Abstract
Migraine is a primary headache disorder marked by recurrent unilateral headache episodes. Calcitonin gene related peptide (CGRP) plays major role in migraine pathophysiology. CGRP is multifunctional, and its vasodilating activity within the central and peripheral blood vessels is one in all its primary functions. The intention is to prove serum calcitonin gene related peptide (CGRP) as an early diagnostic tool for migraine and the novelty is to correlate it with characteristics of migraine so that it helps in early initiation of treatment. Methods. 100 subjects including 90 patients with migraine and 10 with non-headache (NH) age-matched controls were prospectively recruited in our current study. The subjects were aged from 15- 50 years. The clinical assessment was made every month for the three months after the start of therapy. The subjects were compared based on the serum CGRP values. Serum CGRP concentrations were measured by using CGRP ELISA kit. Results. Out of total subjects selected, the maximum (23.3%) subjects were between age 26 and 30 years and least effected age group was 46-50 years (4.44%). Females’ predominance with 82% than males with 18%.Stress was major trigger occurring in 57% of cases. Throbbing pain with elevated CGRP levels 130.44±114.22 and p value (p = 0.01). The average CGRP levels was higher in test group 149.00±93.86 compared to control 61.30±24.37 with p value (p = 0.02). Conclusions. The serum CGRP levels were statistically more in migraine patients correlated with characteristics like throbbing type of pain, stress and inadequate sleep. Hence, the serum CGRP levels estimation can be considered as a diagnostic tool for migraine when the clinical character’s over lap or early in the course of migraine when all criteria for diagnosis are not yet fulfilled.
Highlights
Migraine is a primary headache disorder marked by unilateral recurrent headache episodes with various proposed patho-physiological mechanisms
The aim of this study was to estimate the serum Calcitonin gene related peptide (CGRP) levels in migraine patients and the objective is to correlate the levels with certain characteristics of migraine.CGRP levels estimation could facilitate in assessing its role as diagnostic tool and if the serum CGRP level shows correlation with the characteristics, it should facilitate in early diagnosis which in turn helps in initiation of treatment
As the previous studies proved that the CGRP plays an integral role in migraine pathophysiology as its levels increases in migraine [4,8,9], estimating CGRP in the serum may help in early diagnosis of migraine
Summary
Migraine is a primary headache disorder marked by unilateral recurrent headache episodes with various proposed patho-physiological mechanisms. Migraine can be with or without aura in its mild form may have nausea, giddiness and inflated sensitivity to light and sound [1]. Headaches presents as episodic attacks of variable frequency that disturbs the conventional daily activities , taking a toll on physical, mental and social well being and has severe economic consequences [2]. There are triggers that increase the frequency or severity of headache like stress and anxiety, alkaloid or alcohol intake, inadequate sleep, inadequate. Article history: Received: 21 June 2021 Accepted: 10 August 2021. Romanian Journal of Neurology – Volume XX, No 3, 2021. The identification of headache is supported by International Headache Society Criteria. The two main sorts of migraine are migraine without aura and migraine with aura
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