Prevalence and extent of right-to-left shunt in migraine: a survey of 217 Chinese patients
Background Recently, contrast‐enhanced transcranial Doppler (cTCD) studies have shown that right‐to‐left shunt (RLS) may be a risk factor for migraine in Westerners; however, limited data in the literature describes the prevalence of RLS in Chinese patients with migraine. Objective To assess the pre...
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| Published in | European journal of neurology Vol. 19; no. 10; pp. 1367 - 1372 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
Blackwell Publishing Ltd
01.10.2012
John Wiley & Sons, Inc |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1351-5101 1468-1331 1468-1331 |
| DOI | 10.1111/j.1468-1331.2012.03793.x |
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| Abstract | Background
Recently, contrast‐enhanced transcranial Doppler (cTCD) studies have shown that right‐to‐left shunt (RLS) may be a risk factor for migraine in Westerners; however, limited data in the literature describes the prevalence of RLS in Chinese patients with migraine.
Objective
To assess the prevalence of RLS in patients with migraine in China and to evaluate the relationship between the extent of RLS and migraine.
Methods
A total of 217 consecutive patients with a diagnosis of migraine and 100 volunteers were recruited. cTCD was used to assess the prevalence and the extent of RLS in all subjects.
Results
In the migraine group, the rate of positive RLS was 44.2% (96/217), with 23.5% (51/217) of these being large. In the healthy group, 28.0% (28/100) were positive for RLS overall, and 5.0% (5/100) were large (P = 0.006; P < 0.001). In patients having migraines with aura (MwA), 66.1% (39/59) were positive for RLS overall, and 37.3% (22/59) were large, which was significantly higher when compared with the healthy group (P < 0.001; P < 0.001); in patients having migraines without aura (MwoA), 36.1% (57/158) were positive for RLS overall, and 18.4% (29/158) were large, which was against significantly higher (P < 0.001; P = 0.003). In the MwoA group, the large RLS rate was also higher than in the healthy group (P = 0.002).
Conclusions
A close correlation has been documented between RLS and migraine, especially MwA, but these relationships exist only when the shunts were large. |
|---|---|
| AbstractList | Background
Recently, contrast‐enhanced transcranial Doppler (cTCD) studies have shown that right‐to‐left shunt (RLS) may be a risk factor for migraine in Westerners; however, limited data in the literature describes the prevalence of RLS in Chinese patients with migraine.
Objective
To assess the prevalence of RLS in patients with migraine in China and to evaluate the relationship between the extent of RLS and migraine.
Methods
A total of 217 consecutive patients with a diagnosis of migraine and 100 volunteers were recruited. cTCD was used to assess the prevalence and the extent of RLS in all subjects.
Results
In the migraine group, the rate of positive RLS was 44.2% (96/217), with 23.5% (51/217) of these being large. In the healthy group, 28.0% (28/100) were positive for RLS overall, and 5.0% (5/100) were large (P = 0.006; P < 0.001). In patients having migraines with aura (MwA), 66.1% (39/59) were positive for RLS overall, and 37.3% (22/59) were large, which was significantly higher when compared with the healthy group (P < 0.001; P < 0.001); in patients having migraines without aura (MwoA), 36.1% (57/158) were positive for RLS overall, and 18.4% (29/158) were large, which was against significantly higher (P < 0.001; P = 0.003). In the MwoA group, the large RLS rate was also higher than in the healthy group (P = 0.002).
