R-R interval variation in migraine patients

Year 2006, Volume: 11 Issue: 1-2, 1 - 6, 20.03.2013

Recep Aygül Orhan Deniz Asuman Orhan Nuri Koçak M. Dursun Kaya Hızır Ulvi

Abstract

Abstract. The aim of this study was to evaluate possible cardiovascular autonomic dysfunction in migraine patients with the R-R interval variation (RRIV) measurement, which is an easy and reliable method for the evaluation of parasympathetic function. We studied 71 migraine patients in headache- free intervals (mean age: 31.6±8.9, range 13-57 years; 52 females and 19 males), all without any known heart disease, and 51 age-matched healthy subjects (mean age: 28.8±9.1, range 13-52 years; 25 females and 26 males). RRIVs at rest (R%) and during deep breathing (D%) were studied in all the subjects. The difference between D% and R% (D-R) and the ratio of D% to R% (D/ R) was also determined.The mean values of RRIV in migraine patients at rest [mean RRIV in patients, 15.98±6.30% vs controls, 18.92±5.82% (p < 0.05)] and during deep breathing [mean RRIV in patients, 28.72±9.95% vs controls, 34.57±11.50% (p < 0.05)] and D-R [mean in patients, 12.74±7.90% vs controls, 15.64±8.20% (p < 0.05)] were significantly lower compared with the controls, but D/R [mean in patients, 1.90±0.58% vs controls, 1.86±0.42% (p > 0.05)] was not significant. Patients with migraine have hypofunction in the parasympathetic nervous system during routine daily activity in the headache-free period.

Key words: Migraine, autonomic dysfunction, R-R interval variation, parasympathetic nervous system

Keywords

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References

• Havanka-Kanniainen H. Autonomic dysfunction in migraine with special reference to cardiovascular reflexes, plasma noradrenaline levels and effects of nimodipine [Doctoral dissertation]. 1986; Oulu: University of Oulu.
• Sacks O. The physiological organisation of migraines. In: Migraine: Revised and Expanded. London: Picador, 1995; pp 193-204.
• Cortelli P, de Carolis P, Sturani A, Ligabue A, et al. Cardiovascular and biochemical assessment in migraine patients submitted to tilt test. Funct Neurol 1986;1: 285-29.
• Havanka-Kanniainen H, Tolonen U, Myllyla VV. Cardiovascular reflexes in young migraine patients. Headache 1986;41: 420-424.
• Anthony M. Biochemical indices of sympathetic activity in migraine. Cephalalgia 1981;41: 83-89.
• Boccuni M, Alessandri M, Fusco BM, Cang F. The pressor hyperresponsiveness to phenylephrine unmasks sympathetic hypofunction in migraine. Cephalalgia 1989;41: 239-245.
• Cortelli P, Pierangeli G, Parch´y P, Contin M, Baruzzi A, Lugaresi E. Autonomic nervous system function in migraine without aura. Headache 1991;41: 457-462.
• Gotoh F, Komatsumoto S, Araki N, Gomi S. Noradrenergic nervous activity in migraine. Arch Neurol 1984;41: 951-955.
• Havanka-Kanniainen H, Juujarvi K, Tolonen U, Myllyla VV. Cardiovascular reflex and plasma noradrenaline levels in migraine patients before and during nimodipine medication. Headache 1987; 41: 34- 44.
• Havanka-Kanniainen H, Tolonen U, Myllyla VV. Autonomic dysfunction in migraine: A survey of 188 patients. Headache 1988; 41: 465-470.
• Shechter A, Stewart WF, Silberstein SD, Lipton RB. Migraine and autonomic nervous system function: a population-based, case-control study. Neurology 2002;58: 422-427.
• Yakinci C, Mungen B, Er H, Durmaz Y & Karabüber H. Autonomic nervous system function in childhood migraine. Pediatrics International 1999;41: 529-533.
• Hilsted J, Jensen SB. A simple test for autonomic neuropathy in juvenile diabetics. Acta Med Scand 1979;205: 385- 387.
• Persson A, Solders G. R-R variations: a test of autonomic dysfunction. Acta Neurol Scand 1983; 67: 285-293.
• Shahani TB, Day TJ, Cros D, Khalil N, Kneebone CS. RR interval variation and the sympathetic skin response in the assessment of autonomic function in peripheral neuropathy. Arch Neurol 1990;47: 659-664.
• Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia 1988;8: 1-96.
• Yoldas T, Ulvi H, Dolu Y, Yigiter Y & Mungen B. RR interval variation and the sympathetic skin response in the assessment of autonomic function in migraine patients. Cephalalgia 2002;22: 1–35.
• Sharma KR, Romano JG, Ram Ayyar D, Rotta FT, Facca A, Sanchez-Ramos J. Sympathetic skin response and heart rate variability in patients with Huntington disease. Arch Neurol 1999;56: 1248-1252.
• Drory VE, Nisipeanu PF, Korczyn AD. Tests of autonomic dysfunction in patients with multiple sclerosis. Acta Neurol Scand 1995;92: 356-360.
• Wang SJ, Fuh JL, Shan DE, Liao KK, Lin KP, Tsai CP, Wu ZA. Sympathetic skin response and R-R interval variation in Parkinson’s disease. Mov Disord 1993;8: 151-157.
• Eckberg DL. Human sinus arrhythmia as an index of vagal cardiac outflow. J Appl Physiol 1983;54: 961- 966.
• Low PA. Quantitation of autonomic dysfunction. In: Dyck PJ, Thomas PK (eds) Peripheral neuropathy. Saunders, Philadelphia, 1993, pp 729-745.
• Low PA, Denq JC, Opher-Gehrking TL, Dyck PJ, O’Brien PC, Slezak JM. Effect of age and gender on sudomotor and cardiovagal function and blood pressure response to tilt in normal subjects. Muscle Nerve 1997;20: 1561-1568.
• Apel S, Kuritzky A, Zahavi I, Zingelman M, Akselrod S. Evidence for instability of the autonomic nervous system in patients with migraine headache. Headache 1992;32: 10-17.
• Tabata M, Takeshima T, Burioka N, Nomura T, Ishizaki K, Mori N, Kowa H, Nakashima K. Cosinor analysis of heart rate variability in ambulatory migraineurs. Headache 2000;40: 457-463.
• Thomsen LL, Iversen HK, Boesen F, Olesen J. Transcranial Doppler and cardiovascular responses during cardiovascular autonomic tests in migraineurs during and outside attacks. Brain 1995;118: 1319- 1327.
• Lance JW. Current concepts of migraine pathogenesis. Neurology 1993;41: 11-15.
• Pearce JMS. Neural aspects of migraine. In: Blau JN (Ed) Migraine: Clinical and Research Aspects. The Johns Hopkins University Press, Baltimore, 1987, pp 247-264.
• Adams RD, Victor M, Ropper AH. Principles of Neurology, 6th edn. McGraw-Hill Inc., New York, 1997, pp 522- 51.