Heart rate variability in women with migraine: a cross-sectional pilotstudy
DOI:
https://doi.org/10.48208/HeadacheMed.2026.7Keywords:
Migraine, Autonomic Nervous System, Variability, Heart rateAbstract
Introduction
Migraine, a neurological disorder highly prevalent among women, affects the autonomic nervous system, which regulates heart rate. Heart rate regulation is assessed through HRV.
Objective
To assess reduced HRV in women with migraine during the interictal period.
Methods
This cross-sectional study included 45 female volunteers aged 20 to 50 years (24 ± 5 SD). Participants were divided into a Migraine Group (MG, n= 35; 25 ± 5 SD) and a Control Group (CG, n = 10; 21 ±2 SD), according to the ID Migraine Questionnaire criteria. HRV variables analyzed included standard deviation of the average N–N interval (SDNN), square root of the mean squared differences of successive N–N intervals (RMSSD), proportion derived by dividing NN50 by the total number of N–N intervals (pNN50), low frequency (LF), high frequency (HF), and LF/HF. Statistical was performed using Jamovi, applying Student’s t-tests and Mann–Whitney tests.
Results
For MG and CG, respectively: SDNN 35.7 ± 11.7 ms vs. 33.0 ± 11.6 ms (P = 0.523); RMSSD 29.9 ± 14.5 ms vs. 28.0±12.8 ms (P = 0.743); pNN50 11.2 ± 12.3% vs. 8.85 ± 10.8% (P = 0.583); LF 730 ± 502 ms² vs. 720 ± 454 ms² (P = 0.968); HF 547 ± 524 ms² vs. 442 ± 357 ms² (P= 0.555); LF/HF 2.32 ± 2.48 vs. 2.11 ± 1.23 (P = 0.527).
Conclusion
Both groups exhibited reduced HRV with increased sympathetic activity; however, no statistically significant differences were observed between groups.
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References
1. Aguilar-Shea AL, Membrilla MD JA, Diaz-de-Teran J. Migraine review for general practice. Aten Primaria 2022;54:1–8. Doi:10.1016/j.aprim.2021.102208.
2. Gribbin CL, Dani KA, Tyagi A. Chronic Migraine. Neurol India 2021;69:S67–75. Doi:10.4103/0028-3886.315972.
3. Deng Y, Wang HH, Ngai FW, Zhang D, Qin J, Chen X, et al. Associations of combined lifestyle index with migraine prevalence and headache frequency: a cross-sectional study from the MECH-HK study. J Headache Pain 2024;25:1–14. Doi:10.1186/s10194-024-01729-y.
4. Comitê de Classificação das Cefaleias da Sociedade Internacional de Cefaleia. Classificação Internacional das Cefaleias. 3rd ed. São Paulo: Omnifarma; 2018.
5. Puledda F, Silva EM, Suwanlaong K, Goadsby PJ. Migraine: from pathophysiology to treatment. J Neurol 2023;270:3654–66. Doi:10.1007/s00415-023-11706-1.
6. Chen S-T, Wu J-W. A new era for migraine: The role of calcitonin gene-related peptide in the trigeminovascular system. Update on Emerging Treatments for Migraine, vol. 255, Elsevier; 2020, p. 123–42. Doi:10.1016/bs.pbr.2020.05.012.
7. Bandeira PM, Reis FJJ, Sequeira VCC, Chaves ACS, Fernandes O, Arruda-Sanchez T. Heart rate variability in patients with low back pain: a systematic review. Scand J Pain 2021;21:426–33. Doi:10.1515/sjpain-2021-0006.
8. Koenig J, Williams DP, Kemp AH, Thayer JF. Vagally mediated heart rate variability in headache patients—a systematic review and meta-analysis. Cephalalgia 2016;36:265–78. Doi:10.1177/0333102415583989.
9. Zhang L, Qiu S, Zhao C, Wang P, Yu S. Heart Rate Variability Analysis in Episodic Migraine: A Cross-Sectional Study. Front Neurol 2021;12:1–9. Doi:10.3389/fneur.2021.647092.
10. Cygankiewicz I, Zareba W. Heart rate variability. In: Buijs RM, Swaab DF, editors. Autonomic Nervous System, vol. 117, Elsevier; 2013, p. 379–93. Doi:10.1016/B978-0-444-53491-0.00031-6.