Conclusions
A close correlation has been documented between RLS and migraine, especially MwA, but these relationships exist only when the shunts were large. Background Recently, contrast-enhanced transcranial Doppler (cTCD) studies have shown that right-to-left shunt (RLS) may be a risk factor for migraine in Westerners; however, limited data in the literature describes the prevalence of RLS in Chinese patients with migraine. Objective To assess the prevalence of RLS in patients with migraine in China and to evaluate the relationship between the extent of RLS and migraine. Methods A total of 217 consecutive patients with a diagnosis of migraine and 100 volunteers were recruited. cTCD was used to assess the prevalence and the extent of RLS in all subjects. Results In the migraine group, the rate of positive RLS was 44.2% (96/217), with 23.5% (51/217) of these being large. In the healthy group, 28.0% (28/100) were positive for RLS overall, and 5.0% (5/100) were large (P = 0.006; P < 0.001). In patients having migraines with aura (MwA), 66.1% (39/59) were positive for RLS overall, and 37.3% (22/59) were large, which was significantly higher when compared with the healthy group (P < 0.001; P < 0.001); in patients having migraines without aura (MwoA), 36.1% (57/158) were positive for RLS overall, and 18.4% (29/158) were large, which was against significantly higher (P < 0.001; P = 0.003). In the MwoA group, the large RLS rate was also higher than in the healthy group (P = 0.002). Conclusions A close correlation has been documented between RLS and migraine, especially MwA, but these relationships exist only when the shunts were large. [PUBLICATION ABSTRACT] Recently, contrast-enhanced transcranial Doppler (cTCD) studies have shown that right-to-left shunt (RLS) may be a risk factor for migraine in Westerners; however, limited data in the literature describes the prevalence of RLS in Chinese patients with migraine.BACKGROUNDRecently, contrast-enhanced transcranial Doppler (cTCD) studies have shown that right-to-left shunt (RLS) may be a risk factor for migraine in Westerners; however, limited data in the literature describes the prevalence of RLS in Chinese patients with migraine.To assess the prevalence of RLS in patients with migraine in China and to evaluate the relationship between the extent of RLS and migraine.OBJECTIVETo assess the prevalence of RLS in patients with migraine in China and to evaluate the relationship between the extent of RLS and migraine.A total of 217 consecutive patients with a diagnosis of migraine and 100 volunteers were recruited. cTCD was used to assess the prevalence and the extent of RLS in all subjects.METHODSA total of 217 consecutive patients with a diagnosis of migraine and 100 volunteers were recruited. cTCD was used to assess the prevalence and the extent of RLS in all subjects.In the migraine group, the rate of positive RLS was 44.2% (96/217), with 23.5% (51/217) of these being large. In the healthy group, 28.0% (28/100) were positive for RLS overall, and 5.0% (5/100) were large (P = 0.006; P < 0.001). In patients having migraines with aura (MwA), 66.1% (39/59) were positive for RLS overall, and 37.3% (22/59) were large, which was significantly higher when compared with the healthy group (P < 0.001; P < 0.001); in patients having migraines without aura (MwoA), 36.1% (57/158) were positive for RLS overall, and 18.4% (29/158) were large, which was against significantly higher (P < 0.001; P = 0.003). In the MwoA group, the large RLS rate was also higher than in the healthy group (P = 0.002).RESULTSIn the migraine group, the rate of positive RLS was 44.2% (96/217), with 23.5% (51/217) of these being large. In the healthy group, 28.0% (28/100) were positive for RLS overall, and 5.0% (5/100) were large (P = 0.006; P < 0.001). In patients having migraines with aura (MwA), 66.1% (39/59) were positive for RLS overall, and 37.3% (22/59) were large, which was significantly higher when compared with the healthy group (P < 0.001; P < 0.001); in patients having migraines without aura (MwoA), 36.1% (57/158) were positive for RLS overall, and 18.4% (29/158) were large, which was against significantly higher (P < 0.001; P = 0.003). In the MwoA group, the large RLS rate was also higher than in the healthy group (P = 0.002).A close correlation has been documented between RLS and migraine, especially MwA, but these relationships exist only when the shunts were large.CONCLUSIONSA close correlation has been documented between RLS and migraine, especially MwA, but these relationships exist only when the shunts were large. Recently, contrast-enhanced transcranial Doppler (cTCD) studies have shown that right-to-left shunt (RLS) may be a risk factor for migraine in Westerners; however, limited data in the literature describes the prevalence of RLS in Chinese patients with migraine. To assess the prevalence of RLS in patients with migraine in China and to evaluate the relationship between the extent of RLS and migraine. A total of 217 consecutive patients with a diagnosis of migraine and 100 volunteers were recruited. cTCD was used to assess the prevalence and the extent of RLS in all subjects. In the migraine group, the rate of positive RLS was 44.2% (96/217), with 23.5% (51/217) of these being