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allied
academies
Volume 2
June 11-13, 2018 | London, UK
Neurology and Neuroscience
6
th
International Conference on
Assessment of autonomic function during Ictal and Interictal Period of Migraine
Abhinav Singh Verma
All India Institute of Medical Sciences, India
Background:
Studies suggest adegreeof autonomicdysfunction
which gets implicated in pathophysiology of migraine, but
none has ever commented on differences among ictal and
interictal (headache free) period of migraine. Therefore,
this study aims at assessing and comparing autonomic
dysfunction during ictal and interictal period of migraine.
Methodology:
Patients with migraine according to ICHD 3rd
edition β version criteria were recruited for the study. Tests of
sympathetic function (beat to beat blood pressure changes in
Head-Up-Tilt test) and parasympathetic function (heart rate
responses to Deep Breathing and Valsalva Manoeuvre) were
performed, each during ictal and interictal period. The results of
theictalperiodwerethencomparedwiththatofinterictalperiod.
Results:
Ten patients [Eight female (80%), 20-58 years,
mean 34.6] were studied. Nine patients (90%) showed
Expiration: Inspiration [E:I] ratio {Ratio of maximum RR
interval during expiration phase with minimum RR interval
during inspiration phase} in Deep Breathing test below
1.24 (p=0.008) and four patients (40%) showed 30:15 ratio
{Ratio of RR interval during 30th heart beat with that during
15
th
heart beat} in Head-Up-Tilt test below 1.04 (p=0.045),
thus indicating significantly impaired vagal response. These
results were in ictal period. All patients exhibited normal
parasympathetic response during interictal period and intact
sympathetic function during both ictal and interictal periods.
Conclusion:
There is significant parasympathetic dysfunction
in ictal state as compared to headache-free periods.
Parasympathetic dysfunction is observed in E:I ratio (p=0.008),
ΔHR (p=0.014), 30:15 ratio (p=0.045). There is no objective
evidence of sympathetic dysfunction in ictal period as
compared to headache-free periods. Therefore, this study
provides newer insight into the pathophysiology of a migraine
attack- the genesis of the ictal state, which is attributed to
parasympathetic dysfunction.
Speaker Biography
Abhinav Singh Verma has completed his MBBS from the premier institute, All India
Institute of Medical Sciences (AIIMS), New Delhi. He is an ICMR award winning
researcher and active researcher in the department of Neurology at AIIMS, New Delhi.
e:
abhinavsinghverma@gmail.com