Tong Qiuling, Yao Yu, Xia Yanhuo, Chen Zhibo, Ji Gangze, Chen Liuzhu, Jin Rujun, Dong Wanli
Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.
Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.
Int J Gen Med. 2023 Aug 21;16:3645-3654. doi: 10.2147/IJGM.S423296. eCollection 2023.
To investigate the influence of patent foramen ovale (PFO) on the clinical features of migraine without aura (MoA).
We consecutively enrolled 390 MoA patients and compared the frequency of headache, episode duration, and the Visual Analogue Scale (VAS), Headache Impact Test 6 (HIT-6), and European Health Interview Survey-Quality of Life 8-item index (EUROHIS-QOL8) scores of patients with and without PFO, those with the mild right-to-left shunt (RLS) and moderate to large RLS, and those with permanent RLS and latent RLS using a nonparametric Mann-Whitney -test. In addition, we analyzed the clinical features of migraine in 39 MoA patients before and after PFO closure treatment using the paired Wilcoxon test.
The prevalence of PFO in the 390 MoA patients was 44.4%. Patients with PFO had significantly higher frequency of headaches, VAS scores, HIT-6 scores, and incidence of white matter lesions than those without PFO (all < 0.05). Patients with moderate to large RLS had significantly higher VAS scores than those with mild RLS ( = 0.002). Additionally, 39 MoA patients underwent PFO closure, which remarkably decreased their frequency of headache, episode duration, VAS scores, and HIT-6 scores, and increased their EUROHIS-QOL8 scores.
The migraine features in MoA patients could be influenced by PFO, especially in patients with moderate to large shunt, in whom PFO closure improved the symptoms.
探讨卵圆孔未闭（PFO）对无先兆偏头痛（MoA）临床特征的影响。
我们连续纳入了390例MoA患者，采用非参数曼-惠特尼检验比较有无PFO、轻度右向左分流（RLS）与中至大量RLS、永久性RLS与潜在性RLS患者的头痛频率、发作持续时间、视觉模拟量表（VAS）评分、头痛影响测试6（HIT-6）评分以及欧洲健康访谈调查-生活质量8项指标（EUROHIS-QOL8）评分。此外，我们采用配对威尔科克森检验分析了39例MoA患者在PFO封堵治疗前后的偏头痛临床特征。
390例MoA患者中PFO的患病率为44.4%。与无PFO的患者相比，有PFO的患者头痛频率、VAS评分、HIT-6评分及白质病变发生率显著更高（均P<0.05）。中至大量RLS的患者VAS评分显著高于轻度RLS的患者（P=0.002）。另外，39例MoA患者接受了PFO封堵，这显著降低了他们的头痛频率、发作持续时间、VAS评分和HIT-6评分，并提高了他们的EUROHIS-QOL8评分。
MoA患者的偏头痛特征可能受PFO影响，尤其是在中至大量分流的患者中，PFO封堵可改善症状。
