1
|
Jiménez-Jiménez FJ, Alonso-Navarro H, García-Martín E, Espada-Rubio S, Agúndez JAG. Oxidative Stress and Migraine. Mol Neurobiol 2024:10.1007/s12035-024-04114-7. [PMID: 38499906 DOI: 10.1007/s12035-024-04114-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 03/08/2024] [Indexed: 03/20/2024]
Abstract
The pathogenesis of migraine is not completely understood, but inflammation and oxidative stress seem to be involved, according to data from an experimental model of the disease. This narrative review summarizes data from studies on oxidative stress markers in migraine patients, case-control association studies on the possible association of candidate genes related to oxidative stress with the risk for migraine, studies showing the presence of oxidative stress in experimental models of migraine, and studies on the efficacy of antioxidant drugs in migraine therapy. Many studies have addressed the value of concentrations of prooxidant and antioxidant substances or the activity of antioxidant enzymes in different tissues (mainly in serum/plasma or in blood cells) as possible biomarkers for migraine, being thiobarbituric acid (TBA) reactive substances (TBARS) such as malonyl dialdehyde acid (MDA) and 4-hydroxynonenal, and nitric oxide (this at least during migraine attacks in patients with migraine with aura (MWA) the most reliable. In addition, the possible usefulness of antioxidant treatment is not well established, although preliminary short-term studies suggest a beneficial action of some of them such as Coenzyme Q10 and riboflavin. Both topics require further prospective, multicenter studies with a long-term follow-up period involving a large number of migraine patients and controls.
Collapse
Affiliation(s)
- Félix Javier Jiménez-Jiménez
- Section of Neurology, Hospital Universitario del Sureste, Arganda del Rey, Ronda del Sur 10, 28500, Madrid, Spain.
| | - Hortensia Alonso-Navarro
- Section of Neurology, Hospital Universitario del Sureste, Arganda del Rey, Ronda del Sur 10, 28500, Madrid, Spain
| | - Elena García-Martín
- Universidad de Extremadura, University Institute of Molecular Pathology Biomarkers, Cáceres, Spain
| | - Silvina Espada-Rubio
- Section of Neurology, Hospital Universitario del Sureste, Arganda del Rey, Ronda del Sur 10, 28500, Madrid, Spain
| | - José A G Agúndez
- Universidad de Extremadura, University Institute of Molecular Pathology Biomarkers, Cáceres, Spain
| |
Collapse
|
2
|
Paolucci M, Altamura C, Vernieri F. The Role of Endothelial Dysfunction in the Pathophysiology and Cerebrovascular Effects of Migraine: A Narrative Review. J Clin Neurol 2021; 17:164-175. [PMID: 33835736 PMCID: PMC8053543 DOI: 10.3988/jcn.2021.17.2.164] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 12/17/2022] Open
Abstract
Background and Purpose Migraine is a complex neurovascular disorder whose triggers are not entirely understood. Endothelial dysfunction might play a role in migraine, and there have been numerous reports on endothelium dysfunction and migraine pathophysiology, but their reciprocal cause–effect relationship remains unclear. This review reports the current evidence on endothelium dysfunction, its link with migraine, and its possible consequences for cerebral hemodynamics. Methods We performed a systematic literature search of PubMed up to March 2020. We included 115 articles in a narrative review. Results Several studies have demonstrated that endothelium dysfunction may play an important role in migraine. Despite the lack of specific biomarkers, there is evidence of oxidative stress and inflammation—two of the primary causes of endothelial damage—in migraine. The main consequences of endothelial dysfunction are increased vascular tone, thrombosis, inflammation, and increased vascular permeability. As a consequence of oxidative stress, the activity of endothelin-1 is not counterbalanced by nitric oxide (NO), whose levels decrease to lead to vasoconstriction and a possible contribution to cortical spreading depression. NO is involved in pain perception via the cyclic guanosine monophosphate (cGMP) pathway and the induction of calcitonin gene-related peptide. Oxidative stress may induce a hypercoagulable state that mainly affects platelet function through different mechanisms. Endothelial dysfunction seems to be particularly pronounced in migraine with aura (MA). Endothelial dysfunction in migraine particularly involves intracranial vessels, since flow-mediated dilation cannot detect overt peripheral vascular dysfunction. Conclusions Endothelial dysfunction is a vascular risk marker. How it impacts migraine, and particularly MA, needs to be understood better by defining its possible role in increasing the stroke risk in migraine patients.
Collapse
Affiliation(s)
- Matteo Paolucci
- Headache and Neurosonology Unit, Neurology, Campus Bio-Medico University of Rome, Rome, Italy.,Neurology Unit, M. Bufalini Hospital, Cesena, AUSL Romagna, Italy.
| | - Claudia Altamura
- Headache and Neurosonology Unit, Neurology, Campus Bio-Medico University of Rome, Rome, Italy
| | - Fabrizio Vernieri
- Headache and Neurosonology Unit, Neurology, Campus Bio-Medico University of Rome, Rome, Italy
| |
Collapse
|
3
|
Gross EC, Putananickal N, Orsini AL, Vogt DR, Sandor PS, Schoenen J, Fischer D. Mitochondrial function and oxidative stress markers in higher-frequency episodic migraine. Sci Rep 2021; 11:4543. [PMID: 33633187 PMCID: PMC7907128 DOI: 10.1038/s41598-021-84102-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 02/12/2021] [Indexed: 01/31/2023] Open
Abstract
Increasing evidence points towards the role of mitochondrial functioning, energy metabolism, and oxidative stress in migraine. However not all previous research has been conclusive and some mitochondrial function/oxidative stress markers have not yet been examined. To this end, alpha-lipoic acid (ALA), total thiols, total plasma antioxidant capacity (TAC), lipid peroxide (PerOx), oxidised LDL (oxLDL), HbA1c and lactate were determined in the serum of 32 higher frequency episodic migraineurs (5-14 migraine days/ months, 19 with aura, 28 females) in this cross-sectional study. The majority of patients had abnormally low ALA and lactate levels (87.5% and 78.1%, respectively). 46.9% of the patients had abnormally high PerOx values, while for thiols and TAC over one third of patients had abnormally low values (31.2% and 37.5%, respectively). 21.9% of patients had abnormally low HbA1c and none had an HbA1c level above 5.6%. oxLDL was normal in all but one patient. This study provides further evidence for a role of oxidative stress and altered metabolism in migraine pathophysiology, which might represent a suitable therapeutic target. ALA, being too low in almost 90% of patients, might represent a potential biomarker for migraine. Further research is needed to replicate these results, in particular a comparison with a control group.This study is part of the trial registration: ClinicalTrials.gov: NCT03132233, registered on 27.04.2017, https://clinicaltrials.gov/ct2/show/NCT03132233 .
Collapse
Affiliation(s)
- Elena C Gross
- Division of Paediatric Neurology, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland.
| | - Niveditha Putananickal
- Division of Paediatric Neurology, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
| | - Anna-Lena Orsini
- Division of Paediatric Neurology, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Neurology Department, University Hospital Basel (USB), University of Basel, Basel, Switzerland
| | - Deborah R Vogt
- Clinical Trail Unit (CTU), Department of Clinical Research, University Hospital Basel (USB), University of Basel, Basel, Switzerland
| | - Peter S Sandor
- RehaClinic Group, Bad Zurzach, University of Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Jean Schoenen
- Headache Research Unit, Dept of Neurology-Citadelle Hospital., University of Liège, Liège, Belgium
| | - Dirk Fischer
- Division of Paediatric Neurology, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
| |
Collapse
|
4
|
Yao L, Cai K, Mei F, Wang X, Fan C, Jiang H, Xie F, Li Y, Bai L, Peng K, Deng W, Lai S, Wang J. Urine Nitric Oxide Is Lower in Parents of Autistic Children. Front Psychiatry 2021; 12:607191. [PMID: 34093255 PMCID: PMC8175662 DOI: 10.3389/fpsyt.2021.607191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 04/16/2021] [Indexed: 01/15/2023] Open
Abstract
Parents raising children with autism spectrum disorder (ASD) usually carry on their daily life under tremendous stress, but limited empirical research has been devoted to this population. It is known that parents' health status directly impacts therapeutic outcome of ASD children. As an important regulator in cardiovascular, nervous and immune systems, nitric oxide (NO) levels haven't been reported in parents of ASD children yet. In this study, we measured urine nitrite and nitrate from 43 ASD parents (ASD-P), and 43 healthy adults in the same range of age (Control) who didn't have any ASD descendants. Comparison between the ASD-P and Control groups showed that NO 2 - , NO 3 - , and NO 2 - / NO 3 - were all significantly lower in the ASD-P group. Analysis on the interaction effect of sex and group indicated that urine NO 3 - of mothers in ASD-P was lower than that in females of the Control group, but no significant difference was observed between males in both groups. It is for the first time that urine nitric oxide metabolites (nitrite, nitrate) levels were precisely reported to differentiate parents of autistic children from other adults without ASD descendants. This phenomenon suggests that parents (especially mothers) of autistic children might have experienced more mental and physical stressors, which led to decreased NO levels during metabolism. Further investigations are necessary to uncover the etiology of low urine NO among parents of autistic children.