large. In the healthy group, 28.0% (28/100) were positive for RLS overall, and 5.0% (5/100) were large (P = 0.006; P < 0.001). In patients having migraines with aura (MwA), 66.1% (39/59) were positive for RLS overall, and 37.3% (22/59) were large, which was significantly higher when compared with the healthy group (P < 0.001; P < 0.001); in patients having migraines without aura (MwoA), 36.1% (57/158) were positive for RLS overall, and 18.4% (29/158) were large, which was against significantly higher (P < 0.001; P = 0.003). In the MwoA group, the large RLS rate was also higher than in the healthy group (P = 0.002). A close correlation has been documented between RLS and migraine, especially MwA, but these relationships exist only when the shunts were large. Recently, contrast-enhanced transcranial Doppler (cTCD) studies have shown that right-to-left shunt (RLS) may be a risk factor for migraine in Westerners; however, limited data in the literature describes the prevalence of RLS in Chinese patients with migraine. To assess the prevalence of RLS in patients with migraine in China and to evaluate the relationship between the extent of RLS and migraine. A total of 217 consecutive patients with a diagnosis of migraine and 100 volunteers were recruited. cTCD was used to assess the prevalence and the extent of RLS in all subjects. In the migraine group, the rate of positive RLS was 44.2% (96/217), with 23.5% (51/217) of these being large. In the healthy group, 28.0% (28/100) were positive for RLS overall, and 5.0% (5/100) were large (P=0.006; P<0.001). In patients having migraines with aura (MwA), 66.1% (39/59) were positive for RLS overall, and 37.3% (22/59) were large, which was significantly higher when compared with the healthy group (P<0.001; P<0.001); in patients having migraines without aura (MwoA), 36.1% (57/158) were positive for RLS overall, and 18.4% (29/158) were large, which was against significantly higher (P<0.001; P=0.003). In the MwoA group, the large RLS rate was also higher than in the healthy group (P =0.002). A close correlation has been documented between RLS and migraine, especially MwA, but these relationships exist only when the shunts were large. |
| Author | Yang, Y. Jin, H. Xing, Y. Guo, Z.-N. Wang, X. Xu, J. Wu, J. Feng, J. |
| Author_xml | – sequence: 1 givenname: Y. surname: Yang fullname: Yang, Y. organization: Department of Neurology, The First Norman Bethune Hospital of Jilin University, Chang Chun, China – sequence: 2 givenname: Z.-N. surname: Guo fullname: Guo, Z.-N. organization: Center for Neurovascular Ultrasound, The First Norman Bethune Hospital of Jilin University, Chang Chun, China – sequence: 3 givenname: J. surname: Wu fullname: Wu, J. organization: Department of Neurology, The First Norman Bethune Hospital of Jilin University, Chang Chun, China – sequence: 4 givenname: H. surname: Jin fullname: Jin, H. organization: Department of Neurology, The First Norman Bethune Hospital of Jilin University, Chang Chun, China – sequence: 5 givenname: X. surname: Wang fullname: Wang, X. organization: Department of Electrodiagnosis, The First Norman Bethune Hospital of Jilin University, Chang Chun, China – sequence: 6 givenname: J. surname: Xu fullname: Xu, J. organization: Department of Electrodiagnosis, The First Norman Bethune Hospital of Jilin University, Chang Chun, China – sequence: 7 givenname: J. surname: Feng fullname: Feng, J. organization: Department of Neurology, The First Norman Bethune Hospital of Jilin University, Chang Chun, China – sequence: 8 givenname: Y. surname: Xing fullname: Xing, Y. email: xingyq@sina.com organization: Department of Neurology, The First Norman Bethune Hospital of Jilin University, Chang Chun, China |
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| References_xml | – reference: Henry P , Auray JP , Gaudin AF , et al. Prevalence and clinical characteristics of migraine in France. Neurology 2002; 59: 232-237. – reference: Anzola GP , Frisoni GB , Morandi E , Casilli F , Onorato E . Shunt-associated migraine responds favorably to atrial septal repair: a case-control study. Stroke 2006; 37: 430-434. – reference: Lange MC , Zétola VF , Piovesan ÉJ , Werneck LC . Saline versus saline with blood as a contrast agent for right-to-left shunt diagnosis by transcranial Doppler: is there a significant difference? J Neuroimaging 2012; 22: 17-20. – reference: Gori S , Morelli N , Fanucchi S , et al. The extent of right-to-left shunt fails to correlate with severity of clinical picture in migraine with aura. Neurol Sci 2006; 27: 14-17. – reference: Anzola GP , Magoni M , Guindani M , Rozzini L , Dalla Volta G . Potential source of cerebral embolism in migraine with aura: a transcranial Doppler study. 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Migraine, patent foramen ovale and migraine triggers. J Headache Pain 2007; 8: 7-12. – reference: Anzola GP , Morandi E , Casilli F , Onorato E . Different degrees of right-to-left shunting predict migraine and stroke: data from 420 patients. Neurology 2006; 66: 765-767. – reference: Del Sette M , Angeli S , Leandri M , et al. Migraine with aura and right-to-left shunt on transcranial Doppler: a case-control study. Cerebrovasc Dis 1998; 8: 327-330. – reference: Schwerzmann M , Nedeltchev K , Lagger F , et al. Prevalence and size of directly detected patent foramen ovale in migraine with aura. Neurology 2005; 65: 1415-1418. – reference: Jesurum JT , Fuller CJ , Renz J , Krabill KA , Spencer MP , Reisman M . Diagnosis of secondary source of right-to-left shunt with balloon occlusion of patent foramen ovale and power M-mode transcranial Doppler. JACC Cardiovasc Interv 2009; 2: 561-567. – reference: Sharma A , Gheewala N , Silver P . 