Is migraine a mirror of the vessel wall?

Close associations between migraine and the cerebral vascular system are well-known. Further, there is increasing evidence that migraine, and specifically migraine with aura, is linked to impaired endovascular function that is not restricted to cerebral arteries.1,2 In this issue of Neurology ®, Schillaci and colleagues3 extend our knowledge of this association by evaluating the link of migraine with pulse wave velocity and aortic augmentation index among 60 patients with migraine and an equal number of age- and sex-matched controls. Pulse wave velocity and aortic augmentation index are simple indirect measures of arterial rigidity. The speed of the pulse wave increases with increasing rigidity of the arteries. The augmentation index measures the proportion of central pulse pressure that is attributed to the reflected pulse wave from distal aortic bifurcations. These measures are relatively low in younger subjects in whom the artery wall is usually elastic and compliant. The mean age of the participants was 33 years and 17 (28%) patients had migraine with aura. Patients were enrolled from a specialty headache clinic and the controls were selected from healthy staff members or individuals examined for a clinical …