Document Detail


Microemboli may link spreading depression, migraine aura, and patent foramen ovale.
MedLine Citation:
PMID:  20225282     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Patent foramen ovale and pulmonary arteriovenous shunts are associated with serious complications such as cerebral emboli, stroke, and migraine with aura. The pathophysiological mechanisms that link these conditions are unknown. We aimed to establish a mechanism linking microembolization to migraine aura in an experimental animal model.
METHODS: We introduced particulate or air microemboli into the carotid circulation in mice to determine whether transient microvascular occlusion, insufficient to cause infarcts, triggered cortical spreading depression (CSD), a propagating slow depolarization that underlies migraine aura.
RESULTS: Air microemboli reliably triggered CSD without causing infarction. Polystyrene microspheres (10 microm) or cholesterol crystals (<70 microm) triggered CSD in 16 of 28 mice, with 60% of the mice (40% of those with CSD) showing no infarcts or inflammation on detailed histological analysis of serial brain sections. No evidence of injury was detected on magnetic resonance imaging examination (9.4T; T2 weighted) in 14 of 15 selected animals. The occurrence of CSD appeared to be related to the magnitude and duration of flow reduction, with a triggering mechanism that depended on decreased brain perfusion but not sustained tissue damage.
INTERPRETATION: In a mouse model, microemboli triggered CSD, often without causing microinfarction. Paradoxical embolization then may link cardiac and extracardiac right-to-left shunts to migraine aura. If translatable to humans, a subset of migraine auras may belong to a spectrum of hypoperfusion disorders along with transient ischemic attacks and silent infarcts.
Authors:
Ala Nozari; Ergin Dilekoz; Inna Sukhotinsky; Thor Stein; Katharina Eikermann-Haerter; Christina Liu; Yumei Wang; Matthew P Frosch; Christian Waeber; Cenk Ayata; Michael A Moskowitz
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of neurology     Volume:  67     ISSN:  1531-8249     ISO Abbreviation:  Ann. Neurol.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-03-31     Completed Date:  2010-04-16     Revised Date:  2014-09-21    
Medline Journal Info:
Nlm Unique ID:  7707449     Medline TA:  Ann Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  221-9     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Animals
Cerebrovascular Circulation / physiology*
Cortical Spreading Depression / physiology*
Disease Models, Animal
Electroencephalography / methods
Embolism / complications*
Foramen Ovale, Patent / etiology*
Functional Laterality / physiology
Magnetic Resonance Imaging / methods
Mice
Mice, Inbred C57BL
Microcirculation / physiology*
Migraine with Aura / etiology*
Neurologic Examination / methods
Grant Support
ID/Acronym/Agency:
GM07592/GM/NIGMS NIH HHS; NS061505/NS/NINDS NIH HHS; NS35611/NS/NINDS NIH HHS; P01 NS035611-14/NS/NINDS NIH HHS; R01 NS061505/NS/NINDS NIH HHS
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