Changes in cerebral autoregulation, stroke‐related blood biomarkers, and autonomic regulation after patent foramen ovale closure in severe migraine patients

AIMS: This study aimed to investigate changes in dynamic cerebral autoregulation (dCA), 20 stroke‐related blood biomarkers, and autonomic regulation after patent foramen ovale (PFO) closure in severe migraine patients. METHODS: Patent foramen ovale severe migraine patients, matched non‐PFO severe migraine patients, and healthy controls were included. dCA and autonomic regulation were evaluated in each participant at baseline, and within 48‐h and 30 days after closure in PFO migraineurs. A panel of stroke‐related blood biomarkers was detected pre‐surgically in arterial‐and venous blood, and post‐surgically in the arterial blood in PFO migraineurs. RESULTS: Forty‐five PFO severe migraine patients, 50 non‐PFO severe migraine patients, and 50 controls were enrolled. The baseline dCA function of PFO migraineurs was significantly lower than that of non‐PFO migraineurs and controls but was rapidly improved with PFO closure, remaining stable at 1‐month follow‐up. Arterial blood platelet‐derived growth factor‐BB (PDGF‐BB) levels were higher in PFO migraineurs than in controls, which was immediately and significantly reduced after closure. No differences in autonomic regulation were observed among the three groups. CONCLUSION: Patent foramen ovale closure can improve dCA and alter elevated arterial PDGF‐BB levels in migraine patients with PFO, both of which may be related to the preventive effect of PFO closure on stroke occurrence/recurrence.