ORIGINAL RESEARCH article
Front. Neurol.
Sec. Headache and Neurogenic Pain
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1600006
Serum 25(OH)D Deficiency as a Predictor of Symptom Nonrelief After PFO Closure in Migraine Patients: A Cohort Study
Provisionally accepted
Fengfeng Wang*
Qun Li- Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Patent foramen ovale (PFO) is increasingly recognized as a potential contributor to migraine, particularly in migraine with aura. Although transcatheter PFO closure has been proposed as a treatment option, not all patients experience symptom relief. Serum 25(OH)D deficiency has been implicated in migraine pathophysiology, but its impact on therapeutic response following PFO closure remains unclear.In this cohort study, 180 patients with migraine and confirmed PFO who underwent transcatheter closure were followed for 12 months. Based on symptom relief status at followup, participants were divided into a Symptom-Relieved Group (n = 121) and a Symptom-Nonrelieved Group (n = 59). Clinical characteristics and serum 25-hydroxy25(OH)D [25(OH)D] levels were compared between groups. Correlation and multivariate logistic regression analyses were used to assess associations between serum 25(OH)D levels and clinical outcomes. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of serum 25(OH)D.Patients in the Symptom-Nonrelieved Group had significantly lower serum 25(OH)D levels compared to those in the Symptom-Relieved Group (42.31 ± 15.24 vs. 72.42 ± 18.63 nmol/L, P < 0.001). Lower serum 25(OH)D levels were significantly associated with worse sleep quality, higher headache impact, and greater anxiety. Logistic regression identified 25(OH)D deficiency as an independent predictor of symptom nonrelief (adjusted OR = 0.243, 95% CI: 0.102-0.514, P < 0.011). ROC analysis indicated good predictive accuracy for serum 25(OH)D levels (AUC = 0.823, 95% CI: 0.731-0.914).Serum 25(OH)D deficiency is significantly associated with poor symptom improvement after PFO closure in migraine patients and may serve as an independent predictor of therapeutic response. Routine assessment and correction of serum 25(OH)D deficiency should be considered as part of comprehensive care in this population.
Keywords: patent foramen ovale, Migraine, pediatric patients, 25(OH)D, Symptom relief, Transcatheter closure, prognostic biomarker
Received: 25 Mar 2025; Accepted: 07 Jul 2025.
Copyright: © 2025 Wang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Fengfeng Wang, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.