Collapse
Affiliation(s)
- Lulu Yao
- National 111 Center for Cellular Regulation and Molecular Pharmaceutics, Hubei University of Technology, Wuhan, China.,Department of Biomedicine and Biopharmacology, Hubei University of Technology, Wuhan, China
| | - Kun Cai
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Fanghua Mei
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Xiaohua Wang
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Chuangang Fan
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Hong Jiang
- Department of Child Health Care, Huangshi Maternity and Child Health Care Hospital, Wuhan, China
| | - Fang Xie
- Department of Child Health Care, Huangshi Maternity and Child Health Care Hospital, Wuhan, China
| | - Ying Li
- Department of Child Health Care, Huangshi Maternity and Child Health Care Hospital, Wuhan, China
| | - Lu Bai
- National 111 Center for Cellular Regulation and Molecular Pharmaceutics, Hubei University of Technology, Wuhan, China.,Department of Biomedicine and Biopharmacology, Hubei University of Technology, Wuhan, China
| | - Kang Peng
- National 111 Center for Cellular Regulation and Molecular Pharmaceutics, Hubei University of Technology, Wuhan, China.,Department of Biomedicine and Biopharmacology, Hubei University of Technology, Wuhan, China
| | - Wenwen Deng
- National 111 Center for Cellular Regulation and Molecular Pharmaceutics, Hubei University of Technology, Wuhan, China.,Department of Biomedicine and Biopharmacology, Hubei University of Technology, Wuhan, China
| | - Shenghan Lai
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jun Wang
- National 111 Center for Cellular Regulation and Molecular Pharmaceutics, Hubei University of Technology, Wuhan, China.,Department of Biomedicine and Biopharmacology, Hubei University of Technology, Wuhan, China
| |
Collapse
|
5
|
Togha M, Razeghi Jahromi S, Ghorbani Z, Ghaemi A, Rafiee P. An investigation of oxidant/antioxidant balance in patients with migraine: a case-control study. BMC Neurol 2019; 19:323. [PMID: 31837702 PMCID: PMC6911287 DOI: 10.1186/s12883-019-1555-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 12/04/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND In recent years, the role of neuroinflammation and oxidative stress in migraine pathogenesis has achieved considerable interest; however, to date findings are equivocal. Thus, the objective of this study was to investigate biomarkers of oxidative stress in episodic and chronic migraineurs (EM and CM patients) and controls. METHODS Forty-four patients with EM, 27 individuals with CM and 19 age-sex-matched controls were enrolled. After collecting data on demographic and headache characteristics, blood samples were collected and analyzed to detect serum levels of oxidative stress biomarkers (malondialdehyde (MDA) and nitric oxide (NO)); total antioxidant capacity using Trolox equivalent antioxidant capacity (TEAC) assay; and antioxidant enzymes (catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase-1 (GPx-1)). RESULTS Serum levels of CAT and SOD were significantly lower in the CM group than the EM group and controls. However, serum GPx-1 levels of the CM patients were slightly higher than the EM patients and controls (P-value≤0.001). CM patients had lower mean TEAC values than EM patients and controls. In addition, serum levels of NO and MDA were significantly elevated among subjects with CM compared to EM and control individuals (P-value≤0.001). Pearson correlation analysis revealed negative correlations between the number of days of having headaches per month and serum concentrations of the two antioxidant enzymes CAT (r = - 0.60, P-value< 0.001) and SOD (r = - 0.50, P-value< 0.001) as well as TEAC values (r = - 0.61, P-value< 0.001); however, there were positive correlations between headache days and serum GPx-1 levels (r = 0.46, P-value< 0.001), NO (r = 0.62, P-value< 0.001), and MDA (r = 0.64, P-value< 0.001). CONCLUSION Present findings highlighted that chronic migraineurs had lower total non-enzymatic antioxidant capacity and higher oxidative stress than episodic migraineurs and control individuals. Although more studies are needed to confirm these data, applying novel prophylactic medications or dietary supplements with antioxidant properties could be promising in migraine therapy.
Collapse
Affiliation(s)
- Mansoureh Togha
- Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. .,Headache Department, Neurology Ward, Sina University Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Soodeh Razeghi Jahromi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeinab Ghorbani
- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.,Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Ghaemi
- Department of Virology, Pasteur Institute of Iran, Tehran, Iran
| | - Pegah Rafiee
- Student Research Committee, (Department and Faculty of Nutrition Sciences and Food Technology), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
6
|
The metabolic face of migraine - from pathophysiology to treatment. Nat Rev Neurol 2019; 15:627-643. [PMID: 31586135 DOI: 10.1038/s41582-019-0255-4] [Citation(s) in RCA: 127] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2019] [Indexed: 12/11/2022]
Abstract
Migraine can be regarded as a conserved, adaptive response that occurs in genetically predisposed individuals with a mismatch between the brain's energy reserve and workload. Given the high prevalence of migraine, genotypes associated with the condition seem likely to have conferred an evolutionary advantage. Technological advances have enabled the examination of different aspects of cerebral metabolism in patients with migraine, and complementary animal research has highlighted possible metabolic mechanisms in migraine pathophysiology. An increasing amount of evidence - much of it clinical - suggests that migraine is a response to cerebral energy deficiency or oxidative stress levels that exceed antioxidant capacity and that the attack itself helps to restore brain energy homeostasis and reduces harmful oxidative stress levels. Greater understanding of metabolism in migraine offers novel therapeutic opportunities. In this Review, we describe the evidence for abnormalities in energy metabolism and mitochondrial function in migraine, with a focus on clinical data (including neuroimaging, biochemical, genetic and therapeutic studies), and consider the relationship of these abnormalities with the abnormal sensory processing and cerebral hyper-responsivity observed in migraine. We discuss experimental data to consider potential mechanisms by which metabolic abnormalities could generate attacks. Finally, we highlight potential treatments that target cerebral metabolism, such as nutraceuticals, ketone bodies and dietary interventions.
Collapse
|
7
|
Ghorbani Z, Togha M, Rafiee P, Ahmadi ZS, Rasekh Magham R, Haghighi S, Razeghi Jahromi S, Mahmoudi M. Vitamin D in migraine headache: a comprehensive review on literature. Neurol Sci 2019; 40:2459-2477. [PMID: 31377873 DOI: 10.1007/s10072-019-04021-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 07/19/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION As a primary headache, migraine has been established as the first leading disability cause worldwide in the subjects who aged less than 50 years. A variety of dietary supplements have been introduced for migraine complementary treatment. As an anti-inflammatory and antioxidant agent, vitamin D is one of these agents which has been of interest in recent years. Although higher prevalence of vitamin D deficiency/insufficiency has been highlighted among migraineurs compared to controls, there is not any consensus in prescribing vitamin D in clinical practice. Therefore, in the current review, in addition to observational and case-control studies, we also included clinical trials concerning the effects of vitamin D supplementation on migraine/headache. METHODS Based on a PubMed/MEDLINE and ScienceDirect database search, this review study includes published articles up to June 2019 concerning the association between migraine/headache and vitamin D status or supplementation. RESULTS The percentage of subjects with vitamin D deficiency and insufficiency among migraineurs and headache patients has been reported to vary between 45 and 100%. In a number of studies, vitamin D level was negatively correlated with frequency of headaches. The present findings show that supplementation with this vitamin in a dose of 1000-4000 IU/d could reduce the frequency of attacks in migraineurs. CONCLUSION It seems a high proportion of migraine patients might suffer from vitamin D deficiency/insufficiency. Further, the current evidence shows that in addition to routine drug therapy, vitamin D administration might reduce the frequency of attacks in migraineurs. However, these results have yet to be confirmed.
Collapse
Affiliation(s)
- Zeinab Ghorbani
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansoureh Togha
- Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Pegah Rafiee
- Student Research Committee, Department and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeynab Sadat Ahmadi
- Department of Nutrition, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Reyhaneh Rasekh Magham
- Department of Nutrition, Faculty of Medical Sciences, Science & Research Branch, Islamic Azad University, Tehran, Iran
| | - Samane Haghighi
- Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Soodeh Razeghi Jahromi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Mahmoudi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
- Pediatric Gastroenterology and Hepatology Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
- Dietitians and Nutrition Experts Team (DiNET), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
| |
Collapse
|
8
|
Gross EC, Klement RJ, Schoenen J, D'Agostino DP, Fischer D. Potential Protective Mechanisms of Ketone Bodies in Migraine Prevention. Nutrients 2019; 11:E811. [PMID: 30974836 PMCID: PMC6520671 DOI: 10.3390/nu11040811] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 12/15/2022] Open
Abstract
An increasing amount of evidence suggests that migraines are a response to a cerebral energy deficiency or oxidative stress levels that exceed antioxidant capacity. The ketogenic diet (KD), a diet mimicking fasting that leads to the elevation of ketone bodies (KBs), is a therapeutic intervention targeting cerebral metabolism that has recently shown great promise in the prevention of migraines. KBs are an alternative fuel source for the brain, and are thus likely able to circumvent some of the abnormalities in glucose metabolism and transport found in migraines. Recent research has shown that KBs-D-β-hydroxybutyrate in particular-are more than metabolites. As signalling molecules, they have the potential to positively influence other pathways commonly believed to be part of migraine pathophysiology, namely: mitochondrial functioning, oxidative stress, cerebral excitability, inflammation and the gut microbiome. This review will describe the mechanisms by which the presence of KBs, D-BHB in particular, could influence those migraine pathophysiological mechanisms. To this end, common abnormalities in migraines are summarised with a particular focus on clinical data, including phenotypic, biochemical, genetic and therapeutic studies. Experimental animal data will be discussed to elaborate on the potential therapeutic mechanisms of elevated KBs in migraine pathophysiology, with a particular focus on the actions of D-BHB. In complex diseases such as migraines, a therapy that can target multiple possible pathogenic pathways seems advantageous. Further research is needed to establish whether the absence/restriction of dietary carbohydrates, the presence of KBs, or both, are of primary importance for the migraine protective effects of the KD.
Collapse
Affiliation(s)
- Elena C Gross
- Division of Paediatric Neurology, University Children's Hospital Basel (UKBB), University of Basel, 4056 Basel, Switzerland.
| | - Rainer J Klement
- Department of Radiation Oncology, Leopoldina Hospital Schweinfurt, 97422 Schweinfurt, Germany.
| | - Jean Schoenen
- Headache Research Unit, University of Liège, Dept of Neurology-Citadelle Hospital, 4000 Liège, Belgium.
| | - Dominic P D'Agostino
- Department of Molecular Pharmacology and Physiology, Metabolic Medicine Research Laboratory, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA.
