Patent foramen ovale and migraine: A quantitative systematic review

Research output: Contribution to journalArticle

158 Citations (Scopus)

Abstract

Initial studies indicate an increased prevalence of patent foramen ovale (PFO) in migraineurs with aura, and an increased prevalence of migraine and migraine with aura in persons with PFO. Retrospective analyses of PFO closure suggest clinically significant improvements in migraine patterns. The aim of this study was to examine the prevalence of migraine in patients with PFO, the prevalence of PFO in migraineurs, and the effect of PFO closure on migraine. We conducted a quantitative systematic review of articles on migraine and PFO that met inclusion criteria, then reviewed, appraised, and subjected them to data extraction. Of 134 articles identified, 18 met a priori selection criteria. The estimated strength of association between PFO and migraine, reflected by summary odds ratios (ORs), was 5.13 [95% confidence interval (CI) 4.67, 5.59], and between PFO and migraine with aura the OR was 3.21 (95% CI 2.38, 4.17). The grade of evidence was low. The association between migraine and PFO was OR 2.54 (95% CI 2.01, 3.08). The grade of evidence was low to moderate. Six studies of PFO closure suggested improvement in migraine, but had a very low grade of evidence. The low-to-moderate grade of evidence from observational studies supports an apparent association between PFO and migraine. Although PFO closure seemed to affect migraine patterns favourably, the very low grade of available evidence to support this association precludes definitive conclusions.

Original languageEnglish (US)
Pages (from-to)531-540
Number of pages10
JournalCephalalgia
Volume28
Issue number5
DOIs
StatePublished - May 2008

Fingerprint

Patent Foramen Ovale
Migraine Disorders
Migraine with Aura
Odds Ratio
Confidence Intervals
Patient Selection
Observational Studies
Epilepsy

Keywords

  • Headache disorders
  • Migraine
  • Migraine aura
  • Paradoxical embolism
  • Patent foramen ovale
  • Right-to-left shunt

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Patent foramen ovale and migraine : A quantitative systematic review. / Schwedt, Todd J; Demaerschalk, Bart M; Dodick, David William.

In: Cephalalgia, Vol. 28, No. 5, 05.2008, p. 531-540.

Research output: Contribution to journalArticle

@article{155204c1713d4379b24f9efcd9b9f730,
title = "Patent foramen ovale and migraine: A quantitative systematic review",
abstract = "Initial studies indicate an increased prevalence of patent foramen ovale (PFO) in migraineurs with aura, and an increased prevalence of migraine and migraine with aura in persons with PFO. Retrospective analyses of PFO closure suggest clinically significant improvements in migraine patterns. The aim of this study was to examine the prevalence of migraine in patients with PFO, the prevalence of PFO in migraineurs, and the effect of PFO closure on migraine. We conducted a quantitative systematic review of articles on migraine and PFO that met inclusion criteria, then reviewed, appraised, and subjected them to data extraction. Of 134 articles identified, 18 met a priori selection criteria. The estimated strength of association between PFO and migraine, reflected by summary odds ratios (ORs), was 5.13 [95{\%} confidence interval (CI) 4.67, 5.59], and between PFO and migraine with aura the OR was 3.21 (95{\%} CI 2.38, 4.17). The grade of evidence was low. The association between migraine and PFO was OR 2.54 (95{\%} CI 2.01, 3.08). The grade of evidence was low to moderate. Six studies of PFO closure suggested improvement in migraine, but had a very low grade of evidence. The low-to-moderate grade of evidence from observational studies supports an apparent association between PFO and migraine. Although PFO closure seemed to affect migraine patterns favourably, the very low grade of available evidence to support this association precludes definitive conclusions.",
keywords = "Headache disorders, Migraine, Migraine aura, Paradoxical embolism, Patent foramen ovale, Right-to-left shunt",
author = "Schwedt, {Todd J} and Demaerschalk, {Bart M} and Dodick, {David William}",
year = "2008",
month = "5",
doi = "10.1111/j.1468-2982.2008.01554.x",
language = "English (US)",
volume = "28",
pages = "531--540",
journal = "Cephalalgia",
issn = "0333-1024",
publisher = "SAGE Publications Ltd",
number = "5",

}

TY - JOUR

T1 - Patent foramen ovale and migraine

T2 - A quantitative systematic review

AU - Schwedt, Todd J

AU - Demaerschalk, Bart M

AU - Dodick, David William

PY - 2008/5

Y1 - 2008/5

N2 - Initial studies indicate an increased prevalence of patent foramen ovale (PFO) in migraineurs with aura, and an increased prevalence of migraine and migraine with aura in persons with PFO. Retrospective analyses of PFO closure suggest clinically significant improvements in migraine patterns. The aim of this study was to examine the prevalence of migraine in patients with PFO, the prevalence of PFO in migraineurs, and the effect of PFO closure on migraine. We conducted a quantitative systematic review of articles on migraine and PFO that met inclusion criteria, then reviewed, appraised, and subjected them to data extraction. Of 134 articles identified, 18 met a priori selection criteria. The estimated strength of association between PFO and migraine, reflected by summary odds ratios (ORs), was 5.13 [95% confidence interval (CI) 4.67, 5.59], and between PFO and migraine with aura the OR was 3.21 (95% CI 2.38, 4.17). The grade of evidence was low. The association between migraine and PFO was OR 2.54 (95% CI 2.01, 3.08). The grade of evidence was low to moderate. Six studies of PFO closure suggested improvement in migraine, but had a very low grade of evidence. The low-to-moderate grade of evidence from observational studies supports an apparent association between PFO and migraine. Although PFO closure seemed to affect migraine patterns favourably, the very low grade of available evidence to support this association precludes definitive conclusions.

AB - Initial studies indicate an increased prevalence of patent foramen ovale (PFO) in migraineurs with aura, and an increased prevalence of migraine and migraine with aura in persons with PFO. Retrospective analyses of PFO closure suggest clinically significant improvements in migraine patterns. The aim of this study was to examine the prevalence of migraine in patients with PFO, the prevalence of PFO in migraineurs, and the effect of PFO closure on migraine. We conducted a quantitative systematic review of articles on migraine and PFO that met inclusion criteria, then reviewed, appraised, and subjected them to data extraction. Of 134 articles identified, 18 met a priori selection criteria. The estimated strength of association between PFO and migraine, reflected by summary odds ratios (ORs), was 5.13 [95% confidence interval (CI) 4.67, 5.59], and between PFO and migraine with aura the OR was 3.21 (95% CI 2.38, 4.17). The grade of evidence was low. The association between migraine and PFO was OR 2.54 (95% CI 2.01, 3.08). The grade of evidence was low to moderate. Six studies of PFO closure suggested improvement in migraine, but had a very low grade of evidence. The low-to-moderate grade of evidence from observational studies supports an apparent association between PFO and migraine. Although PFO closure seemed to affect migraine patterns favourably, the very low grade of available evidence to support this association precludes definitive conclusions.

KW - Headache disorders

KW - Migraine

KW - Migraine aura

KW - Paradoxical embolism

KW - Patent foramen ovale

KW - Right-to-left shunt

UR - http://www.scopus.com/inward/record.url?scp=41849098159&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=41849098159&partnerID=8YFLogxK

U2 - 10.1111/j.1468-2982.2008.01554.x

DO - 10.1111/j.1468-2982.2008.01554.x

M3 - Article

C2 - 18355348

AN - SCOPUS:41849098159

VL - 28

SP - 531

EP - 540

JO - Cephalalgia

JF - Cephalalgia

SN - 0333-1024

IS - 5

ER -