Highlights
Abstract
Introduction: Migraine has been known for many years, but its
mechanism remains unclear. Different cerebral hemodynamic changes
have been observed at different stages of a migraine attack. Published
results on cerebral hemodynamics are contradictory. For this reason, we
aimed to investigate cerebral hemodynamic changes during attacks as
well as the effects of frovatriptan and rizatriptan.
Methods: Forty migraine patients with aura using rizatriptan (n=20)
and frovatriptan (n=20) and 20 healthy individuals were included in our
study. Cerebral blood flow velocities and breath-holding indices were
recorded bilaterally from middle and posterior cerebral arteries. All
procedures were repeated one hour after treatments and one week after
attacks.
Results: We observed similar values of cerebral blood flow velocities and
breath holding indices in all patients with migraine during the attack-free
period compared to the control group. All cerebral vascular structures in
migraine patients had significantly lower cerebral blood flow velocities
and higher values in breath-holding indices during attacks. After taking
rizatriptan and frovatriptan for an attack, the changes in hemodynamics
disappeared.
Conclusion: During attacks of migraineurs with aura, vasodilatation
develops. In addition, higher vasomotor reactivity during attacks
supports hypersensitivity in migraine pathophysiology. Triptans, acting
as vasoconstrictor agents, were able to stop over-vasodilatation during
attacks. In other words, it is possible that triptans show their effects by
eliminating vascular hypersensitivity during acute attacks.
Keywords: Migraine, hemodynamics, rizatriptan, frovatriptan