Platelet changes in classic migraine

Assessment of inflammation with hematological parameters in patients with migraine and tension-type headache: a prospective study from a tertiary care center

Aim: To investigate the role of inflammatory markers in patients with an acute headache attack. Materials & methods: This prospective controlled observational study comprised 150 subjects (migraine with aura [MA] n = 51, migraine without aura [MO] n = 51, tension-type headache n = 48, healthy controls n = 80). White blood cells (WBC), neutrophil, lymphocyte and platelet counts, mean platelet volume, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were documented. Results: MA and MO constituted 14.2% of the admissions to the emergency department due to headaches. In addition, MA and MO had higher WBC and MO showed higher neutrophil count during the attacks than healthy control (p < 0.05). Conclusion: Although inflammatory parameters, including WBC and neutrophil counts, were high in headache patients, neutrophil-to-lymphocyte ratio did not show a significant rise. Clinical trial registration: NCT04891848.

A meta-analysis of biomarkers related to oxidative stress and nitric oxide pathway in migraine

Background

Oxidative and nitrosative stress are considered key events in the still unclear pathophysiology of migraine.

Methods

Studies comparing the level of biomarkers related to nitric oxide (NO) pathway/oxidative stress in the blood/urine of migraineurs vs. unaffected controls were extracted from the PubMed database. Summary estimates of mean ratios (MR) were carried out whenever a minimum of three papers were available. Nineteen studies were included in the meta-analyses, accounting for more than 1000 patients and controls, and compared with existing literature.

Results

Most studies measuring superoxide dismutase (SOD) showed lower activity in cases, although the meta-analysis in erythrocytes gave null results. On the contrary, plasma levels of thiobarbituric acid reactive substances (TBARS), an aspecific biomarker of oxidative damage, showed a meta-MR of 2.20 (95% CI: 1.65–2.93). As for NOs, no significant results were found in plasma, serum and urine. However, higher levels were shown during attacks, in patients with aura, and an effect of diet was found. The analysis of glutathione precursor homocysteine and asymmetric dimethylarginine (ADMA), an NO synthase inhibitor, gave inconclusive results.

Conclusions

The role of the oxidative pathway in migraine is still uncertain. Interesting evidence emerged for TBARS and SOD, and concerning the possible role of diet in the control of NOx levels.