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Wei S, Du T, Zhang L, Li X, Wang Z, Ning Y, Tang Y, Wu X, Han J. A comprehensive exploration of astrocytes in migraine: a bibliometric and visual analysis. Eur J Med Res 2024; 29:321. [PMID: 38858735 PMCID: PMC11163711 DOI: 10.1186/s40001-024-01919-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 06/03/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Migraine, as a prevalent neurologic disorder, involves intricate and yet incompletely elucidated pathophysiological mechanisms. A plethora of research findings underscores the pivotal role played by astrocytes in the progression of migraines. In order to elucidate the current advances and directions in research pertaining to astrocytes in migraines, we conducted bibliometric analysis of relevant literature and visualized the results. Subsequently, we expound upon these findings to contribute to the evolving understanding of the role of astrocytes in migraine pathophysiology. METHODS On November 21, 2023, we conducted a search on Web of Science (WOS), restricting the document type to articles or reviews and language to English. Following a meticulous selection process involving three researchers, we identified the literature to be included in our analysis. Subsequently, we employed Microsoft Office Excel programs, R, VOSviewer, Scimago Graphica, and CiteSpace software to conduct visualization analysis of basic information and trends regarding journals, countries/regions, and influential authors, institutions, keywords, and papers. RESULTS As of November 21, 2023, relevant literature has been published in 71 journals across 27 countries/regions. This corpus comprises contributions from 576 authors affiliated with 220 institutions, encompassing 865 keywords and referencing 6065 scholarly articles. CEPHALALGIA stands out as the most influential journal in this field, while authors PIETROBON D and DALKARA T have significant impact. The United States is highly influential, with CNR and UNIV PADUA emerging as highly influential institutions. The predominant category is Neurosciences. CONCLUSIONS Future investigators may continue to focus on migraines with aura, familial hemiplegic migraine (FHM), and the crucial calcitonin gene-related peptide (CGRP) system. Employing advanced observational techniques, such as imaging, researchers should pay attention to cellular and tissue structures, such as microglia and the trigeminal ganglion, as well as mechanisms involving inflammation and central sensitization. Moreover, animal models are paramount in obtaining high-quality evidence.
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Affiliation(s)
- Shijie Wei
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Tianqi Du
- Center of Human Reproduction and Genetics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Lili Zhang
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xuhao Li
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhe Wang
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yike Ning
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yu Tang
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xinyu Wu
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jing Han
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
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2
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Wei S, Du T, Zhang L, Li X, Wang Z, Ning Y, Tang Y, Wu X, Han J. A comprehensive exploration of astrocytes in migraine: a bibliometric and visual analysis. Eur J Med Res 2024; 29:321. [PMID: 38858735 DOI: 10.1186/s40001-024-01919-zif:] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 06/03/2024] [Indexed: 07/25/2024] Open
Abstract
BACKGROUND Migraine, as a prevalent neurologic disorder, involves intricate and yet incompletely elucidated pathophysiological mechanisms. A plethora of research findings underscores the pivotal role played by astrocytes in the progression of migraines. In order to elucidate the current advances and directions in research pertaining to astrocytes in migraines, we conducted bibliometric analysis of relevant literature and visualized the results. Subsequently, we expound upon these findings to contribute to the evolving understanding of the role of astrocytes in migraine pathophysiology. METHODS On November 21, 2023, we conducted a search on Web of Science (WOS), restricting the document type to articles or reviews and language to English. Following a meticulous selection process involving three researchers, we identified the literature to be included in our analysis. Subsequently, we employed Microsoft Office Excel programs, R, VOSviewer, Scimago Graphica, and CiteSpace software to conduct visualization analysis of basic information and trends regarding journals, countries/regions, and influential authors, institutions, keywords, and papers. RESULTS As of November 21, 2023, relevant literature has been published in 71 journals across 27 countries/regions. This corpus comprises contributions from 576 authors affiliated with 220 institutions, encompassing 865 keywords and referencing 6065 scholarly articles. CEPHALALGIA stands out as the most influential journal in this field, while authors PIETROBON D and DALKARA T have significant impact. The United States is highly influential, with CNR and UNIV PADUA emerging as highly influential institutions. The predominant category is Neurosciences. CONCLUSIONS Future investigators may continue to focus on migraines with aura, familial hemiplegic migraine (FHM), and the crucial calcitonin gene-related peptide (CGRP) system. Employing advanced observational techniques, such as imaging, researchers should pay attention to cellular and tissue structures, such as microglia and the trigeminal ganglion, as well as mechanisms involving inflammation and central sensitization. Moreover, animal models are paramount in obtaining high-quality evidence.
