R-R interval variation in migraine patients

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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Kaynakça

1. 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.
2. Sacks O. The physiological organisation of migraines. In: Migraine: Revised and Expanded. London: Picador, 1995; pp 193-204.
3. 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.
4. Havanka-Kanniainen H, Tolonen U, Myllyla VV. Cardiovascular reflexes in young migraine patients. Headache 1986;41: 420-424.
5. Anthony M. Biochemical indices of sympathetic activity in migraine. Cephalalgia 1981;41: 83-89.
6. Boccuni M, Alessandri M, Fusco BM, Cang F. The pressor hyperresponsiveness to phenylephrine unmasks sympathetic hypofunction in migraine. Cephalalgia 1989;41: 239-245.
7. 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.
8. Gotoh F, Komatsumoto S, Araki N, Gomi S. Noradrenergic nervous activity in migraine. Arch Neurol 1984;41: 951-955.

9. 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.
10. Havanka-Kanniainen H, Tolonen U, Myllyla VV. Autonomic dysfunction in migraine: A survey of 188 patients. Headache 1988; 41: 465-470.
11. 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.
12. Yakinci C, Mungen B, Er H, Durmaz Y & Karabüber H. Autonomic nervous system function in childhood migraine. Pediatrics International 1999;41: 529-533.
13. Hilsted J, Jensen SB. A simple test for autonomic neuropathy in juvenile diabetics. Acta Med Scand 1979;205: 385- 387.
14. Persson A, Solders G. R-R variations: a test of autonomic dysfunction. Acta Neurol Scand 1983; 67: 285-293.
15. 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.
16. 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.
17. 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.
18. 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.
19. Drory VE, Nisipeanu PF, Korczyn AD. Tests of autonomic dysfunction in patients with multiple sclerosis. Acta Neurol Scand 1995;92: 356-360.
20. 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.
21. Eckberg DL. Human sinus arrhythmia as an index of vagal cardiac outflow. J Appl Physiol 1983;54: 961- 966.
22. Low PA. Quantitation of autonomic dysfunction. In: Dyck PJ, Thomas PK (eds) Peripheral neuropathy. Saunders, Philadelphia, 1993, pp 729-745.
23. 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.
24. 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.
25. 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.
26. 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.
27. Lance JW. Current concepts of migraine pathogenesis. Neurology 1993;41: 11-15.
28. 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.
29. Adams RD, Victor M, Ropper AH. Principles of Neurology, 6th edn. McGraw-Hill Inc., New York, 1997, pp 522- 51.