Multimodal visual functions and cerebrovascular reactivity in migraine patients between attacks

Abstract

Background: Migraineurs had significantly interictal altered visual field and contrast sensitivity (CS) and it has long been thought that these field changes are related to vascular cortical origin. Objective: To investigate the relationship between visual functions and cerebral flow velocities and vasoreactivity in migraineurs between attacks. Methods: The study included 27 migraineurs (23 females and 4 males). Fourteen patients (51.9%) had migraine without aura (MO) and 13 (48.1%) had migraine with aura (MA). Patients are age and sex matched to 14 healthy volunteers. Subjects underwent migraine severity grading by migraine disability assessment score (MIDAS); transcranial Doppler sonography (TCD) with vasoreactivity testing for MCA and PCA; Pattern Reversal Visual Evoked Potential.(PRVEP); CS and visual field study using standard and short wave-length automated perimetry (SAP and SWAP). Results: Compared to controls, patients had significantly impaired response of MCA to HV (P=0.018) and a highly significant lower vasoreactivity index (P=0.0014), prolonged mean P100 latency, lower P100 amplitude (P < 0.05) and lower CS (P < 0.01). SAP and SWAP detected field deficits in patients (63% and 74% respectively); bilateral minimal criteria of glaucomatous damage (37% and 40.7% respectively) and unilateral changes (26% and 33.3% respectively). There was significant negative correlation between VEP P100 latency, and mean MCA flow velocity, mean MCA flow velocity after HV and percentage of vasoreactivity. Conclusion: Migraineurs had significant interictal changes of visual field, contrast function, VEP and cerebrovascular reactivity suggesting that visual function deficits and migraine may share a common vascular etiology.