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Affiliation(s)
- Shijie Wei
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Tianqi Du
- Center of Human Reproduction and Genetics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Lili Zhang
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xuhao Li
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhe Wang
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yike Ning
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yu Tang
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xinyu Wu
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jing Han
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
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3
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Guerrero-Molina MP, Bernabeu-Sanz Á, Ramos-González A, Morales-Conejo M, Delmiro A, Domínguez-González C, Arenas J, Martín MA, González de la Aleja J. Magnetic resonance spectroscopy in MELAS syndrome: correlation with CSF and plasma metabolite levels and change after glutamine supplementation. Neuroradiology 2024; 66:389-398. [PMID: 38114794 DOI: 10.1007/s00234-023-03263-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/02/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE MELAS syndrome is a genetic disorder caused by mitochondrial DNA mutations. We previously described that MELAS patients had increased CSF glutamate and decreased CSF glutamine levels and that oral glutamine supplementation restores these values. Proton magnetic resonance spectroscopy (1H-MRS) allows the in vivo evaluation of brain metabolism. We aimed to compare 1H-MRS of MELAS patients with controls, the 1H-MRS after glutamine supplementation in the MELAS group, and investigate the association between 1H-MRS and CSF lactate, glutamate, and glutamine levels. METHODS We conducted an observational case-control study and an open-label, single-cohort study with single-voxel MRS (TE 144/35 ms). We assessed the brain metabolism changes in the prefrontal (PFC) and parieto-occipital) cortex (POC) after oral glutamine supplementation in MELAS patients. MR spectra were analyzed with jMRUI software. RESULTS Nine patients with MELAS syndrome (35.8 ± 3.2 years) and nine sex- and age-matched controls were recruited. Lactate/creatine levels were increased in MELAS patients in both PFC and POC (0.40 ± 0.05 vs. 0, p < 0.001; 0.32 ± 0.03 vs. 0, p < 0.001, respectively). No differences were observed between groups in glutamate and glutamine (Glx/creatine), either in PFC (p = 0.930) or POC (p = 0.310). No differences were observed after glutamine supplementation. A positive correlation was found between CSF lactate and lactate/creatine only in POC (0.85, p = 0.003). CONCLUSION No significant metabolite changes were observed in the brains of MELAS patients after glutamine supplementation. While we found a positive correlation between lactate levels in CSF and 1H-MRS in MELAS patients, we could not monitor treatment response over short periods with this tool. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04948138; initial release 24/06/2021; first patient enrolled on 1/07/2021. https://clinicaltrials.gov/ct2/show/NCT04948138.
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Affiliation(s)
- María Paz Guerrero-Molina
- Neurology Department, Neuromuscular Disorders Unit, University Hospital, 12 de Octubre Avda. de Córdoba, S/N 28041, Madrid, Spain.
