Women may have greater carotid intima-media thickness (IMT) and elevated levels of biomarkers of endothelial dysfunction during a migraine attack, according to case-control study results published in Neurological Sciences.

A total of 74 women (age 18-50; mean age, 35.1±3.4) diagnosed with migraine according to the International Headache Society-IIIb criteria, and 74 age- and sex-matched healthy controls (without neurologic or systemic diseases) were enrolled. Plasma levels of thiobarbituric acid-reactive substances (TBARS), von Willebrand factor (vWF), C-reactive protein (CRP), homocysteine, and total nitrate/nitrite concentration — all considered markers of endothelial function — were measured. Carotid IMT was also measured using sonography.

Patients with migraine were found to have higher levels of CRP (P <.001), TBARS (P =.02), vWF (P <.001), and IMT (P <.001) compared with healthy control participants. Systolic arterial blood pressure (P <.01), CRP (P =.004), vWF (P =.023), TBARS (P =.024), and right and left internal carotid artery (ICA) IMT (P =.048) were found to independently correlate with migraine, after adjusting for confounders. The right internal carotid artery IMT was found to be independently associated with ergotamine (P =.013) and triptan (P =.026) and the left internal carotid artery IMT was found to correlate with ergotamine (P =.017). Associations between low-density lipoprotein and carotid IMT were also established in participants with migraine (P <.05).

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Study limitations include the small sample size.

Early diagnosis and adequate migraine prophylaxis to reduce migraine attack frequently could prevent the progression of atherosclerosis in young adult [women with migraine],” concluded the study authors.

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Yilmaz Avci A, Akkucuk MH, Torun E, et al. Migraine and subclinical atherosclerosis: endothelial dysfunction biomarkers and carotid intima-media thickness: a case-control study [published online January 15, 2019]. Neurol Sci. doi:10.1007/s10072-019-3710-5