagulopathy and Its Outcomes. Medicina (Kaunas). 2020;56(4).

Tietjen GE. Migraine as a systemic vasculopathy. Cephalalgia. 2009;29(9):987-96.

Tietjen GE, Khubchandani J. Vascular biomarkers in migraine. Cephalalgia. 2015;35(2):95-117.

Azimova JE, Sergeev AV, Korobeynikova LA, Kondratieva NS, Kokaeva ZG, Shaikhaev GO, et al. Effects of MTHFR gene polymorphism on the clinical and electrophysiological characteristics of migraine. BMC Neurol. 2013;13:103.

Samaan Z, Gaysina D, Cohen-Woods S, Craddock N, Jones L, Korszun A, et al. Methylenetetrahydrofolate reductase gene variant (MTHFR C677T) and migraine: a case control study and meta-analysis. BMC Neurol. 2011;11:66.

Kara I, Sazci A, Ergul E, Kaya G, Kilic G. Association of the C677T and A1298C polymorphisms in the 5,10 methylenetetrahydrofolate reductase gene in patients with migraine risk. Brain Res Mol Brain Res. 2003;111(1-2):84-90.

Kowa H, Yasui K, Takeshima T, Urakami K, Sakai F, Nakashima K. The homozygous C677T mutation in the methylenetetrahydrofolate reductase gene is a genetic risk factor for migraine. Am J Med Genet. 2000;96(6):762-4.

Lea RA, Ovcaric M, Sundholm J, MacMillan J, Griffiths LR. The methylenetetrahydrofolate reductase gene variant C677T influences susceptibility to migraine with aura. BMC Med. 2004;2:3.

Scher AI, Terwindt GM, Verschuren WM, Kruit MC, Blom HJ, Kowa H, et al. Migraine and MTHFR C677T genotype in a population-based sample. Ann Neurol. 2006;59(2):372-5.

Orsini A, Sammartino I, Valetto A, Bertini V, Marchese P, Bonuccelli A, et al. Methylenetetrahydrofolate reductase polymorphism (MTHFR C677T) and headache in children: a retrospective study from a tertiary level outpatient service. Ital J Pediatr. 2018;44(1):106.

Güler S, Gürkan H, Tozkir H, Turan N, Çelik Y. An Investigation of the Relationship between the eNOS Gene Polymorphism and Diagnosed Migraine. Balkan J Med Genet. 2014;17(2):49-59.

Palumbo P, Lombardi F, Siragusa G, Dehcordi SR, Luzzi S, Cimini A, et al. Involvement of NOS2 Activity on Human Glioma Cell Growth, Clonogenic Potential, and Neurosphere Generation. Int J Mol Sci. 2018;19(9).

Palumbo P, Lombardi F, Augello FR, Giusti I, Luzzi S, Dolo V, et al. NOS2 inhibitor 1400W Induces Autophagic Flux and Influences Extracellular Vesicle Profile in Human Glioblastoma U87MG Cell Line. Int J Mol Sci. 2019;20(12).

Ashina M, Bendtsen L, Jensen R, Schifter S, Olesen J. Evidence for increased plasma levels of calcitonin gene-related peptide in migraine outside of attacks. Pain. 2000;86(1-2):133-8.

Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. Bmj. 2000;320(7244):1240-3.

McCarthy HD, Cole TJ, Fry T, Jebb SA, Prentice AM. Body fat reference curves for children. Int J Obes (Lond). 2006;30(4):598-602.

Palombo C, Kozakova M, Morizzo C, Gnesi L, Barsotti MC, Spontoni P, et al. Circulating endothelial progenitor cells and large artery structure and function in young subjects with uncomplicated type 1 diabetes. Cardiovasc Diabetol. 2011;10:88.

Axtell AL, Gomari FA, Cooke JP. Assessing endothelial vasodilator function with the Endo-PAT 2000. J Vis Exp. 2010(44).

Eriksen MK, Thomsen LL, Olesen J. The Visual Aura Rating Scale (VARS) for migraine aura diagnosis. Cephalalgia. 2005;25(10):801-10.

Sonbolestan SA, Heshmat K, Javanmard SH, Saadatnia M. Efficacy of Enalapril in Migraine Prophylaxis: A Randomized, Double-blind, Placebo-controlled Trial. Int J Prev Med. 2013;4(1):72-7.