Thursday, April 10, 2008

cardiologist, migraineur: no evidence of pfo correlation

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It is important to me to leave no stone unturned in my attempts to find the source of my migraines and possible ways to reduce their impact on my life.

In the process of conducting some online research about patent foramen ovale (PFO), I came across a thoughtful piece by a cardiologist on in which he shares his perspective on the trend of trying to establish a correlation between PFO and migraine disease.

I hope you will find it as enlightening as I did.

Patent Foramen Ovale and Migraine Headache
For years, cardiologists have postulated a cause-and-effect relationship between migraine headaches and patent foramen ovale (PFO). (The foramen ovale is a hole between the right atrium and left atrium that is important during development of the fetus. Normally a flap of tissue closes up the foramen ovale after birth, but in some individuals the flap does not produce complete closure. These individuals are said to have PFO.) Such a relationship would mean that closing a PFO (a procedure that, conveniently and not coincidentally, cardiologists can perform), might benefit patients who have PFOs and migraines. (Read all about PFOs here.)

The supposed association between PFOs and migraines has led several companies to begin developing catheter-based devices for closing PFOs, and to begin funding clinical trials aimed at demonstrating that closing PFOs reduces or cures migraines. On March 3, the journal Circulation published the results of a the first such randomized clinical trial, the MIST trial. The study was entirely negative. Closing PFOs in patients with severe migraines did not affect the headaches in any way.

Many had hoped the MIST trials would give us some definitive answers as to the question of whether there is a correlation between PFO and migraine disease. Regrettably for cardiologists supporting the theory that there is, the evidence does not support this hypothesis.

Related Posts:
Migraine and PFO Research
The Scoop on PFO

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