Abstract
Introduction: We investigated serum matrix metalloprotease-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) levels in patients with acute phase hemiplegic migraine and migrainous infarction. Background: Migraine is a common disorder that is characterized by episodic headaches. Hemiplegic migraine and migrainous infarction are rare migraine-related conditions with unknown pathophysiology. Methods and Findings: We evaluated serum MMP-9, TIMP-1, and the MMP-9/TIMP-1 ratio in patients with migrainous infarction (patient 1), hemiplegic migraine (patient 2), cerebral infarction with other causes (group 3, n=4), and non-organic disease (group 4, n=5). Serum MMP-9 levels were significantly higher in patients 1 and 2 than in groups 3 and 4. The serum TIMP-1 level was significantly lower in patient 1 than in groups 3 and 4. MMP-9/TIMP-1 ratios were higher in patients 1 and 2 than in groups 3 and 4. Conclusion: MMP-9 levels and the MMP/TIMP-1 ratio may aid in the diagnosis of migraine, and therefore may provide a clue to the etiology of cerebral infarction.
Highlights
We investigated serum matrix metalloprotease-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) levels in patients with acute phase hemiplegic migraine and migrainous infarction
The matrix metalloproteases (MMPs)-9/ tissue inhibitors of metalloproteinases (TIMPs)-1 ratio reflects the disruption of the bloodbrain barrier (BBB); this observation is controversial because a recent magnetic resonance imaging (MRI) study reported no BBB disruption during migraine without aura (MO) attacks [2]
We retrospectively investigated serum MMP-9 and TIMP-1 levels in patients with acute phase hemiplegic migraine and in a patient with migrainous infarction to assess their pathophysiology, including the alterations in BBB permeability
Summary
Migraine is a common disorder that is characterized by episodic headaches accompanied by aura. We retrospectively investigated serum MMP-9 and TIMP-1 levels in patients with acute phase hemiplegic migraine and in a patient with migrainous infarction to assess their pathophysiology, including the alterations in BBB permeability. Patient 1-Migrainous infarctions: At eight years of age, the patient experienced severe pulsating headache and conscious disturbance lasting for a few hours but recovered without sequela. At years and years of age, she experienced conscious disturbance, headache, and visual loss, but recovered without sequela within several days We diagnosed her with hemiplegic migraine, according to ICHD-3 beta guidelines. Brain MRI findings were normal during her course of illness, and her electroencephalography showed frontal dominant high voltage slow waves during conscious disturbance She had no family history of migraine and hemiplegic migraine; this was a sporadic case of migraine. Differences were defined as significant at a probability level of p < 0.05
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