Closure of a patent foramen ovale is associated with a decrease in prevalence of migraine:  A prospective observational study

J.G.L.M. Luermans; M.C. Post; F. Temmerman; V. Thijs; W.J. Schonewille; H.W.T. Plokker; M.J. Suttorp; W.I.H.L. Budts

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Document Details :

Title: Closure of a patent foramen ovale is associated with a decrease in prevalence of migraine
Subtitle: A prospective observational study
Author(s): J.G.L.M. Luermans , M.C. Post , F. Temmerman , V. Thijs , W.J. Schonewille , H.W.T. Plokker , M.J. Suttorp , W.I.H.L. Budts
Journal: Acta Cardiologica
Volume: 63 Issue: 5 Date: 2008
Pages: 571-577
DOI: 10.2143/AC.63.5.2033223

Abstract :
Background — A causal relationship between migraine and a right-to-left shunt, due to a patent foramen ovale (PFO), has been suggested. In mainly retrospective studies, percutaneous closure of a PFO has been associated with a decrease in the prevalence of migraine.
Objective — In this prospective observational study we evaluated whether percutaneous closure of a PFO is associated with a decrease in the prevalence of migraine.
Methods — Between November 2003 and August 2005, we included 92 patients (age > 16 years) who underwent a percutaneous closure of a symptomatic PFO, which was considered to be related to a paradoxical embolism. They received a headache questionnaire before and six months after closure. Two neurologists diagnosed migraine, according to the International Headache Criteria.
Results — Eighty-nine of 92 patients (97%, mean age 51.6 ± 12.3 years, 63 men) completed the questionnaire immediately before PFO closure. The overall prevalence of migraine was 27.0%, for migraine without aura (MA-) 15.7%, and for migraine with aura (MA+) 11.2%. After more than six months of follow-up 84 of 89 patients (94%, mean age 52.1 ± 12.0∞∞years, 60 men) returned the questionnaire. The overall prevalence of migraine in this group decreased from 28.6% to 10.7% (P = 0.001), for MAfrom 16.7% to 8.3% (P = 0.07), and for MA+ from 11.9% to 2.4% (P = 0.02).
Conclusions — Percutaneous PFO closure is related to a decrease in the prevalence of migraine in this prospective observational study. However, randomized placebo controlled trials have to confirm these findings.