Abstract
Proton magnetic resonance spectroscopy (1H-MRS) has been used in a number of studies to assess noninvasively the temporal changes of lactate (Lac) in the activated human brain. Migraine neurobiology involves lack of cortical habituation to repetitive stimuli and a mitochondrial component has been put forward. Our group has recently demonstrated a reduction in the high-energy phosphates adenosine triphosphate (ATP) and phosphocreatine (PCr) in the occipital lobe of migraine without aura (MwoA) patients, at least in a subgroup, in a phosphorus MRS (31P-MRS) study. In previous studies, basal Lac levels or photic stimulation (PS)-induced Lac levels were found to be increased in patients with migraine with aura (MwA) and migraine patients with visual symptoms and paraesthesia, paresia and/or dysphasia, respectively. The aim of this study was to perform functional 1H-MRS at 3 T in 20 MwoA patients and 20 control subjects. Repetitive visual stimulation was applied using MR-compatible goggles with 8 Hz checkerboard stimulation during 12 min. We did not observe any significant differences in signal integrals, ratios and absolute metabolite concentrations, including Lac, between MwoA patients and controls before PS. Lac also did not increase significantly during and following PS, both for MwoA patients and controls. Subtle Lac changes, smaller than the sensitivity threshold (i.e. estimated at 0.1–0.2 μmol/g at 3 T), cannot be detected by MRS. Our study does, however, argue against a significant switch to non-aerobic glucose metabolism during long-lasting PS of the visual cortex in MwoA patients.
Highlights
Migraine is a common, disabling, primary headache disorder, with episodic manifestations that affects women three times more than men [1]
Our group has recently demonstrated a reduction in the high-energy phosphates adenosine triphosphate (ATP) and phosphocreatine (PCr) in the occipital lobe of migraine without aura (MwoA) patients, at least in a subgroup, in a phosphorus magnetic resonance spectroscopy (MRS) (31P-MRS) study
Migraine is divided into two major subtypes: migraine without aura (MwoA) and migraine with aura (MwA) [2]
Summary
Migraine is a common, disabling, primary headache disorder, with episodic manifestations that affects women three times more than men [1]. Subcortical structures, probably including brainstem, hypothalamus and thalamus, are involved in the generation of migraine attacks [3]. J Headache Pain (2011) 12:295–302 interictal brain disorder that predisposes migraine patients to develop an attack. Factors such as genetic background [4,5,6], nitric oxide hypersensitivity [7], lack of cortical habituation [8, 9], and a disturbed energy metabolism [10] may determine the migraine threshold
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