Serum bilirubin as a neuroinflammatory biomarker in chilhood and adolescent migraine

Abstract

To assess the association between serum bilirubin and migraine in children and adolescents. Neurogenic inflammation is involved in migraine pathogenesis in children and adolescents where proinflammatory cytokines play a significant role. Serum bilirubin can be considered as an antioxidant and cytoprotective agent and its concentration may be influenced in migraine by neurogenic inflammation. Serum samples were collected from 40 migrainous children and adolescents and from 40 controls (age, 7–17 years) at Menoufiya university hospitals, Egypt. Total, direct and indirect bilirubin concentrations were measured. Headache features, migraine equivalents, psychiatric comorbidity (using Mini-Kid test) and electroencephalogram “EEG” findings were investigated. Serum total, direct and indirect bilirubin concentrations were significantly lower in migraineurs than controls (P < 0.001). Statistical significance was associated with abnormal EEG findings during headache-free periods (P < 0.01, 0.018, and 0.012 respectively) and not statistically significantly associated with headache features (migraine aura, migraine equivalents, frequency of episodes, severity of pain), abnormal EEG findings during headache attacks or psychiatric comorbidity. Serum bilirubin concentration is lower in migrainous children and adolescents compared to controls, thus, may be considered as a useful marker for neurogenic inflammation in childhood migraine.