Mitral valve prolapse and abnormalities of haemostasis in children and adolescents with migraine with aura and other idiopathic headaches: A pilot study

C. Termine, R. Trotti, P. Ondei, G. Gamba, N. Montani, A. Gamba, M. De Simone, E. Marni, U. Balottin

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective - To investigate the prevalence of mitral valve prolapse (MVP) and abnormalities of haemostasis in children and adolescents with migraine with aura (MA) compared with peers affected by other idiopathic headaches. Materials and methods - We recruited 20 MA patients (10 men and 10 women; age range 8-17 years) and 20 sex- and age-matched subjects with other idiopathic headaches. Both groups underwent colour Doppler transthoracic echocardiography to detect MVP and the following laboratory work-up: plasma prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen, protein C, protein S, homocysteine, lupus anticoagulant, von Willebrand factor (vWF) ristocetin cofactor activity, immunoglobulins (Ig) G and M anticardiolipin antibodies (aCL). Factor V Leiden, factor II and methylenetetrahydrofolate reductase were investigated (we did not test the entire genes, but screened for specific point mutations). Results - The prevalence of MVP was significantly higher in the MA subjects than in the patients affected by other idiopathic headaches (40% vs 10%; P <0.05). Moreover, the MA patients showed a higher rate of above-normal IgM aCL titres (45% vs 10%; P <0.05). Finally, in the group of patients with MVP we found a higher prevalence of aCL in those with MA compared with those affected by other idiopathic headaches. Conclusions - A proportion, at least, of the MA patients showed a more complex phenotype characterized by MVP and/or positive aCL titres. The pathogenetic role of these associations is obscure and larger studies are needed to confirm the usefulness of echocardiographic and laboratory investigations in this area and to identify possible new treatment approaches that might be explored in this group of MA patients.

Original languageEnglish
Pages (from-to)91-96
Number of pages6
JournalActa Neurologica Scandinavica
Volume122
Issue number2
DOIs
Publication statusPublished - Aug 2010

Fingerprint

Migraine with Aura
Tension-Type Headache
Mitral Valve Prolapse
Hemostasis
Anticardiolipin Antibodies
von Willebrand Factor
Immunoglobulin M
Thrombin Time
Methylenetetrahydrofolate Reductase (NADPH2)
Lupus Coagulation Inhibitor
Partial Thromboplastin Time
Doppler Echocardiography
Protein S
Prothrombin Time
Prothrombin
Homocysteine
Protein C
Point Mutation
Fibrinogen
Echocardiography

Keywords

  • haemostasis
  • migraine with aura
  • mitral valve prolapse

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Mitral valve prolapse and abnormalities of haemostasis in children and adolescents with migraine with aura and other idiopathic headaches : A pilot study. / Termine, C.; Trotti, R.; Ondei, P.; Gamba, G.; Montani, N.; Gamba, A.; De Simone, M.; Marni, E.; Balottin, U.

In: Acta Neurologica Scandinavica, Vol. 122, No. 2, 08.2010, p. 91-96.

Research output: Contribution to journalArticle

Termine, C. ; Trotti, R. ; Ondei, P. ; Gamba, G. ; Montani, N. ; Gamba, A. ; De Simone, M. ; Marni, E. ; Balottin, U. / Mitral valve prolapse and abnormalities of haemostasis in children and adolescents with migraine with aura and other idiopathic headaches : A pilot study. In: Acta Neurologica Scandinavica. 2010 ; Vol. 122, No. 2. pp. 91-96.
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AU - Gamba, G.

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AU - De Simone, M.

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AB - Objective - To investigate the prevalence of mitral valve prolapse (MVP) and abnormalities of haemostasis in children and adolescents with migraine with aura (MA) compared with peers affected by other idiopathic headaches. Materials and methods - We recruited 20 MA patients (10 men and 10 women; age range 8-17 years) and 20 sex- and age-matched subjects with other idiopathic headaches. Both groups underwent colour Doppler transthoracic echocardiography to detect MVP and the following laboratory work-up: plasma prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen, protein C, protein S, homocysteine, lupus anticoagulant, von Willebrand factor (vWF) ristocetin cofactor activity, immunoglobulins (Ig) G and M anticardiolipin antibodies (aCL). Factor V Leiden, factor II and methylenetetrahydrofolate reductase were investigated (we did not test the entire genes, but screened for specific point mutations). Results - The prevalence of MVP was significantly higher in the MA subjects than in the patients affected by other idiopathic headaches (40% vs 10%; P <0.05). Moreover, the MA patients showed a higher rate of above-normal IgM aCL titres (45% vs 10%; P <0.05). Finally, in the group of patients with MVP we found a higher prevalence of aCL in those with MA compared with those affected by other idiopathic headaches. Conclusions - A proportion, at least, of the MA patients showed a more complex phenotype characterized by MVP and/or positive aCL titres. The pathogenetic role of these associations is obscure and larger studies are needed to confirm the usefulness of echocardiographic and laboratory investigations in this area and to identify possible new treatment approaches that might be explored in this group of MA patients.

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