Jefferson researchers want to learn if heart defect 'at heart' of some migraines

April 20, 2007

PHILADELPHIA-- Researchers of the heart and headaches at Thomas Jefferson University Hospital are combining efforts to determine if a common heart defect may be the cause of some forms of migraine headaches.

Investigators from the Jefferson Heart Institute and the Jefferson Headache Center are enrolling participants in a blinded study to determine if closing a Patent Foramen Ovale (PFO), a small hole or flap that can allow blood to flow between the right and left sides of the heart, can stop migraines. In newborns, the PFO closes at or shortly after birth, but in 20 percent of adults the gap remains open to some degree.

More than 28 million Americans suffer from migraine headaches. Debilitating migraine headaches cause major disruption in individual's lives and cost billions of dollars in lost work, school and medical treatment each year. More than one quarter of the people who struggle with migraines have the heart defect.

Most people who have a PFO are never screened for it because doctors rarely suspect it of causing health problems but new evidence suggests that individuals with PFO are more susceptible to migraine. This susceptibility is believed to be due to the passage of material from the right side of the heart to the left side of the heart via the PFO. Blood and material that travels through the PFO is not filtered or oxygenated and in this form may travel to the brain, which can trigger the changes in the blood vessels that underlies migraine.

"Strokes, for example are sometimes triggered when blood clots passing through the PFO travel to the brain," said one of the study's primary investigators, David Fischman, M.D., Co-Director of the Cardiac Catherization Laboratory at Thomas Jefferson University Hospital, and Associate Professor of Medicine, Jefferson Medical College of Thomas Jefferson University.

"Up until now cardiologists have told us that patients with migraine get better when they have their PFO closed for other reasons," said Stephen Silberstein, M.D., director of the Jefferson Headache Center, the study's other primary investigator.

"We need to be able to prove that closure of a PFO by itself will actually diminish migraines," said Dr. Silberstein, Professor of Neurology, Jefferson.

In this study, participants will be randomly assigned to one of two groups. One group will undergo a minimally-invasive procedure to close their PFO. An interventional cardiologist will insert a catheter into the heart and release a device which will form a seal around the PFO to prevent the incorrect blood flow. Typically, the procedure lasts one to two hours under local anesthesia.

The other group will not have their PFO closed but will undergo a procedure that only mimics the closure and will continue medical therapy for their migraines. But none of the participants will know to which group they have been assigned to. However, all participants will receive the same post-operative care and will leave the hospital within 24 hours.
-end-
To participate in the study, patients must: For more information about the migraine study, please call 1-800-JEFF-NOW or 215-955-2037, or visit www.jeffersonhospital.org.

Thomas Jefferson University

Related Migraine Articles from Brightsurf:

Disparities in migraine by sexual orientation
Survey data were used to examine the association between sexual orientation (exclusively heterosexual, mostly heterosexual, lesbian, gay or bisexual) and migraine.

Can you paint your migraine?
'Can you draw me a picture of your headache?' may sound like an unusual question - but drawings of headache pain provide plastic surgeons with valuable information on which patients are more or less likely to benefit from surgery to alleviate migraine headaches.

Acupuncture can reduce migraine headaches
Acupuncture can reduce migraine headaches compared to both sham (placebo) acupuncture and usual care, finds a new trial from China published by The BMJ today.

Migraine rats, medical facts
Migraine mechanisms are still far from being fully understood. Escalating data from animal models are 'fact-checking' the neurophysiological and behavioral correlates of the migraine experience in humans, and how they may be affected by current anti-migraine drugs or might translate into new therapies.

Connecting the dots in the migraine brain
This dMRI study pointed to the structural strengthening of connections involving subcortical regions associated with pain processing and weakening in connections involving cortical regions associated with hyperexcitability may coexist in migraine.

Predictors of chronic migraine
A review and meta-analysis found predictors of chronic migraine. Depression, high frequency attacks, medication overuse and allodynia increased the chances for new onset chronic migraine, while annual income -- US$ 50,000 showed a protective effect.

On nitroglycerin, cardiovascular homeostasis and...bam, migraine!
Researchers in Leiden, The Netherlands, found an exaggerated cardiovascular response to nitroglycerin infusion in migraine patients, suggesting an elevated systemic sensitivity to this compound in this population.

All roads lead to migraine
Dr. Samaira Younis, from the Danish Headache Center in Copenhagen, Denmark, shares her research results, which suggests there are no differences between migraine attacks clinical characteristics following administration of 2 different compounds in patients, CGRP and sildenafil, meaning they share common cellular signaling pathways.

Running away from exercise: The curious case of migraine
In spite of the widespread recommendation for regular physical activity as a strategy to manage migraine, for some patients, exercise can instead trigger migraine attacks.

Migraine prevention in children and adolescents
Two medicines already used to prevent migraine in adults also showed efficacy in adolescents with migraine.

Read More: Migraine News and Migraine Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.