| | | | - Ana Ramos-González
- Department of Neuroradiology, University Hospital, 12 de Octubre, Madrid, Spain
| | - Montserrat Morales-Conejo
- Department of Internal Medicine, University Hospital, 12 de Octubre, Madrid, Spain
- National Reference Center for Congenital Errors of Metabolism (CSUR) an European Reference Center for Inherited Metabolic Disease (MetabERN), University Hospital, 12 de Octubre, Madrid, Spain
- Spanish Network for Biomedical Research in Rare Diseases (CIBERER), U723, Madrid, Spain
| | - Aitor Delmiro
- Spanish Network for Biomedical Research in Rare Diseases (CIBERER), U723, Madrid, Spain
- Mitochondrial and Neuromuscular Diseases Laboratory, Instituto de Investigación Sanitaria Hospital, 12 de Octubre' ('imas12'), Madrid, Spain
- Research Institute ('imas12'), University Hospital, 12 de Octubre, Madrid, Spain
| | - Cristina Domínguez-González
- Neurology Department, Neuromuscular Disorders Unit, University Hospital, 12 de Octubre Avda. de Córdoba, S/N 28041, Madrid, Spain
- National Reference Center for Congenital Errors of Metabolism (CSUR) an European Reference Center for Inherited Metabolic Disease (MetabERN), University Hospital, 12 de Octubre, Madrid, Spain
- Spanish Network for Biomedical Research in Rare Diseases (CIBERER), U723, Madrid, Spain
- Research Institute ('imas12'), University Hospital, 12 de Octubre, Madrid, Spain
| | - Joaquín Arenas
- Spanish Network for Biomedical Research in Rare Diseases (CIBERER), U723, Madrid, Spain
- Mitochondrial and Neuromuscular Diseases Laboratory, Instituto de Investigación Sanitaria Hospital, 12 de Octubre' ('imas12'), Madrid, Spain
- Research Institute ('imas12'), University Hospital, 12 de Octubre, Madrid, Spain
| | - Miguel A Martín
- Spanish Network for Biomedical Research in Rare Diseases (CIBERER), U723, Madrid, Spain
- Mitochondrial and Neuromuscular Diseases Laboratory, Instituto de Investigación Sanitaria Hospital, 12 de Octubre' ('imas12'), Madrid, Spain
- Research Institute ('imas12'), University Hospital, 12 de Octubre, Madrid, Spain
| | - Jesús González de la Aleja
- National Reference Center for Congenital Errors of Metabolism (CSUR) an European Reference Center for Inherited Metabolic Disease (MetabERN), University Hospital, 12 de Octubre, Madrid, Spain
- Neurology Department, Epilepsy Unit, University Hospital, 12 de Octubre, Madrid, Spain
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Martami F, Holton KF. Targeting Glutamate Neurotoxicity through Dietary Manipulation: Potential Treatment for Migraine. Nutrients 2023; 15:3952. [PMID: 37764736 PMCID: PMC10537717 DOI: 10.3390/nu15183952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/08/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
Glutamate, the main excitatory neurotransmitter in the central nervous system, is implicated in both the initiation of migraine as well as central sensitization, which increases the frequency of migraine attacks. Excessive levels of glutamate can lead to excitotoxicity in the nervous system which can disrupt normal neurotransmission and contribute to neuronal injury or death. Glutamate-mediated excitotoxicity also leads to neuroinflammation, oxidative stress, blood-brain barrier permeability, and cerebral vasodilation, all of which are associated with migraine pathophysiology. Experimental evidence has shown the protective effects of several nutrients against excitotoxicity. The current review focuses on the mechanisms behind glutamate's involvement in migraines as well as a discussion on how specific nutrients are able to work towards restoring glutamate homeostasis. Understanding glutamate's role in migraine is of vital importance for understanding why migraine is commonly comorbid with widespread pain conditions and for informing future research directions.
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Affiliation(s)
- Fahimeh Martami
- Department of Health Studies, American University, Washington, DC 20016, USA;
| | - Kathleen F. Holton
- Department of Health Studies, American University, Washington, DC 20016, USA;
- Department of Neuroscience, American University, Washington, DC 20016, USA
- Center for Neuroscience and Behavior, American University, Washington, DC 20016, USA
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5
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Zhang S, Azubuine J, Schmeer C. A systematic literature review on the role of glial cells in the pathomechanisms of migraine. Front Mol Neurosci 2023; 16:1219574. [PMID: 37456527 PMCID: PMC10347403 DOI: 10.3389/fnmol.2023.1219574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
Background The pathomechanisms underlying migraine are intricate and remain largely unclear. Initially regarded as a neuronal disorder, migraine research primarily concentrated on understanding the pathophysiological changes within neurons. However, recent advances have revealed the significant involvement of neuroinflammation and the neuro-glio-vascular interplay in migraine pathogenesis. Methods A systematic search was conducted in PubMed, Scopus, and Web of Science databases from their inception until November 2022. The retrieved results underwent a screening process based on title and abstract, and the full texts of the remaining papers were thoroughly assessed for eligibility. Only studies that met the predetermined inclusion criteria were included in the review. Results Fifty-nine studies, consisting of 6 human studies and 53 animal studies, met the inclusion criteria. Among the 6 human studies, 2 focused on genetic analyses, while the remaining studies employed functional imaging, serum analyses and clinical trials. Regarding the 53 animal studies investigating glial cells in migraine, 19 of them explored the role of satellite glial cells and/or Schwann cells in the trigeminal ganglion and/or trigeminal nerve. Additionally, 17 studies highlighted the significance of microglia and/or astrocytes in the trigeminal nucleus caudalis, particularly in relation to central sensitization during migraine chronification. Furthermore, 17 studies examined the involvement of astrocytes and/or microglia in the cortex. Conclusion Glial cells, including astrocytes, microglia, satellite glial cells and Schwann cells in the central and peripheral nervous system, participate both in the development as well as chronic progression of migraine in disease-associated regions such as the trigeminovascular system, trigeminal nucleus caudalis and cortex, among other brain regions.
