chronic migraine and autonomic system

AAN 2013: Chronic migraineurs often present with severe gastric stasis & iInflammation in the enteric autonomic nervous system

  • RSi Communications
  • Mar 16, 2013
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as presented at the American Academy of Neurology 65th Annual Meeting

Presenting at AAN 2013, held March 2013 in San Diego, researchers at the University of Mississippi Medical Center in Jackson, Mississippi, detailed their study of the prevalence of gastric stasis in chronic migraineurs, the association with severity and duration of disorder, and other autonomic comorbidities involving peripheral sensory and motor nervous systems.

They enrolled 29 consecutive gastric motility clinic patients (26 female, 3 male; mean age 40 years; all with chronic migraine were). Baseline gastric emptying times (GET), electromyogram (EMG), intra-operative full thickness gastric biopsy findings, and baseline gastric stasis symptom scores were also recorded via Likert scale and chart reviews.

According to the investigators, the patients’ duration of migraine was an average of 17 years; fourth hour GET was delayed, averaging at 16.22 +/-10.35 (normal fourth hour GET is <10%); the gastric dysmotility symptom of nausea was 3.5 +/-0.66 and vomiting was 2.88 +/-1.66 on a scale of 0-5. They found that inflammatory cells were present in the myenetric plexus: CD4 5.9 +/-4.3; CD8 4.4 +/-4.4, and CD68 6.05 +/-4.1.These cells were not present in healthy controls.

The researchers noted other systemic inflammatory comorbidities: hypothyroidism 6/29, fibromyalgia 3/29, depression 9/29, and endometriosis 2/29. Electromyogram recordings showed sensory abnormalities in upper limbs 6/18, sensory abnormalities in lower limbs 8/18, motor abnormalities in upper limb 6/18, and motor abnormalities in lower limb 7/18.

“Inflammatory enteric nervous system changes are seen in the myenteric plexus of the full thickness gastric tissue along with gastric emptying delays in patients with chronic migraine,” the University of Mississippi researchers concluded.

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