- Institute for Human and Machine Cognition, Ocala, FL 34471, USA.
| | - Dirk Fischer
- Division of Paediatric Neurology, University Children's Hospital Basel (UKBB), University of Basel, 4056 Basel, Switzerland.
| |
Collapse
|
9
|
Yilmaz Avci A, Akkucuk MH, Torun E, Arikan S, Can U, Tekindal MA. Migraine and subclinical atherosclerosis: endothelial dysfunction biomarkers and carotid intima-media thickness: a case-control study. Neurol Sci 2019; 40:703-711. [DOI: 10.1007/s10072-019-3710-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 01/08/2019] [Indexed: 01/03/2023]
|
10
|
Diagnostic and Severity-Tracking Biomarkers for Autism Spectrum Disorder. J Mol Neurosci 2018; 66:492-511. [DOI: 10.1007/s12031-018-1192-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 09/25/2018] [Indexed: 01/06/2023]
|
11
|
Tripathi GM, Kalita J, Misra UK. A study of oxidative stress in migraine with special reference to prophylactic therapy. Int J Neurosci 2017; 128:318-324. [PMID: 28903615 DOI: 10.1080/00207454.2017.1374959] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The role of oxidative stress markers in migraine and effect of treatment on these has been reported. SUBJECTS AND METHODS One hundred and fifty patients having > four attacks of migraine headache/month were included. Headache severity, Migraine Index (MI) and frequency of headache were noted. 120 patients received repetitive transcranial magnetic stimulation (rTMS) therapy and 30 patients received Amitriptyline (AMT). Recovery was defined by 50% improvement in frequency, severity or reduction in MI. Oxidative stress and antioxidant markers have been estimated in patients before and after treatment and correlate the clinical and outcome parameters. RESULTS Glutathione (GSH) (P < 0.001), glutathione-S-transferase (GST) (P = 0.049) and total antioxidant activity (TAC) (P < 0.001) level were significantly reduced in migraine patients. GSH (P = 0.02), GST (P = 0.05) and TAC (P < 0.001) were reduced in ictal migraineurs compared to controls. GSH (P < 0.001) and TAC (P = 0.003) levels increased after treatment compared to the base line. There is an increase in GSH levels in the patients who had improved following rTMS (P = 0.003); placebo (P = 0.001) and AMT (P = 0.013). TAC levels were also increased following rTMS (P = 0.009) and AMT (P = 0.020). CONCLUSION There is evidence of oxidative stress in migraine pathophysiology. Following treatment, oxidative stress declined following both pharmacological and rTMS.
Collapse
Affiliation(s)
- Gyanesh M Tripathi
- a Department of Neurology , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India
| | - Jayantee Kalita
- a Department of Neurology , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India
| | - Usha K Misra
- a Department of Neurology , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India
| |
Collapse
|
12
|
Shukla R, Barthwal MK, Srivastava N, Sharma P, Raghavan SAV, Nag D, Srimal RC, Seth PK, Dikshit M. Neutrophil-Free Radical Generation and Enzymatic Antioxidants in Migraine Patients. Cephalalgia 2016; 24:37-43. [PMID: 14687011 DOI: 10.1111/j.1468-2982.2004.00631.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The present study was undertaken to elucidate the role of circulating neutrophils if any in oxidative stress in migraine by evaluating free radical generation and activities of enzymatic antioxidants in the blood in 55 patients with migraine and 60 healthy controls. Free radical generation was assessed by flow cytometry, while activity of catalase, superoxide dismutase (SOD) and glutathione peroxidase (GPx) was estimated in blood polymorphonuclear neutrophils (PMNs) by standard procedures. Platelet SOD was also measured. No significant change was found in free radical generation and in the activity of catalase, SOD and GPx in migraine patients. Univariate analysis of PMN catalase level revealed that migraineurs with a positive family history had significantly lower catalase activity compared with those with a negative family history. No correlation was found in the activity of antioxidant enzymes with age, duration of disease, time since last attack and headache index. The platelet SOD also did not show any significant change in patients of migraine without aura. Platelet aggregation in the presence or absence of PMNs was also not altered significantly. Thus the findings of the present study suggest that neutrophils are not the cause of oxidative stress observed in migraine patients.
Collapse
Affiliation(s)
- R Shukla
- Department of Neurology, Chhatrapati Shahuji Maharaj Medical University (Upgraded King George's Medical College), Lucknow, India.
| | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Ciancarelli I, Tozzi-Ciancarelli MG, Di Massimo C, Marini C, Carolei A. Flunarizine Effects on Oxidative Stress in Migraine Patients. Cephalalgia 2016; 24:528-32. [PMID: 15196294 DOI: 10.1111/j.1468-2982.2003.00705.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Prophylactic activity of flunarizine in migraine is attributed to its antioxidant properties and to the relief of cerebral vasospasm in which nitric oxide (NO) is involved. We investigated the antimigraine activity of flunarizine and its influence on NO and oxidative marker bioavailability in 25 subjects suffering from migraine without aura and in 25 healthy controls. Urinary samples collected before and after treatment with flunarizine (5 mg orally per day for 6 months) were assayed for NO stable metabolites (NOx) and thiobarbituric acid reactive substances (TBARS). Urinary levels of NOx and TBARS were higher in migraine sufferers before treatment than in healthy controls. No differences were observed in NOx levels in migraine sufferers, before and after flunarizine treatment; urinary TBARS levels were decreased after flunarizine treatment ( P < 0.05) and remained persistently higher than in healthy controls ( P < 0.05). Our results suggest that flunarizine did not prevent NO-mediated vasodilatation, while it proved effective in limiting the oxidative reactions occurring in migraine sufferers.
Collapse
Affiliation(s)
- I Ciancarelli
- Department of Neurology, University of L'Aquila, Italy
| | | | | | | | | |
Collapse
|
14
|
Erdélyi-Bótor S, Komáromy H, Kamson DO, Kovács N, Perlaki G, Orsi G, Molnár T, Illes Z, Nagy L, Kéki S, Deli G, Bosnyák E, Trauninger A, Pfund Z. Serum L-arginine and dimethylarginine levels in migraine patients with brain white matter lesions. Cephalalgia 2016; 37:571-580. [DOI: 10.1177/0333102416651454] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background/Aim Migraine is a risk factor for the formation of silent brain white matter lesions (WMLs) that are possibly ischemic in nature. Although dysfunction of the L-arginine/nitric oxide (NO) pathway has been associated with oxidative stress and endothelial dysfunction in migraine, its role in WML development has not been specifically investigated. Thus, this prospective study aimed to measure the serum concentrations of the NO substrate L-arginine, the NO synthase inhibitor asymmetric dimethylarginine (ADMA), and the L-arginine transport regulator symmetric dimethylarginine (SDMA) in migraine patients in a headache-free period. Methods All participants underwent MR imaging to assess for the presence of WMLs on fluid-attenuated inversion recovery imaging. Altogether 109 migraine patients (43 with lesions, 66 without lesions) and 46 control individuals were studied. High-performance liquid chromatography was used to quantify L-arginine, ADMA and SDMA serum concentrations. Migraine characteristics were investigated, and participants were screened for risk factors that can lead to elevated serum ADMA levels independent of migraine. Results Migraine patients and controls did not differ in regard to vascular risk factors. Migraineurs with WMLs had a longer disease duration ( p < 0.001) and a higher number of lifetime headache attacks ( p = 0.005) than lesion-free patients. Higher L-arginine serum levels were found in both migraine subgroups compared to controls ( p < 0.001). Migraine patients with WMLs showed higher ADMA concentrations than lesion-free patients and controls ( p < 0.001, for both). In migraineurs, the presence of WMLs, aura and increasing age proved to be significant predictors of increased ADMA levels ( p = 0.008, 0.047 and 0.012, respectively). SDMA serum levels of lesional migraineurs were higher than in nonlesional patients ( p < 0.001). The presence of lesions and increasing age indicated an increased SDMA level ( p = 0.017 and 0.001, respectively). Binary logistic regression analysis showed that ADMA level ( p = 0.006), increasing age ( p = 0.017) and the total number of lifetime migraine attacks ( p = 0.026) were associated with an increased likelihood of exhibiting WMLs. There was no significant effect of age on ADMA and SDMA concentrations in controls. Conclusions Elevated ADMA levels may impact the pathogenesis of migraine-related WMLs by influencing cerebrovascular autoregulation and vasomotor reactivity. Higher SDMA concentrations may indirectly influence NO synthesis by reducing substrate availability. Elevated L-arginine serum levels might reflect an increased demand for NO synthesis.
Collapse
Affiliation(s)
| | | | | | - Norbert Kovács
- Department of Neurology, University of Pécs, Pécs, Hungary
| | - Gábor Perlaki
- Department of Neurology, University of Pécs, Pécs, Hungary
- Diagnostic Center of Pécs, Pécs, Hungary
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Gergely Orsi
- Department of Neurology, University of Pécs, Pécs, Hungary
- Diagnostic Center of Pécs, Pécs, Hungary
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Tihamér Molnár
- Department of Anesthesiology and Intensive Care, University of Pécs, Pécs, Hungary
| | - Zsolt Illes
- Department of Neurology, University of Pécs, Pécs, Hungary
| | - Lajos Nagy
- Department of Applied Chemistry, University of Debrecen, Debrecen, Hungary
| | - Sándor Kéki
- Department of Applied Chemistry, University of Debrecen, Debrecen, Hungary
| | - Gabriella Deli
- Department of Neurology, University of Pécs, Pécs, Hungary
| | - Edit Bosnyák
- Department of Neurology, University of Pécs, Pécs, Hungary
| | | | - Zoltán Pfund
- Department of Neurology, University of Pécs, Pécs, Hungary
| |
Collapse
|
15
|
Gumusyayla S, Vural G, Bektas H, Neselioglu S, Deniz O, Erel O. A novel oxidative stress marker in migraine patients: dynamic thiol–disulphide homeostasis. Neurol Sci 2016; 37:1311-7. [DOI: 10.1007/s10072-016-2592-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 04/26/2016] [Indexed: 11/29/2022]
|
16
|
Eren Y, Dirik E, Neşelioğlu S, Erel Ö. Oxidative stress and decreased thiol level in patients with migraine: cross-sectional study. Acta Neurol Belg 2015; 115:643-9. [PMID: 25595415 DOI: 10.1007/s13760-015-0427-y] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 01/03/2015] [Indexed: 11/26/2022]
Abstract
Although migraine is a neurological disorder known since long, its physiopathology remains unclear. Recent studies suggest that migraine is associated with oxidative stress; however, they report divergent results. The aim of the present study was to evaluate total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), and serum thiol level in migraine patients with or without aura. The study group consisted of 141 migraine patients. The control group included 70 healthy subjects. TAS, TOS, OSI were evaluated using a method developed by Erel. Serum thiol level was measured using the Hu method. No difference was found in TAS, TOS, OSI between the patients and controls. The level of thiol was significantly lower in patients than in controls. Negative correlations were detected between thiol level and Migraine Disability Assessment score in patients. Although TAS, TOS, and OSI were similar to those of the control group, serum thiol level, an important marker of antioxidant capacity, was significantly lower in migraines compared with controls, and caused more serious disability. Novel treatment approaches may be developed based on these data, and compounds containing thiol, such as alpha lipoic acid and N-acetyl cysteine, may be used in prophylaxis.
Collapse
Affiliation(s)
- Yasemin Eren
- Department of Neurology, Dıskapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
| | - Ebru Dirik
- Department of Neurology, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Salim Neşelioğlu
- Department of Biochemistry, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Özcan Erel
- Department of Biochemistry, Yıldırım Beyazıt University Medical Faculty, Ankara, Turkey
| |
Collapse
|
17
|
García-Martín E, Martínez C, Serrador M, Alonso-Navarro H, Navacerrada F, García-Albea E, Agúndez JAG, Jiménez-Jiménez FJ. Neuronal Nitric Oxide Synthase (nNOS, NOS1) rs693534 and rs7977109 Variants and Risk for Migraine. Headache 2015; 55:1209-17. [PMID: 26283425 DOI: 10.1111/head.12617] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND/OBJECTIVES Many biochemical, pharmacological, neuropathological, and experimental data suggest a possible role of nitric oxide in the pathogenesis of migraine. We investigated the possible association between functional single nucleotide polymorphisms (SNPs) in the neuronal nitric oxide synthase gene (NOS1 or nNOS; chromosome 12q24.22) and the risk for migraine. METHODS We studied the frequency of the of rs7977109 and rs693534 genotypes and allelic variants in 197 patients with migraine and 308 healthy controls using a TaqMan-based qPCR assay. As a secondary analysis, we studied the possible influence of gender, age at onset of migraine, positive family history of migraine, and presence or absence of aura on the genotypes frequency. RESULTS The frequencies of rs7977109 and rs693534 genotypes and allelic variants were not associated with the risk for migraine with OR for minor alleles = 0.94 (95% CI 0.72-1.23) and = 0.88 (0.68-1.15), respectively, and the lack of association was not influenced by gender, age at onset of migraine, positive family history of migraine, and presence or absence of aura. CONCLUSION NOS1 rs7977109 and rs693534 genotypes and allelic variants are not associated with the risk for migraine in Caucasian Spanish people.
Collapse
Affiliation(s)
- Elena García-Martín
- Department of Pharmacology, University of Extremadura, Cáceres, Spain.,Red de Investigación de Reacciones Adversas a Alergenos y Fármacos, Instituto de Salud Carlos III, Madrid, Spain.,AMGenomics, Cáceres, Spain
| | - Carmen Martínez
- Red de Investigación de Reacciones Adversas a Alergenos y Fármacos, Instituto de Salud Carlos III, Madrid, Spain.,Department of Pharmacology, University of Extremadura, Badajoz, Spain
| | - Mercedes Serrador
- Department of Family Medicine, Hospital "Príncipe de Asturias,", Universidad de Alcalá, Madrid, Spain
| | - Hortensia Alonso-Navarro
- Section of Neurology, Hospital Universitario del Sureste, Madrid, Spain.,Department of Medicine-Neurology, Hospital "Príncipe de Asturias,", Universidad de Alcalá, Madrid, Spain
| | - Francisco Navacerrada
- Section of Neurology, Hospital Universitario del Sureste, Madrid, Spain.,Service of Neurology, Hospital "Ramón y Cajal,", Universidad de Alcalá, Madrid, Spain
| | - Esteban García-Albea
- Department of Medicine-Neurology, Hospital "Príncipe de Asturias,", Universidad de Alcalá, Madrid, Spain
| | - José A G Agúndez
- Department of Pharmacology, University of Extremadura, Cáceres, Spain.,Red de Investigación de Reacciones Adversas a Alergenos y Fármacos, Instituto de Salud Carlos III, Madrid, Spain.,AMGenomics, Cáceres, Spain
| | - Félix Javier Jiménez-Jiménez
- Section of Neurology, Hospital Universitario del Sureste, Madrid, Spain.,Department of Medicine-Neurology, Hospital "Príncipe de Asturias,", Universidad de Alcalá, Madrid, Spain
| |
Collapse
|
18
|
Vitamin supplementation as possible prophylactic treatment against migraine with aura and menstrual migraine. BIOMED RESEARCH INTERNATIONAL 2015; 2015:469529. [PMID: 25815319 PMCID: PMC4359851 DOI: 10.1155/2015/469529] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 02/17/2015] [Indexed: 12/13/2022]
Abstract
Migraine is the most common form of headache disorder globally. The etiology of migraine is multifactorial, with genetic components and environmental interactions considered to be the main causal factors. Some researchers postulate that deficits in mitochondrial energy reserves can cause migraine or an increase in homocysteine levels can lead to migraine attacks; therefore, vitamins could play a vital role in migraine prevention. For instance, riboflavin influences mitochondrial dysfunction and prevents migraine. Genes such as flavoenzyme 5,10-methylenetetrahydrofolate reductase (MTHFR), especially the C677T variant, have been associated with elevated plasma levels of homocysteine and migraine with aura. Homocysteine catalyzation requires the presence of vitamins B6, B12, and folic acid, which can decrease the severity of migraine with aura, making these vitamins potentially useful prophylactic agents for treating migraine with aura. Menstrual migraine, on the other hand, is associated with increased prostaglandin (PG) levels in the endometrium, indicating a role for vitamin E, which is an anti-PG. Vitamin C can also be used as a scavenger of reactive oxygen species for treating neurogenic inflammation in migraine patients. This paper reviews possible therapies based on vitamin supplementation for migraine prophylaxis, focusing on migraine with aura and menstrual migraine.
Collapse
|
19
|
Neri M, Frustaci A, Milic M, Valdiglesias V, Fini M, Bonassi S, Barbanti P. A meta-analysis of biomarkers related to oxidative stress and nitric oxide pathway in migraine. Cephalalgia 2015; 35:931-7. [DOI: 10.1177/0333102414564888] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 11/16/2014] [Indexed: 01/30/2023]
Abstract
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.
Collapse
Affiliation(s)
- Monica Neri
- Clinical and Molecular Epidemiology, Area of Systems Approaches and Non-Communicable Diseases, IRCCS San Raffaele Pisana, Italy
| | - Alessandra Frustaci
- Clinical and Molecular Epidemiology, Area of Systems Approaches and Non-Communicable Diseases, IRCCS San Raffaele Pisana, Italy
| | - Mirta Milic
- Clinical and Molecular Epidemiology, Area of Systems Approaches and Non-Communicable Diseases, IRCCS San Raffaele Pisana, Italy
- Institute for Medical Research and Occupational Health, Mutagenesis Unit, Croatia
| | - Vanessa Valdiglesias
- Clinical and Molecular Epidemiology, Area of Systems Approaches and Non-Communicable Diseases, IRCCS San Raffaele Pisana, Italy
| | | | - Stefano Bonassi
- Clinical and Molecular Epidemiology, Area of Systems Approaches and Non-Communicable Diseases, IRCCS San Raffaele Pisana, Italy
| | - Piero Barbanti
- Headache and Pain Unit, Department of Neurological, Motor and Sensorial Sciences, IRCCS San Raffaele Pisana, Italy
| |
Collapse
|
20
|
Butt JH, Franzmann U, Kruuse C. Endothelial function in migraine with aura - a systematic review. Headache 2014; 55:35-54. [PMID: 25546573 DOI: 10.1111/head.12494] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND An increased risk of ischemic stroke is repeatedly reported in young subjects with migraine with aura (MA). Such may be caused by changes in endothelial function. The present review evaluates current evidence on endothelial function in MA patients. METHODS A systematic search of electronic databases (Medline, Embase, Cochrane library) was performed, and a search in associated reference lists of identified studies was done. RESULTS In total, 27 studies met inclusion criteria for this review. Six studies assessed endothelial function by flow-mediated dilation; four reported no differences compared with healthy subjects, one study reported an increase and one study a decrease in migraineurs. Peripheral arterial tonometry was applied in one study where no changes were detected between groups. Likewise, applying venous occlusion plethysmography elicited comparable responses. Arterial function was investigated in six studies; increased augmentation index and decreased arterial distensibility were reported in migraineurs, whereas findings regarding pulse wave velocity were dissimilar. However, when investigating levels of endothelial progenitor cells, two studies reported reduced levels in migraineurs, and several studies on endothelial markers in the areas of inflammation, oxidative stress, and coagulation found increased endothelial activation in migraineurs, particularly in MA. One study, assessing cerebral endothelial function using transcranial Doppler sonography, reported lower cerebrovascular reactivity to L-arginine in the posterior cerebral arteries in migraineurs. CONCLUSION Endothelial dysfunction appears not to be of importance in MA patients. However, the studies were few with a wide variety of techniques applied in small groups of patients. Endothelial biomarkers were increased in patients indicating a possible subtle change in the endothelium. Further investigations on larger groups of patients combining testing of endothelial dysfunction as well as biomarkers are warranted to identify whether or not endothelial changes may play a role in the increased risk of stroke in young MA patients.
