Meta-analysis Of The Efficacy Of Patent Foramen Ovale Closure In Patients With Patent Foramen Oval-related Migraine

Objective:At present,it has been reported that the occurrence of migraine is related to patent foramen ovale,but whether the closure of patent foramen ovale is effective in the treatment of migraine remains controversial.Methods:In this study,randomized controlled trials and cohort studies from Cochrane database,Pub Med,EMbase,CNKI,Wanfang database,VIP Science and Technology Journal database,and Chinese biomedical Database were retrieved from the establishment of the database to February 28,2023.Review Manager 5.4 statistical software was used for meta-analysis.Results:Fourteen studies(5 RCTS and 9 cohort studies)involving 1560 migraine patients were identified.1.In the RCT analysis,the response rate of the PFO occlusion group was higher than that of the control group [OR=3.86,95%CI(1.35,11.04),P=0.01].2.In the RCT analysis,the reduction in the number of days of migraine attacks per month in the PFO occlusion group was higher than that in the control group[MD=-0.56,95%CI(-1.08,-0.03),P=0.04].3.In RCT subgroup analysis,after Hou Jianzhu 2021 studies due to heterogeneity,made closure of migraine frequency to reduce the no statistical significance(MD and 95% CI 0.30 [0.68,0.08]).4.In the subgroup analysis of the cohort study,after the removal of Deng Ye 2021 study due to heterogeneity,the PFO occlusion group also had a higher reduction in the frequency of migraine attacks compared with the control group(MD and 95%CI-0.90 [-1.15,-0.66]).5.In the cohort study analysis,PFO occlusion significantly reduced the mean duration of each migraine attack in migraine patients compared with the control group after the Gao Jianchao 2022 study was removed due to heterogeneity [MD=-1.45,95%CI(-2.66,-0.24),P=0.02].6.In the cohort study analysis,the reduction in HIT-6score was also higher in the PFO occlusion group compared with the control group after He 2019 study was removed due to heterogeneity [MD=-7.38,95%CI(-8.90,-5.86),P<0.0001].7.In the cohort study analysis,the reduction of MIDAS in the PFO occlusion group was higher than that in the control group [MD=-10.61,95%CI(-13.81,-7.42),P<0.00001].Conclusion:PFO occlusion can reduce the monthly frequency of migraine attacks,the number of days and duration of migraine attacks,improve the quality of life and the severity of migraine in migraine patients,and increase the response rateof patients with MA.It is concluded that PFO occlusion is correlated with the reduction of migraine burden.But there was no statistically significant reduction in the monthly frequency of migraine attacks in the RCT group.