Abnormal heart rate variability and its application in predicting treatment efficacy in patients with chronic migraine: An exploratory study

Chun Hsiang Chuang, Jhe Yu Li, Jung Tai King, Wei Ta Chen, Shih Pin Chen, Yen Feng Wang, Hung Yu Liu, Fu Jung Hsiao, Li-Ling Pan, Shuu Jiun Wang, Kuan Lin Lai*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Aim: This study aimed to investigate the extent of autonomic nervous system dysfunction in patients with chronic migraine using heart rate variability analysis. In addition, we explored the potential association between heart rate variability and treatment outcomes in patients receiving preventive treatment. Methods: In this cross-sectional and prospective study, we compared heart rate variability profiles in 81 preventive-naïve chronic migraine patients and 58 healthy controls. In addition, treatment responses of patients, who received a 12-week treatment with flunarizine, were assessed in relation to baseline heart rate variability. Results: We observed that chronic migraine patients had a reduced heart rate variability, signifying autonomic dysfunction in comparison to healthy controls. Furthermore, patients presenting normal heart rate variability, characterized by a standard deviation exceeding 30 milliseconds in normal-to-normal RR intervals, experienced a superior response to flunarizine treatment. This improvement was exemplified by a significantly larger reduction in monthly headache days for patients with higher heart rate variability compared to those with lower heart rate variability: −9.7 (5.9) vs. −6.2 (6.0) days (p =.026). Conclusions: Autonomic dysfunction occurs in chronic migraine as evaluated by heart rate variability. A preserved function is associated with a better treatment outcome to flunarizine. Trial registration: Neurologic Signatures of Chronic Pain Disorders, NCT02747940. Registered 22 April 2016, https://clinicaltrials.gov/ct2/show/NCT02747940.

Original languageEnglish
JournalCephalalgia
Volume43
Issue number10
DOIs
StatePublished - Oct 2023

Keywords

  • Chronic migraine
  • electrocardiogram
  • flunarizine
  • heart rate variability
  • monthly headache days

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