Why the study?
Autonomic nervous system testing has aided in evaluating autonomic dysfunction in migraine patients, prompting a review of literature investigating autonomic function in migraine patients versus healthy subjects.
Do migraine patients exhibit altered autonomic nervous system function compared to healthy controls?
Do migraine patients exhibit altered autonomic nervous system function compared to healthy controls?
Migraine patients demonstrate interictal autonomic nervous system dysfunction compared to healthy controls, suggesting a need to evaluate ANS function, especially when using migraine-specific prophylactic therapies.
Migraine patients warrant ANS evaluation before prophylaxis; confirms interictal dysfunction and extends evidence for targeted monitoring.
BACKGROUND: Autonomic nervous system (ANS) testing has aided in our ability to evaluate autonomic dysfunction in migraine patients. We reviewed the literature in multiple databases which investigate ANS function in migraine patients and healthy subjects. METHODS: This systematic review and meta-analysis examined the respective deep breathing, Valsalva manoeuvre, orthostatic and isometric challenge results, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analyses of Observational Studies in Epidemiology (MOOSE) statements. RESULTS: Seven articles met all inclusion criteria. Fixed-effects meta-analysis showed migraine patients (n = 424), collectively, had lower interictal autonomic test results compared with healthy controls (n = 268). In detail, this was true for the standardized mean difference (g) of deep breathing (g= -0.32; 95% confidence interval (CI) -0.48, -0.16), orthostatic challenge (g= -0.28; 95% CI -0.44, -0.13) and isometric challenge (g= -0.55; 95% CI -0.71, -0.39) and for the difference of means (MD) of the Valsalva ratio (MD = -0.17; 95% CI -0.23, -0.10). CONCLUSIONS: Interictal ANS dysfunction can be identified in migraine patients when compared to healthy controls. These findings indicate the importance to evaluate ANS function in migraine patients - especially, as migraine-specific prophylactic therapies (such as anti-calcitonin gene-related peptide (CGRP) antibodies) may affect the function of the ANS.
No takes yet. Share an insight, caveat, or question.
Pavelić et al. (2024) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: