{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T18:11:29Z","timestamp":1769883089724,"version":"3.49.0"},"reference-count":43,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T00:00:00Z","timestamp":1643846400000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2020R1A2B5B01001826"],"award-info":[{"award-number":["2020R1A2B5B01001826"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the effect of chronic caffeine use and caffeine cessation on vasodilatory function in the posterior circulation in patients with migraine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Studies regarding cerebrovascular reactivity (CVR) using vasodilatory stimuli in patients with migraine have yielded conflicting results. We postulated that CVR may not be static, and caffeine might negatively affect vasodilatory function via its vasoconstrictive effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective longitudinal observation study, we recruited patients with episodic migraine who were 18\u201350\u00a0years of age and free of vascular risk factors at the Samsung Medical Center between August 2015 and March 2020. Patients were classified into caffeine users and non\u2010users at baseline, and caffeine users were instructed to discontinue caffeine intake. We measured the mean breath\u2010holding index (BHI) of bilateral posterior cerebral arteries (PCA) using transcranial Doppler in all the included patients at baseline and followed up after 3\u00a0months. We compared breath\u2010holding indices cross\u2010sectionally between caffeine users and non\u2010users and analyzed BHI changes according to caffeine cessation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 84 patients completed the study protocol. Cross\u2010sectional analysis showed that the baseline BHI of PCA was lower in caffeine users (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a056, 1.1 [interquartile range (IQR) 0.8\u20131.3]) than that in nonusers (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a028, 1.3 [IQR 1.0\u20131.5],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.030). In the longitudinal analysis, caffeine quitters showed a significant improvement in BHI in PCA (baseline 1.1 [IQR 0.8\u20131.2], follow\u2010up 1.3 [IQR 1.0\u20131.4],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.034), whereas continuous users and non\u2010users did not. Multivariable analysis showed an independent effect of caffeine cessation on the changes in BHI of PCA (unstandardized\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a00.27, 95% confidence interval 0.01\u20130.53,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.044).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with migraine, caffeine use is associated with reduced CVR in the posterior circulation, and caffeine cessation might be beneficial in improving CVR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.14263","type":"journal-article","created":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T12:36:24Z","timestamp":1643891784000},"page":"169-175","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Effect of caffeine and caffeine cessation on cerebrovascular reactivity in patients with migraine"],"prefix":"10.1111","volume":"62","author":[{"given":"Young\u2010Eun","family":"Gil","sequence":"first","affiliation":[{"name":"Department of Neurology Ajou University School of Medicine, Ajou University Medical Center Suwon South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mi Ji","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology Neuroscience Center Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soohyun","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Neurology Uijeongbu Eulji Medical Center Eulji University School of Medicine Uijeongbu Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chin\u2010Sang","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Neurology Neuroscience Center Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,2,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1212\/WNL.0b013e3181d0cc8b","article-title":"Migraine and cardiovascular disease: a population\u2010based study","volume":"74","author":"Bigal ME","year":"2010","journal-title":"Neurology"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1212\/01.WNL.0000151857.43225.49","article-title":"Cardiovascular risk factors and migraine: the GEM population\u2010based study","volume":"64","author":"Scher AI","year":"2005","journal-title":"Neurology"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.b3914","article-title":"Migraine and cardiovascular disease: systematic review and meta\u2010analysis","volume":"339","author":"Sch\u00fcrks M","year":"2009","journal-title":"BMJ"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"3032","DOI":"10.1161\/STROKEAHA.113.002465","article-title":"Migraine and hemorrhagic stroke: a meta\u2010analysis","volume":"44","author":"Sacco S","year":"2013","journal-title":"Stroke"},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.amjmed.2009.12.021","article-title":"Migraine headache and ischemic stroke risk: an updated meta\u2010analysis","volume":"123","author":"Spector JT","year":"2010","journal-title":"Am J Med"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.c3966","article-title":"Migraine with aura and risk of cardiovascular and all cause mortality in men and women: prospective cohort study","volume":"341","author":"Gudmundsson LS","year":"2010","journal-title":"BMJ"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1177\/0333102414550106","article-title":"Migraine and stroke: in search of shared mechanisms","volume":"35","author":"Mawet J","year":"2015","journal-title":"Cephalalgia"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1007\/s11910-017-0729-y","article-title":"Migraine and stroke: what's the link? 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