Abstract
Background: Although there have been many magnetic resonance spectroscopy (MRS) studies of migraine, few have focused on migraines during an attack. Here, we aimed to assess metabolite changes in the brain of patients with migraine, both during an attack and in the interictal phase.Methods: Six patients (one man and five women, mean age: 39 ± 10 years) with migraine without aura during the attack (MWoA-DA), 13 patients (three men and 10 women, mean age: 31 ± 9 years) with migraine without aura during the interictal period (MWoA-DI), and 13 healthy controls (HC) (four men and nine women, mean age: 31 ± 9 years) were studied. All subjects underwent an MRS examination focusing on the occipital lobe. Metabolite changes were investigated among three groups.Results: The MWoA-DA patients had lower glutathione/total creatine ratio (GSH/tCr) than the MWoA-DI patients and HC. Furthermore, MWoA-DI patients showed lower total choline/total creatine ratio (tCho/tCr) than those in the other two groups. The GSH/tCr ratio was positively correlated with attack frequency in the MWoA-DI group. The tCho/tCr ratio was positively correlated with attack frequency and Migraine Disability Assessment Scale (MIDAS) scores in the MWoA-DA group.Conclusion: The present study suggests the existence of distinct pathophysiological states between the MWoA-DA and MWoA-DI groups. Neuronal dysfunction is a possible predisposing factor for migraine attack onset, along with oxidative stress and inflammation.
Highlights
Migraine is a common neurological disorder, characterized by recurrent headache and is typically accompanied by nausea, photophobia, and phonophobia [1]
The studies have reported increased [8,9,10] or decreased [11] glutamate, increased [12] or decreased [13, 14] gammaaminobutyric acid, increased [12, 15] myo-inositol, decreased [11, 16] N-acetyl-aspartate, and decreased [17] choline. Most of these studies have focused on migraine during the interictal phase; only three case reports have shown the results of brain metabolite changes in hemiplegic migraine during attacks, which is a rare variant of migraine with aura [18,19,20]
This study was the first to investigate the changes in brain GSH in migraineurs using 1H-magnetic resonance spectroscopy (MRS)
Summary
Migraine is a common neurological disorder, characterized by recurrent headache and is typically accompanied by nausea, photophobia, and phonophobia [1]. Proton magnetic resonance spectroscopy (1H-MRS) is a noninvasive method to detect brain metabolite concentrations and offers a better understanding of the underlying pathophysiologic mechanisms of migraine. The studies have reported increased [8,9,10] or decreased [11] glutamate, increased [12] or decreased [13, 14] gammaaminobutyric acid, increased [12, 15] myo-inositol, decreased [11, 16] N-acetyl-aspartate, and decreased [17] choline Most of these studies have focused on migraine during the interictal phase; only three case reports have shown the results of brain metabolite changes in hemiplegic migraine during attacks, which is a rare variant of migraine with aura [18,19,20]. We aimed to assess metabolite changes in the brain of patients with migraine, both during an attack and in the interictal phase
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