Collapse
Affiliation(s)
- Jawad H Butt
- Department of Neurology, Neurovascular Research Unit, Copenhagen University Hospital Herlev, Herlev, Denmark
| | | | | |
Collapse
|
21
|
Abstract
In women ages 15-45 years, an additional set of risk factors are important in the pathogenesis of ischemic stroke. Some of these pertain strictly to women, and relate to exogenous hormones and pregnancy. Various other conditions are more common in women, which include migraine with aura, selected vascular disorders and autoimmune conditions. These differences do have implications for management in both the primary and secondary prevention of stroke in this age group.
Collapse
|
22
|
Decreased antioxidant status in migraine patients with brain white matter hyperintensities. Neurol Sci 2014; 35:1925-9. [DOI: 10.1007/s10072-014-1864-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 06/24/2014] [Indexed: 10/25/2022]
|
23
|
Cetinkaya Y, Dasdemir S, Gencer M, Bireller ES, Ozkok E, Aydin M, Cakmakoglu B. DNA repair gene variants in migraine. Genet Test Mol Biomarkers 2014; 18:568-73. [PMID: 24892639 DOI: 10.1089/gtmb.2014.0037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
AIMS Migraine is a common and debilitating episodic disorder characterized by recurrent headache attacks associated with autonomic symptoms. It affects an estimated 12% of the population. The etiology of the underlying neurodegenerative process is widely unknown; however, oxidative stress is a unifying factor in the current theories of migraine pathogenesis. After demonstrating the observation that oxidative DNA damage is detectable in migraine disease, searching the role played by DNA repair systems in migraine diseases could bring us much significant information about the pathogenesis of migraine. We prospectively investigated whether DNA repair gene polymorphisms (XRCC1 Arg399Gln, XRCC3 Thr241Met XPD Lys751Gln, XPG Asp1104His, APE1 Asp148Glu, hOGG1 Ser326Cys) account for an increased risk of migraine. The present analyses are based on 135 case subjects with migraine disease and 101 noncase subjects. Genotyping of DNA repair gene polymorphisms (XRCC1 Arg399Gln, XRCC3 Thr241Met XPD Lys751Gln, XPG Asp1104His, APE1 Asp148Glu, hOGG1 Ser326Cys) was detected by polymerase chain reaction-restriction fragment length polymorphism. RESULTS We demonstrated that apurinic endonuclease (APE), X-ray repair complementing defective repair in Chinese hamster cells 3 (XRCC3), xeroderma pigmentosum D (XPD), and hOGG1 gene variants were associated with an increased risk for development of migraine disease (p<0.05). In contrast, no statistically significant differences were found in genotype distributions of X-ray repair complementing defective repair in Chinese hamster cells 1 (XRCC1) and XPG between migraine cases and controls (p>0.05). CONCLUSIONS Our findings have suggested that APE1, XRCC3, XPD, and hOGG1 gene variants could facilitate the development of migraine disease.
Collapse
Affiliation(s)
- Yilmaz Cetinkaya
- 1 Department of Neurology, Haydarpasa Numune Training and Research Hospital , Istanbul, Turkey
| | | | | | | | | | | | | |
Collapse
|
24
|
Rathnasiri Bandara SM. Migraine and psychiatric disorders co-morbidity explained by sinus hypoxic nitric oxide theory - a new hypothesis on the Sino rhinogenic theory. Med Hypotheses 2013; 82:257-65. [PMID: 24411127 DOI: 10.1016/j.mehy.2013.11.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 11/23/2013] [Accepted: 11/26/2013] [Indexed: 01/17/2023]
Abstract
Migraine is an extremely common incapacitating neurovascular disorder and has co morbidity with many psychiatric illnesses which are caused by neurotransmitter imbalance, neurodegenerative changes and genetic predisposition. The sinus hypoxic nitric oxide theory presents, diffused paranasal sinus nitric oxide in the nasal mucosa has been hypothesized as the primary molecule that initiates migraine. Existence of such pathophysiology in human beings is termed as sinus hypoxic nitric oxide phenomena. According to this new hypothesis the sinorhinogenic trigeminal nerve impulse distribution of the central nervous system, is suggested to cause central neurotransmitter track dysfunction and cortical spreading depression with neurodegeneration that may relate to co morbidity. Moreover, avoidance of the excess sinorhinogenic central neuronal influence to the brain in early child hood and early intervention in the case of genetic susceptible history with psychiatric illnesses would help to prevent the progression or aggravation of psychiatric illnesses according to this hypothesis. This article explains a new pathophysiological initiation between central effects of sinorhinogenic nitric oxide phenomena and psychiatric disorders. It also provides an etiologically important neuro vascular impulse generating pathway to cause or aggravate psychiatric disorders. Therefore patients who are clinically suspected of having migraine headache and psychiatric disorders should receive a comprehensive sinorhinological examination and evaluation based on the sinus hypoxic nitric oxide phenomena.
Collapse
|
25
|
Chen SP, Chung YT, Liu TY, Wang YF, Fuh JL, Wang SJ. Oxidative stress and increased formation of vasoconstricting F2-isoprostanes in patients with reversible cerebral vasoconstriction syndrome. Free Radic Biol Med 2013; 61:243-8. [PMID: 23608464 DOI: 10.1016/j.freeradbiomed.2013.04.022] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Revised: 03/28/2013] [Accepted: 04/13/2013] [Indexed: 10/26/2022]
Abstract
The pathophysiology of reversible cerebral vasoconstriction syndrome (RCVS) is unknown. Oxidative stress is detrimental to endothelial function and vascular reactivity. We hypothesized that the oxidative stress marker 8-iso-prostaglandin F2α, which is also a potent vasoconstrictor, might contribute to the pathogenesis of RCVS. Recruited participants included 103RCVS patients, 53 patients with primary headache with acute severe attacks, and 54 healthy controls. Subjects recruited prior to 2009 were discovery cohort, whereas those after 2009, replication cohort. Urine samples were obtained from all patients at registration and from 79 patients with RCVS again at remission stage. Urine 8-iso-prostaglandin F2α was analyzed by liquid chromatography-tandem mass spectrometry. Patients with RCVS received magnetic resonance angiography and transcranial color-coded sonography. In RCVS patients, the urine 8-iso-prostaglandin F2α level was higher than that in the other groups in discovery, replication, and combined cohorts (RCVS, 0.29±0.18; primary headache with acute severe attacks, 0.21±0.19; control, 0.18±0.09ng/mg creatinine; P<0.001), and it was positively correlated with the flow velocities of major intracranial arteries, especially within the first week of disease onset (middle cerebral artery, Spearman's correlation coefficient [rs]=0.580, P=0.002; anterior cerebral artery, rs=0.472, P=0.042; posterior cerebral artery, rs=0.457, P=0.022; basilar artery, rs= 0.530, P=0.002). The 8-iso-prostaglandin F2α level decreased from the ictalto remission stage in RCVS patients (0.31±0.21 vs 0.16±0.10ng/mg creatinine, P<0.001). 8-Iso-prostaglandin F2α was higher in patients with RCVS and correlated with the severity of vasoconstrictions. Further studies are required to explore its potential pathogenic role.
Collapse
Affiliation(s)
- Shih-Pin Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Brain Research Center, National Yang-Ming University, Taipei, Taiwan.
| | - Yu-Ting Chung
- Institute of Environmental and Occupational Health Sciences, National Yang-Ming University School of Medicine, Taipei, Taiwan; Department of Medical Research & Education, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Tsung-Yun Liu
- Institute of Environmental and Occupational Health Sciences, National Yang-Ming University School of Medicine, Taipei, Taiwan; Department of Medical Research & Education, Taipei Veterans General Hospital, Taipei, Taiwan; Department and Institute of Pharmacology, School of Medicine, National Yang-Ming University, Taipei.
| | - Yen-Feng Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Brain Research Center, National Yang-Ming University, Taipei, Taiwan.
| | - Jong-Ling Fuh
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Brain Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Brain Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.
| |
Collapse
|
26
|
Vurucu S, Karaoglu A, Paksu MS, Yesilyurt O, Oz O, Unay B, Akin R. Relationship between oxidative stress and chronic daily headache in children. Hum Exp Toxicol 2013; 32:113-9. [PMID: 23315275 DOI: 10.1177/0960327112459204] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to investigate the relationship between oxidative stress and chronic daily headache (CDH) in children. Although there are reports that oxidative injury may play a role in the pathophysiology of some neurologic disorders, such as migraine and epilepsy, by disrupting or destroying cell membranes through the formation of free radical and reactive oxygen species, the pathophysiology of headache is not clearly established. A total of 38 children (16 boys and 22 girls) with CDH, aged between 7 and 15 years, were enrolled in the study. The control group consisted of 39 healthy children (17 boys and 22 girls), aged between 7 and 14 years. The mean age was 10.9 ± 2.2 years for both the groups. Activities of erythrocyte superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) as well as malondialdehyde (MDA) levels in all the children of both the groups were measured. Mean activities of erythrocyte SOD, CAT, and GPx as well as MDA levels were significantly higher in the study group than in the control group (p < 0.001). The findings of this study suggest that oxidative stress may play a causal or consequential role in children with CDH.
