Endothelial dysfunction state in migraine headache and neutrally mediated syncope in children and young adults

Abstract

Background: Recent evidences have supported migraine headache and neurally mediated syncope as the especial types of endotheliopathies. To determine endothelial function in patients with migraine headache or those with neurally mediated syncope,the present study was conducted. Materials and Methods: This cross-sectional study was performed on 93 consecutive patients aged 5-20 years in four groups; neurally mediated syncope, migraine, both neurally mediated syncope and migraine, and control groups. All subjects were tested for basic biophysical and biochemical features including age, gender, body mass index, systolic, and diastolic blood pressures, intima-media thickness (IMT) and flow-mediated dilation (FMD) , blood hemoglobin, fasting blood glucose, lipid profile, intercellular adhesion molecule (ICAM), vascular cell adhesion molecule (VCAM), and E-selectin. Results: The mean levels of VCAM and ICAM were significantly higher in all groups when compared to control group (P < 0.05). FMD was significantly higher in syncope, migraine, and syncope and migraine groups than in the control group (P < 0.05). Furthermore, mean IMT was significantly lower in migraine and also in syncope and migraine groups than in syncope group and control group (P <0.05). Examining the association between IMT and other baseline parameters showed positive association of IMT with systolic and diastolic blood pressures. Conclusion: Endothelial dysfunction is seen in both migraine headache and neurally mediated syncope.Changes in endothelial functional indices are also dependent on the blood pressure.

Key words: Endothelial function, flow-mediated dilation, intima-media thickness, migraine headache, syncope