Abstract
ObjectiveThe aim of this cross-sectional study was to investigate the cortical metabolite concentrations in patients suffering from migraine with aura (MWA). We hypothesized that occipital γ-aminobutyric acid (GABA) levels are lower in MWA patients.BackgroundRecent studies have indicated that a disturbance in the inhibitory GABA is involved in triggering the migraine aura. We aimed to explore this using a novel magnetic resonance spectroscopy sequence.MethodsUsing spin echo full intensity acquired localized spectroscopy on a Siemens 3 Tesla magnetic resonance scanner, we obtained occipital and parietal metabolite concentrations in 14 patients suffering from migraine with aura and a group of 16 matched healthy subjects.All scans were performed at Aarhus University Hospital, at the Center for Functionally Integrative Neuroscience (CFIN).ResultsNo difference was found in GABA/(Total creatine) levels in either the occipital cortex (p = 0.744) or in the somatosensory cortex (p = 0.305).ConclusionThese findings indicate that cortical GABA levels are normal in patients suffering from relatively few migraine attacks. Previous studies have reported that cortical GABA in patients with more frequent migraines is reduced; further investigation of the inhibitory system in migraine patients is warranted to determine the underlying mechanisms.
Highlights
Migraine is an episodic type of primary headache affecting a large proportion of the population with a female preponderance
These findings indicate that cortical GABA levels are normal in patients suffering from relatively few migraine attacks
Previous studies have reported that cortical GABA in patients with more frequent migraines is reduced; further investigation of the inhibitory system in migraine patients is warranted to determine the underlying mechanisms
Summary
Migraine is an episodic type of primary headache affecting a large proportion of the population with a female preponderance. Cortical spreading depression (CSD) is thought to be the physiological mechanism underlying migraine aura; studies using both magnetic resonance spectroscopy (MRS) and visually evoked potentials indicate an abnormal inhibition-excitation balance [2–6]. Previous MRS studies have investigated change of cortical GABA in migraine patients [2–5]. Studies were underpowered and inconclusive, MRS methods differed, and study population included a mixture of migraine patients with and without aura with large variability in headache frequency [8]. Based on prior studies by Bridge et al [2] and Bigal et al [5], it is possible that occipital GABA levels are reduced in frequent migraine. These findings have not yet been replicated. We aimed to explore this using a novel magnetic resonance spectroscopy sequence
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