Collapse
Affiliation(s)
- S Vurucu
- Department of Pediatric Neurology, Gulhane Military Medical Faculty, Ankara, Turkey
| | | | | | | | | | | | | |
Collapse
|
27
|
Alaşehirli B, Akçalı A, Demiryürek AT, Özel A, Erdal ME, Neyal M. Lack of association between the C276T polymorphism of the neuronal nitric oxide synthase gene and migraine. Int J Neurosci 2012; 123:50-4. [PMID: 22937753 DOI: 10.3109/00207454.2012.724743] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A migraine attack is a spectacularly complex brain event that can produce a wide array of neurological and systemic symptoms. The molecular mechanisms and genetics of migraine have not yet been clarified. The objective of this study was to analyze the genotype distributions and allele frequencies for the C276T polymorphism of the neuronal nitric oxide synthase (nNOS) gene among the patients with migraine. The diagnosis of migraine was made clinically based on questionnaires. One hundred and twenty patients with migraine were genotyped for the C276T polymorphism of the nNOS gene and compared with 185 age-matched healthy controls. Genomic DNA from migraine patients and controls was analyzed by polymerase chain reaction (PCR). A PCR-restriction fragment-length polymorphism analysis of nNOS gene polymorphism was performed, and the results were compared. Neither genotype distributions nor the allele frequencies for the C276T polymorphism showed a significant difference between the groups. Additionally, there was no marked differences in genotype distribution or allele frequencies for the migraine without aura and migraine with aura subgroups when compared to control group. These results suggested that migraine of the Turkish population seemed to develop without any alterations in nNOS C276T polymorphism. Our data showed that there is no marked association between the C276T polymorphism of the nNOS gene and migraine.
Collapse
Affiliation(s)
- Belgin Alaşehirli
- Department of Medical Pharmacology, Faculty of Medicine, University of Gaziantep, Gaziantep, Turkey.
| | | | | | | | | | | |
Collapse
|
28
|
Cordero MD, Cano-García FJ, Alcocer-Gómez E, De Miguel M, Sánchez-Alcázar JA. Oxidative stress correlates with headache symptoms in fibromyalgia: coenzyme Q₁₀ effect on clinical improvement. PLoS One 2012; 7:e35677. [PMID: 22532869 PMCID: PMC3330812 DOI: 10.1371/journal.pone.0035677] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Accepted: 03/21/2012] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Fibromyalgia (FM) is a chronic pain syndrome with unknown etiology and a wide spectrum of symptoms such as allodynia, debilitating fatigue, joint stiffness and migraine. Recent studies have shown some evidences demonstrating that oxidative stress is associated to clinical symptoms in FM of fibromyalgia. We examined oxidative stress and bioenergetic status in blood mononuclear cells (BMCs) and its association to headache symptoms in FM patients. The effects of oral coenzyme Q(10) (CoQ(10)) supplementation on biochemical markers and clinical improvement were also evaluated. METHODS We studied 20 FM patients and 15 healthy controls. Clinical parameters were evaluated using the Fibromyalgia Impact Questionnaire (FIQ), visual analogues scales (VAS), and the Headache Impact Test (HIT-6). Oxidative stress was determined by measuring CoQ(10), catalase and lipid peroxidation (LPO) levels in BMCs. Bioenergetic status was assessed by measuring ATP levels in BMCs. RESULTS We found decreased CoQ(10), catalase and ATP levels in BMCs from FM patients as compared to normal control (P < 0.05 and P < 0.001, respectively) We also found increased level of LPO in BMCs from FM patients as compared to normal control (P < 0.001). Significant negative correlations between CoQ(10) or catalase levels in BMCs and headache parameters were observed (r = -0.59, P < 0.05; r = -0.68, P < 0.05, respectively). Furthermore, LPO levels showed a significant positive correlation with HIT-6 (r = 0.33, P<0.05). Oral CoQ(10) supplementation restored biochemical parameters and induced a significant improvement in clinical and headache symptoms (P < 0.001). DISCUSSION The results of this study suggest a role for mitochondrial dysfunction and oxidative stress in the headache symptoms associated with FM. CoQ10 supplementation should be examined in a larger placebo controlled trial as a possible treatment in FM.
Collapse
Affiliation(s)
- Mario D Cordero
- Centro Andaluz de Biología del Desarrollo, Universidad Pablo de Olavide-CSIC-Junta de Andalucía and Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Sevilla, Spain.
| | | | | | | | | |
Collapse
|
29
|
Caminero A, Sánchez Del Río González M. Migraña como factor de riesgo cerebrovascular. Neurologia 2012; 27:103-11. [DOI: 10.1016/j.nrl.2011.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 02/28/2011] [Accepted: 03/08/2011] [Indexed: 10/28/2022] Open
|
30
|
Caminero A, Sánchez Del Río González M. Migraine as a cerebrovascular risk factor. NEUROLOGÍA (ENGLISH EDITION) 2012. [DOI: 10.1016/j.nrleng.2012.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
31
|
Perko D, Pretnar-Oblak J, Šabovič M, Zaletel M, Žvan B. Associations between cerebral and systemic endothelial function in migraine patients: a post-hoc study. BMC Neurol 2011; 11:146. [PMID: 22085841 PMCID: PMC3254070 DOI: 10.1186/1471-2377-11-146] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 11/15/2011] [Indexed: 01/22/2023] Open
Abstract
Background There is a growing interest in the role of the endothelium in migraine. Recently, our group showed differences in endothelial function between the anterior and posterior cerebral circulation in healthy subjects, reduced vasodilatatory capacity of the posterior cerebral circulation and unimpaired systemic endothelial function in migraine patients without comorbidities. However, the relationship between cerebral and systemic endothelial function and the anterior and posterior cerebral endothelial function in migraine patients is still not clear. Methods We compared cerebral and systemic endothelial function through post-hoc linear regression analysis of cerebrovascular reactivity (CVR) to L-arginine between the middle cerebral artery (MCA) and flow-mediated vasodilatation (FMD) of the right brachial artery and the posterior cerebral artery (PCA) and FMD in migraine patients without comorbidities and in healthy subjects. The anterior and posterior cerebral endothelial function was also compared using post-hoc linear regression analysis between CVR to L-arginine in the MCA and the PCA. Results No significant correlation was found between CVR to L-arginine in the MCA and FMD and in the PCA and FMD in migraine patients with aura (p = 0.880 vs. p = 0.682), without aura (p = 0.153 vs. p = 0.179) and in healthy subjects (p = 0.869 vs. p = 0.662). On the other hand, we found a significant correlation between CVR to L-arginine in the MCA and PCA in migraine patients with aura (p = 0.004), without aura (p = 0.001) and in healthy subjects (p = 0.002). Detailed analysis of the linear regression between all migraine patients and healthy subjects did not show any difference in the regression coefficient (slope) (p = 0.382). However, a significant difference in curve elevation (intercept) was found (p = 0.002). Conclusions Our study suggests that the endothelial function in the cerebral and systemic circulation might be different in migraine patients without comorbidities, while that of the anterior and posterior cerebral circulation might be coupled. These results could improve understanding of endothelial function in migraine patients without comorbidities.
Collapse
Affiliation(s)
- Denis Perko
- Department of Neurology, University Medical Centre Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenia.
| | | | | | | | | |
Collapse
|
32
|
Mitochondrial dependent apoptosis: ameliorative effect of flunarizine on ischemia-reperfusion of celiac artery-induced gastric lesions in the rat. Dig Dis Sci 2011; 56:2244-51. [PMID: 21327706 DOI: 10.1007/s10620-011-1607-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Accepted: 01/29/2011] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Ischemia-reperfusion is a major event for induction of cellular apoptosis. Apoptosis is due to the activation of death receptor and/or mitochondrial pathways. Mitochondrial permeability transition pore opening is the cause of apoptosis. In our present study, we tried to evaluate the role of flunarizine in ischemia and reperfusion of celiac artery-induced gastric lesion in the rat. METHODS The therapeutic potential of flunarizine was assessed by measuring the changes in gastric lesion index, biomarker (i.e., thiobarbituric acid reactive substance, reduced glutathione, superoxide dismutase, myeloperoxidase, and total calcium and protein content), and mitochondrial damage (i.e., adenosine triphosphate and deoxyribonucleic acid fragmentation content) in ischemia and reperfusion-induced gastric lesion model. RESULTS Medium and higher doses of flunarizine produced a significant (P<0.05) ameliorative effect which was observed from the assessment of all the above-mentioned parameters (i.e., increase in reduced glutathione, superoxide dismutase and decrease in thiobarbituric acid reactive substance, myeloperoxidase, and total calcium content). Similar results were also obtained from omeprazole and cyclosporine. In the pre-treated group, deoxyribonucleic acid fragmentation pattern has also indicated that a mitochondria-associated anti-apoptotic effect of flunarizine was responsible to prevent the ischemia and reperfusion of celiac artery-induced gastric lesion. CONCLUSION The gastroprotective effect of flunarizine may be produced due to its inactivation potential of mitochondrial permeability transition pore opening associated with anti-oxidative, calcium regulation along with its anti-apoptotic effect.
Collapse
|
33
|
Yilmaz N, Aydin O, Yegin A, Tiltak A, Eren E. Increased levels of total oxidant status and decreased activity of arylesterase in migraineurs. Clin Biochem 2011; 44:832-7. [DOI: 10.1016/j.clinbiochem.2011.04.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 04/10/2011] [Accepted: 04/13/2011] [Indexed: 10/18/2022]
|
34
|
|
35
|
Uzar E, Evliyaoglu O, Toprak G, Acar A, Yucel Y, Calisir T, Cevik MU, Tasdemir N. Increased asymmetric dimethylarginine and nitric oxide levels in patients with migraine. J Headache Pain 2011; 12:239-43. [PMID: 21359872 PMCID: PMC3072497 DOI: 10.1007/s10194-011-0323-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Accepted: 11/14/2010] [Indexed: 01/08/2023] Open
Abstract
Asymmetric dimethylarginine (ADMA) has been found as correlated with endothelial dysfunction and oxidative stress. There are few studies regarding ADMA and nitric oxide (NO) levels in patients with migraine and alterations of ADMA and NO levels during migraine attack are not well-known. Therefore, in present study, we aimed to measure NO and ADMA levels in patients with migraine and compare them with the control group to investigate the correlation between migraine, oxidative stress and endothelial dysfunction. The migraine group consisted of 59 patients, including 22 suffering from migraine with aura and 37 suffering from migraine without aura. The control group consisted of 31 healthy volunteers without headache. The patients in migraine group were divided into subgroups based on whether attack period was present or not and whether it was migraine with or without aura. Plasma ADMA levels were measured using an enzyme-linked immunosorbent assay method. Migraine patients had higher concentrations of NO (35.6±7.7, 31.0±6.2 μmol/L, respectively, p=0.005) and ADMA (0.409±0.028, 0.381±0.044 μmol/L, respectively, p = 0.001) levels when compared with the healthy controls. During migraine attack, NO and ADMA levels were found to be significantly higher in migraine group as compared to control group (respectively, p=0.015, p=0.014). Similarly, NO and ADMA levels in the patients with migraine in the interictal period were found to be significantly higher as compared to control group (p=0.011, p=0.003). In conclusion, higher ADMA and NO levels of patients with migraine supported that oxidative stress and endothelial dysfunction may have a role in migraine pathogenesis.