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Potential faces of patent foramen ovale (PFO PFO) publication-title: Echocardiography – volume: 24 start-page: 9 issue: Suppl. 1 year: 2004 end-page: 160 article-title: The international classification of headache disorders: 2nd edition publication-title: Cephalalgia – volume: 27 start-page: 14 year: 2006 end-page: 17 article-title: The extent of right‐to‐left shunt fails to correlate with severity of clinical picture in migraine with aura publication-title: Neurol Sci – volume: 29 start-page: 1322 year: 1998 end-page: 1328 article-title: The need to quantify right‐to‐left shunt in acute ischemic stroke: a case‐control study publication-title: Stroke – volume: 37 start-page: 430 year: 2006 end-page: 434 article-title: Shunt‐associated migraine responds favorably to atrial septal repair: a case‐control study publication-title: Stroke – volume: 10 start-page: 490 year: 2000 end-page: 496 article-title: Detection of right‐to‐left shunt with ultrasound contrast agent and transcranial Doppler sonography publication-title: Cerebrovasc Dis – volume: 14 start-page: 102 year: 1993 end-page: 105 article-title: Preliminary investigation on the epidemiology of migraine in China publication-title: Zhonghua Liu Xing Bing Xue Za Zhi – volume: 65 start-page: 1415 year: 2005 end-page: 1418 article-title: Prevalence and size of directly detected patent foramen ovale in migraine with aura publication-title: Neurology – volume: 75 start-page: 984 year: 2004 end-page: 987 article-title: Platelet‐leukocyte interaction and platelet activation in migraine: a link to ischemic stroke? publication-title: J Neurol Neurosurg Psychiatry – volume: 41 start-page: 646 year: 2001 end-page: 657 article-title: Prevalence and burden of migraine in the United States: data from the American Migraine Study II publication-title: Headache – volume: 30 start-page: S109 issue: Suppl. 1 year: 2009 end-page: S111 article-title: Prevalence and characteristics of right‐to‐left shunt in migraine with aura: a survey on 120 Italian patients publication-title: Neurol Sci – volume: 3 start-page: 104 year: 2003 end-page: 108 article-title: Epidemiology of migraine and other types of headache in Asia publication-title: Curr Neurol Neurosci Rep – volume: 68 start-page: 343 year: 2007 end-page: 349 article-title: Migraine prevalence, disease burden, and the need for preventive therapy publication-title: Neurology – volume: 28 start-page: 913 year: 2011 end-page: 917 article-title: Role of patent foramen ovale in migraine etiology and treatment: a review publication-title: Echocardiography – volume: 66 start-page: 765 year: 2006 end-page: 767 article-title: Different degrees of right‐to‐left shunting predict migraine and stroke: data from 420 patients publication-title: Neurology – volume: 52 start-page: 1622 year: 1999 end-page: 1625 article-title: Potential source of cerebral embolism in migraine with aura: a transcranial Doppler study publication-title: Neurology – volume: 121 start-page: 1406 year: 2010 end-page: 1412 article-title: Lack of association between migraine headache and patent foramen ovale: results of a case‐control study publication-title: Circulation – volume: 59 start-page: 232 year: 2002 end-page: 237 article-title: Prevalence and clinical characteristics of migraine in France publication-title: Neurology – volume: 8 start-page: 7 year: 2007 end-page: 12 article-title: Migraine, patent foramen ovale and migraine triggers publication-title: J Headache Pain – volume: 74 start-page: 1078 year: 2009 end-page: 1084 article-title: Is a predominant left‐to‐right shunt associated with migraine?: a prospective atrial septal defect closure study publication-title: Catheter Cardiovasc Interv |
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Recently, contrast‐enhanced transcranial Doppler (cTCD) studies have shown that right‐to‐left shunt (RLS) may be a risk factor for migraine in... Recently, contrast-enhanced transcranial Doppler (cTCD) studies have shown that right-to-left shunt (RLS) may be a risk factor for migraine in Westerners;... Background Recently, contrast-enhanced transcranial Doppler (cTCD) studies have shown that right-to-left shunt (RLS) may be a risk factor for migraine in... |
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| SubjectTerms | Adult Asian Continental Ancestry Group China - epidemiology contrast-enhanced transcranial Doppler Data processing Female Foramen Ovale, Patent - complications Foramen Ovale, Patent - epidemiology Headache Humans Male Migraine Migraine Disorders - etiology Migraine Disorders - pathology Prevalence right-to-left shunt Risk factors Shunts Ultrasound |
| Title | Prevalence and extent of right-to-left shunt in migraine: a survey of 217 Chinese patients |
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