11. Kim S-W, Park H-Y, Jung W-S, Lim K. Predicting Heart Rate Variability Parameters in Healthy Korean Adults: A Preliminary Study. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2021;58:1–10. Doi:10.1177/00469580211056201.
12. Arakaki X, Arechavala RJ, Choy EH, Bautista J, Bliss B, Molloy C, et al. The connection between heart rate variability (HRV), neurological health, and cognition: A literature review. Front Neurosci 2023;17:1–10. Doi:10.3389/fnins.2023.1055445.
13. Machado Â, Haertel LM. Neuroanatomia funcional. 3rd ed. Atheneu; 2013.
14. Li L, Wang D, Pan H, Huang L, Sun X, He C, et al. Non-invasive Vagus Nerve Stimulation in Cerebral Stroke: Current Status and Future Perspectives. Front Neurosci 2022;16:1–13. Doi:10.3389/fnins.2022.820665.
15. Butt MF, Albusoda A, Farmer AD, Aziz Q. The anatomical basis for transcutaneous auricular vagus nerve stimulation. J Anat 2020;236:588–611. Doi:10.1111/joa.13122.
16. Catai AM, Pastre CM, Godoy MF de, Silva E da, Takahashi AC de M, Vanderlei LCM. Heart rate variability: are you using it properly? Standardisation checklist of procedures. Braz J Phys Ther 2020;24:91–102. Doi:10.1016/j.bjpt.2019.02.006.
17. Mattos ACMT de, Souza JA de, Moreira Filho PF, Jurno ME, Velarde LGC. ID-MigraineTM questionnaire and accurate diagnosis of migraine. Arq Neuropsiquiatr 2017;75:446–50. Doi:10.1590/0004-282x20170069.
18. Vila XA, Lado MJ, Cuesta-Morales P. Evidence Based Recommendations for Designing Heart Rate Variability Studies. J Med Syst 2019;43:1–10. Doi:10.1007/s10916-019-1437-8.
19. Tiwari R, Kumar R, Malik S, Raj T, Kumar P. Analysis of Heart Rate Variability and Implication of Different Factors on Heart Rate Variability. Curr Cardiol Rev 2021;17:1–10. Doi:10.2174/1573403X16999201231203854.
20. Voss A, Schroeder R, Heitmann A, Peters A, Perz S. Short-Term Heart Rate Variability—Influence of Gender and Age in Healthy Subjects. PLoS One 2015;10:1–33. Doi:10.1371/journal.pone.0118308.
21. Arslan D. Interactions Between The Painful Disorders and The Autonomic Nervous System. Ağrı - The Journal of The Turkish Society of Algology 2022;34:155–65. Doi:10.14744/agri.2021.43078.
22. Shi M, Luo D, Guo J, Yang D, Li Z, Zhao H. The Function of the Autonomic Nervous System in Asian Patients With Chronic Migraine. Front Neurosci 2022;16:1–10. Doi:10.3389/fnins.2022.773321.
23. Azam MA, Katz J, Mohabir V, Ritvo P. Individuals with tension and migraine headaches exhibit increased heart rate variability during post-stress mindfulness meditation practice but a decrease during a post-stress control condition – A randomized, controlled experiment. International Journal of Psychophysiology 2016;110:66–74. Doi:10.1016/j.ijpsycho.2016.10.011.
24. Rossi DM, de Souza HCD, Bevilaqua-Grossi D, Vendramim ACC, Philbois SV, Carvalho GF, et al. Impairment on Cardiovascular Autonomic Modulation in Women with Migraine. Int J Environ Res Public Health 2022;20:1–8. Doi:10.3390/ijerph20010763.
25. Wang H, Gao X, Shi Y, Wu D, Li C, Wang W. Effects of trunk posture on cardiovascular and autonomic nervous systems: A pilot study. Front Physiol 2022;13:1–12. Doi:10.3389/fphys.2022.1009806.
26. Ng CYH, Tan BYQ, Teo YN, Teo YH, Syn NLX, Leow AST, et al. Myocardial infarction, stroke and cardiovascular mortality among migraine patients: a systematic review and meta-analysis. J Neurol 2022;269:2346–58. Doi:10.1007/s00415-021-10930-x.
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Copyright (c) 2026 Izabela Millery da Silva Cruz, Daniella Cunha Brandão, Mayara Costa Barros, Jaqueline Severo dos Santos, Helena Cysneiros, Emanuel Roger dos Santos Reis, Daniella Araújo de Oliveira (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