Collapse
Affiliation(s)
- Ertugrul Uzar
- Department of Neurology, Faculty of Medicine, Dicle University School of Medicine, Dicle University, 21280 Diyarbakir, Turkey.
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Perko D, Pretnar-Oblak J, Sabovic M, Zvan B, Zaletel M. Endothelium-dependent vasodilatation in migraine patients. Cephalalgia 2011; 31:654-60. [PMID: 21296807 DOI: 10.1177/0333102410390396] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Endothelial dysfunction could be involved in the pathophysiology of migraine. The results obtained from a few studies on endothelial dysfunction in migraine are controversial. We investigated brachial flow-mediated dilatation (FMD), which reflects systemic endothelial dysfunction, in migraine patients without comorbidities. By employing strict inclusion criteria we avoided the possible changes to FMD from confounding factors. METHODS Forty migraine patients without comorbidities (20 with and 20 without aura) and 20 healthy subjects were included. FMD of brachial arteries and carotid intima-media thickness were measured by using standard procedures. RESULTS We did not find any difference in FMD between migraine patients and healthy subjects (p = .96). Also, no differences were found among healthy subjects, migraine patients with aura and without aura (p = .99). CONCLUSION Our study showed that systemic endothelial function is not impaired in migraine patients without comorbidities, neither in those with or without aura. Considering these findings, the investigation of cerebral endothelial function would be useful in a further investigation of the role of endothelial (dys)function in migraine pathophysiology.
Collapse
Affiliation(s)
- Denis Perko
- University Medical Center Ljubljana, Department of Neurology, Ljubljana, Slovenia.
| | | | | | | | | |
Collapse
|
37
|
Ameliorative effect of flunarizine in cisplatin-induced acute renal failure via mitochondrial permeability transition pore inactivation in rats. Naunyn Schmiedebergs Arch Pharmacol 2010; 383:57-64. [PMID: 21058009 DOI: 10.1007/s00210-010-0572-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Accepted: 10/18/2010] [Indexed: 01/19/2023]
Abstract
This study was aimed to evaluate the protective effect of flunarizine on cisplatin-induced acute renal failure. Administration of cisplatin (6 mg/kg, i.p. on day 6) significantly increased serum blood urea nitrogen and creatinine, urinary N-acetyl β-D-glucosaminidase, tissue thiobarbituric acid reactive substances and total calcium whereas, decreased body weight, fractional excretion of sodium, creatinine clearance tissue-reduced glutathione, mitochondrial cytochrome c oxidase, and ATP levels were observed in acute renal failure rats. Moreover, cisplatin produced histopathological changes in the renal tissue. Furthermore, flunarizine (100, 200, and 300 μM/kg, p.o., for six consecutive days) was administered to evaluate its therapeutic potential in acute renal failure, and the results were compared with cyclosporin A (50 μM/kg, p.o., for six consecutive days) as a reference drug. Flunarizine resulted in the attenuation of cisplatin-induced renal dysfunction, oxidative stress marker, mitochondrial damage, and histopathological changes in rats. Medium and higher doses of flunarizine produced significant renal protective effect which was comparable to cyclosporin A. The results of this study clearly revealed that flunarizine protected the kidney against the nephrotoxic effect of cisplatin via mitochondrial permeability transition pore inactivation potential.
Collapse
|
38
|
Ali AM, Awad TG, Al-Adl NM. Efficacy of combined topiramate/thioctic acid therapy in migraine prophylaxis. Saudi Pharm J 2010; 18:239-43. [PMID: 23960733 PMCID: PMC3731023 DOI: 10.1016/j.jsps.2010.07.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2010] [Accepted: 07/10/2010] [Indexed: 11/19/2022] Open
Abstract
Migraine cannot be cured and the aim, shared with the patient, is to minimise the impact of the illness on the patient's life and lifestyle. The aim of prophylaxis is to reduce the number of migraine attacks. Prophylaxis should be considered when appropriately used acute management gives inadequate control of symptoms. The efficacy and safety of topiramate 50 mg/d and thioctic acid (α-lipoic acid) 300 mg/d either as monotherapy or in combination were investigated as migraine prophylactic agents. Forty secondary school migraineur girls were enrolled in the study. The study was conducted in two phases, a prospective baseline phase and 1-month treatment phase. Combined topiramate/thioctic acid therapy was more effective than either topiramate or thioctic acid monotherapy as a migraine-preventive treatment. Combined topiramate/thioctic acid therapy decreased the mean monthly migraine frequency from 5.86 ± 1.2 to 2.6 ± 0.98 (p ⩽ 0.05), topiramate (50 mg/d) from 5.71 ± 1.4 to 4.75 ± 1.5 and thioctic acid (300 mg/d) from 5.68 ± 1.6 to 5.22 ± 1.8. Reduction in mean monthly migraine days was also significantly greater in the group receiving combined topiramate/thioctic acid (from 12.32 ± 1.85 to 5.74 ± 1.1) compared to those receiving either topiramate 50 mg/d (from 12.7 ± 1.34 to 11.85 ± 1.35) or thioctic acid 300 mg/d (from 12.5 ± 1.72 to 11.65 ± 1.44). The responder rate (% of patients showing ⩾50% reduction in monthly migraine frequency) was 85% in patients receiving combined topiramate/thioctic acid therapy compared to 30% and 20% in patients receiving either topiramate or thioctic acid, respectively. The incidence of adverse events was higher in patients receiving topiramate (50 mg/d) monotherapy. The most common adverse events were nausea, fatigue, paraesthesia and taste perversion. We conclude that combined topiramate/thioctic acid therapy is more effective and better tolerated than topiramate monotherapy. The combination has lower monthly medication costs compared to the traditionally used topiramate 100 mg monotherapy.
Collapse
Affiliation(s)
- Ahmed M. Ali
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, October 6 University, October 6 City, Central Axis, Part 1/1 October 6 Governate, Egypt
| | | | - Nagwa M. Al-Adl
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, October 6 University, October 6 City, Central Axis, Part 1/1 October 6 Governate, Egypt
| |
Collapse
|
39
|
Erol I, Alehan F, Aldemir D, Ogus E. Increased vulnerability to oxidative stress in pediatric migraine patients. Pediatr Neurol 2010; 43:21-4. [PMID: 20682198 DOI: 10.1016/j.pediatrneurol.2010.02.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2009] [Revised: 12/22/2009] [Accepted: 02/11/2010] [Indexed: 11/29/2022]
Abstract
Little is known about the role of oxidative stress in the pathogenesis of pediatric migraine. The objective of the present study was to investigate, during a headache-free period, the activities of erythrocyte antioxidant enzymes in children and adolescents diagnosed with migraine. In all, 47 migraine patients (age range, 8-17 years; mean, 14.1 +/- 2.4 years, 14 with aura) and 35 control subjects were included. Superoxide dismutase, glutathione peroxidase, and catalase activities were measured in erythrocytes. Although superoxide dismutase activities did not differ between groups, both catalase and glutathione peroxidase activities were significantly lower in migraine patients (P = 0.001 and P = 0.009, respectively). Activities of all three antioxidant enzymes were similar across migraine subgroups; there was no correlation with age and sex. These results confirm vulnerability to oxidative stress in pediatric migraine. Further studies and search for new therapeutic agents with antioxidant properties are needed.
Collapse
Affiliation(s)
- Ilknur Erol
- Division of Child Neurology, Baskent University, Ankara, Turkey
| | | | | | | |
Collapse
|
40
|
Toda N, Ayajiki K, Okamura T. Cerebral blood flow regulation by nitric oxide in neurological disorders. Can J Physiol Pharmacol 2010; 87:581-94. [PMID: 19767882 DOI: 10.1139/y09-048] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
There has been a rapid increase in the amount of information on the physiological and pathophysiological roles of nitric oxide (NO) in the brain. This molecule, which is formed by the constitutive isoforms of NO synthase, endothelial (eNOS) and neuronal (nNOS), plays an obligatory role in the regulation of cerebral blood flow and cell viability and in the protection of nerve cells or fibres against pathogenic factors associated with Alzheimer's disease, Huntington's disease, seizures, and migraine. Cerebral blood flow is impaired by decreased formation of NO from endothelial cells, autonomic nitrergic nerves, or brain neurons and also by increased production of reactive oxygen species (ROS). The NO-ROS interaction is an important topic in discussing blood flow and cell viability in the brain. Excessive production of NO by inducible NOS (iNOS) and nNOS in the brain participates in neurotoxicity. Recent studies on brain circulation have provided useful information about the involvement of impaired NO availability or uncontrolled NO production in cerebral pathogenesis, including Alzheimer's disease, seizures, vascular headaches, and inflammatory disorders. Insight into the role of NO in the brain will contribute to our better understanding of cerebral hemodynamic dysfunction and will aid in developing novel therapeutic measures in diseases of the central nervous system.
Collapse
Affiliation(s)
- Noboru Toda
- Toyama Institute for Cardiovascular Pharmacology Research, 7-13, 1-Chome, Azuchi-machi, Chuo-ku, Osaka 541-0052, Japan.
| | | | | |
Collapse
|
41
|
García-Martín E, Martínez C, Serrador M, Alonso-Navarro H, Navacerrada F, Agúndez JAG, Jiménez-Jiménez FJ. Paraoxonase 1 (PON1) polymorphisms and risk for migraine. J Neurol 2010; 257:1482-5. [DOI: 10.1007/s00415-010-5551-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 03/10/2010] [Accepted: 03/22/2010] [Indexed: 11/24/2022]
|
42
|
Abstract
Epidemiological studies suggests that migraine is associated with disorders of the cerebral, coronary, retinal, dermal and peripheral vasculature. There is evidence that migraine is associated with endothelial dysfunction, both as a cause and a consequence. Endothelial dysfunction, a vascular risk factor, is characterized by endothelial activation and impaired vascular reactivity. Plasma and genetic biomarkers for these conditions have been identified. The clinical significance lies in the potential for the rapid identification of migraineurs at increased risk of ischaemic stroke and vascular disease through ascertainment of endothelial dysfunction biomarkers. It is uncertain whether stroke, myocardial infarction and other vasculopathies can be prevented by migraine prophylaxis, endothelial repair, platelet inhibition or a combination of these strategies.
Collapse
Affiliation(s)
- G E Tietjen
- The University of Toledo, Department of Neurology, Toledo, OH 76508, USA.
| |
Collapse
|
43
|
Galletti F, Cupini LM, Corbelli I, Calabresi P, Sarchielli P. Pathophysiological basis of migraine prophylaxis. Prog Neurobiol 2009; 89:176-92. [DOI: 10.1016/j.pneurobio.2009.07.005] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2008] [Revised: 07/14/2009] [Accepted: 07/28/2009] [Indexed: 01/04/2023]
|
44
|
|
45
|
Gupta R, Pathak R, Bhatia MS, Banerjee BD. Comparison of oxidative stress among migraineurs, tension-type headache subjects, and a control group. Ann Indian Acad Neurol 2009; 12:167-72. [PMID: 20174497 PMCID: PMC2824933 DOI: 10.4103/0972-2327.56316] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2008] [Revised: 03/26/2009] [Accepted: 07/06/2009] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND A primary headache, particularly migraine, is associated with oxidative stress during the attack. However, data regarding the interictal state in migraineurs and in those with tension-type headache (TTH) is limited. OBJECTIVES (1) To assess the oxidative stress in migraineurs and TTH subjects in between the episodes and (2) to see if there is a difference in the degree of oxidative stress in the different subtypes of migraine and TTH. MATERIALS AND METHODS Fifty migraineurs, 50 patients with TTH, and 50 control subjects were included in this study after screening for the exclusion criteria. Diagnosis of headache was made according to the International Classification of Headache Disorders (ICHD)-2 criteria. A venous blood sample was collected from the antecubital vein at least 3 days after the last attack of headache. The sample was centrifuged immediately and the plasma was stored at -70 degrees C. The ferric reducing activity of plasma (FRAP) and the malondialdehyde (MDA) levels were assessed using colorimetric methods. Statistical analysis was done with the help of SPSS for Windows, v 11.0. One way ANOVA with post hoc Tukey test, independent sample t test, univariate regression, and multivariate regression analysis were done as indicated. RESULTS Migraineurs had higher values of MDA and FRAP than the subjects in the other two groups (P<0.001). No difference was observed between the TTH group and the control group. FRAP levels were significantly higher in subjects who had mixed migraine (migraine with aura and without aura) as compared to those with only migraine without aura (mean difference 196.1; 95% CI = 27.3 to 364.9; P = 0.01). Similarly, oxidative stress was significantly higher in patients with episodic TTH as compared to those with chronic TTH (FRAP t = 3.16; P = 0.003 and MDA t = 2.75; P = 0.008). CONCLUSIONS This study suggests that oxidative stress continues even between headache episodes in migraineurs but not in those with TTH. This could probably be consequent to the different pathophysiological mechanisms of TTH and migraine.
Collapse
Affiliation(s)
- Ravi Gupta
- Departments of Psychiatry, University College of Medical Sciences and GTB Hospital, Dilshad Garden, Delhi-110 095, India
| | - Rahul Pathak
- Departments of Biochemistry, University College of Medical Sciences and GTB Hospital, Dilshad Garden, Delhi-110 095, India
| | - Manjeet Singh Bhatia
- Departments of Psychiatry, University College of Medical Sciences and GTB Hospital, Dilshad Garden, Delhi-110 095, India
| | - Basu Deb Banerjee
- Departments of Biochemistry, University College of Medical Sciences and GTB Hospital, Dilshad Garden, Delhi-110 095, India
| |
Collapse
|
46
|
Abstract
An association between migraine and ischemic stroke has been observed for many years but the exact mechanisms by which migraine can lead to stroke are currently still under investigation. Migraine seems to affect neurovascular factors and substances that increase the risk of stroke during and in between migraine attacks. Ischemic stroke can occur as a complication of an attack of migraine with aura. Epidemiological studies suggest that vascular risk factors are increased in migraineurs, thus increasing the incidence of stroke. Another important issue is a patent foramen ovale (PFO), which is a well-known risk factor for stroke and which, on the other hand, seems to be more frequent in migraineurs than in people without. The purpose of this review is to summarize the current literature linking the two neurological diseases: migraine and stroke.
Collapse
Affiliation(s)
- Zaza Katsarava
- Department of Neurology, University of Essen, Hufelandstrasse 55, 45122 Essen, Germany.
| | | | | |
Collapse
|
47
|
|
48
|
Sacco S, Cerone D, Carolei A. Comorbid neuropathologies in migraine: an update on cerebrovascular and cardiovascular aspects. J Headache Pain 2008; 9:237-48. [PMID: 18600300 PMCID: PMC3451940 DOI: 10.1007/s10194-008-0048-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2008] [Accepted: 06/03/2008] [Indexed: 01/01/2023] Open
Abstract
Several conditions are comorbid with migraine; our review is focused on the relation between migraine, and cerebrovascular and cardiovascular diseases. Despite many studies showed an association between migraine and patent foramen ovale, it is still not known whether its presence might be causal for the migraine pathogenesis and currently its closure cannot be recommended for migraine prevention. On the contrary, conflicting epidemiological data link migraine to arterial hypertension and the use of antihypertensive agents acting on the renin-angiotensin system sounds promising in migraine prevention. A complex bidirectional relation exists between migraine and stroke, and new evidences show a clear association between migraine and coronary heart disease. In both conditions, migraine represents a defined risk factor although the magnitude of the risk varies across the different studies. However, since the risk is low in the general population, it is not possible to identify which migraineurs will develop a cardiovascular or a cerebrovascular event making difficult to apply preventive measures.
Collapse
Affiliation(s)
- Simona Sacco
- Department of Neurology, University of L'Aquila, Piazzale Salvatore Tommasi, L'Aquila, Italy
| | | | | |
Collapse
|
49
|
Tuncel D, Tolun FI, Gokce M, Imrek S, Ekerbiçer H. Oxidative stress in migraine with and without aura. Biol Trace Elem Res 2008; 126:92-7. [PMID: 18690416 DOI: 10.1007/s12011-008-8193-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Accepted: 06/27/2008] [Indexed: 10/21/2022]
Abstract
Migraine is the most common neurological disorder, but the molecular basis is still not completely understood. An impairment of mitochondrial oxidative metabolism might play a role in the pathophysiology. The goal of this study was to investigate the differences in oxidative stress status with the measurement of erythrocyte superoxide dismutase (SOD), catalase activity, and malondialdehyde (MDA) levels in the migraine patients with or without aura and attack. There were 56 patients (46 female, 10 male) in the migraine group and 25 matched healthy subjects in the control group. The patients comprised 37 with migraine without aura (MWoA], 19 with migraine with aura (MWA), and 22 with headache attack. The MDA levels of patients in the migraine group were significantly higher than that in the control group. The SOD activity was significantly higher in the MWA as compared to MWoA. There was no significant correlation between these levels and headache attack period. Conclusively, in this preliminary study, we had found increased oxidative stress in the migraine patients especially the patients with MWA. Further knowledge about this issue may contribute the cause and complications of migraine and may be essential for development of treatment approaches.
Collapse
Affiliation(s)
- Deniz Tuncel
- Department of Neurology, Faculty of Medicine, Kahramanmaras Sutcu Imam University , Kahramanmaras, Turkey.
| | | | | | | | | |
Collapse
|
50
|
Tietjen EG. Migraine and ischaemic heart disease and stroke: potential mechanisms and treatment implications. Cephalalgia 2007; 27:981-7. [PMID: 17661875 DOI: 10.1111/j.1468-2982.2007.01407.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The migraine-ischemia relationship is best understood in the context of the pathophysiology of migraine. Potential mechanisms of migrainous infarction (stroke occurring during migraine) include vasospasm, hypercoagulability, and vascular changes related to cortical spreading depression. Stroke occurring remote for the migraine attack may be related to arterial dissection, cardioembolism, and endothelial dysfunction. Endothelial dysfunction, a process mediated by oxidative stress, may be a cause or a consequence of migraine, and explain the relationship of migraine to vascular factors and ischemic heart disease. It remains uncertain whether stroke or myocardial infarction can be prevented by migraine prophylaxis, endothelial repair, platelet inhibition, or a combination of these strategies. Although triptans are generally considered safe for use in migraine, caution is warranted in those with multiple vascular risk factors. Known vascular disease is a contraindication to triptan use.
Collapse
Affiliation(s)
- E Gretchen Tietjen
- Department of Neurology, The University of Toledo-Health Science Campus, Toledo, OH 43614, USA.
| |
Collapse
|