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6
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O'Hare L, Tarasi L, Asher JM, Hibbard PB, Romei V. Excitation-Inhibition Imbalance in Migraine: From Neurotransmitters to Brain Oscillations. Int J Mol Sci 2023; 24:10093. [PMID: 37373244 DOI: 10.3390/ijms241210093] [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: 05/15/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
Migraine is among the most common and debilitating neurological disorders typically affecting people of working age. It is characterised by a unilateral, pulsating headache often associated with severe pain. Despite the intensive research, there is still little understanding of the pathophysiology of migraine. At the electrophysiological level, altered oscillatory parameters have been reported within the alpha and gamma bands. At the molecular level, altered glutamate and GABA concentrations have been reported. However, there has been little cross-talk between these lines of research. Thus, the relationship between oscillatory activity and neurotransmitter concentrations remains to be empirically traced. Importantly, how these indices link back to altered sensory processing has to be clearly established as yet. Accordingly, pharmacologic treatments have been mostly symptom-based, and yet sometimes proving ineffective in resolving pain or related issues. This review provides an integrative theoretical framework of excitation-inhibition imbalance for the understanding of current evidence and to address outstanding questions concerning the pathophysiology of migraine. We propose the use of computational modelling for the rigorous formulation of testable hypotheses on mechanisms of homeostatic imbalance and for the development of mechanism-based pharmacological treatments and neurostimulation interventions.
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Affiliation(s)
- Louise O'Hare
- Division of Psychology, Nottingham Trent University, Nottingham NG1 4FQ, UK
| | - Luca Tarasi
- Centro Studi e Ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia, Alma Mater Studiorum-Università di Bologna, Campus di Cesena, Via Rasi e Spinelli, 176, 47521 Cesena, Italy
| | - Jordi M Asher
- Department of Psychology, University of Essex, Colchester CO4 3SQ, UK
| | - Paul B Hibbard
- Department of Psychology, University of Essex, Colchester CO4 3SQ, UK
| | - Vincenzo Romei
- Centro Studi e Ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia, Alma Mater Studiorum-Università di Bologna, Campus di Cesena, Via Rasi e Spinelli, 176, 47521 Cesena, Italy
- Facultad de Lenguas y Educación, Universidad Antonio de Nebrija, 28015 Madrid, Spain
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7
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Zhang X, Wang W, Bai X, Mei Y, Tang H, Yuan Z, Zhang X, Li Z, Zhang P, Hu Z, Zhang Y, Yu X, Sui B, Wang Y. Alterations in regional homogeneity and multiple frequency amplitudes of low-frequency fluctuation in patients with new daily persistent headache: a resting-state functional magnetic resonance imaging study. J Headache Pain 2023; 24:14. [PMID: 36814220 PMCID: PMC9946707 DOI: 10.1186/s10194-023-01543-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/02/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND New daily persistent headache (NPDH) is a rare primary headache that is highly disabling. The pathophysiology of NDPH is still unclear, and we aimed to reveal the underlying mechanism of NDPH through functional magnetic resonance imaging (fMRI) analysis. METHODS In this cross-sectional study, thirty patients with NDPH and 30 healthy controls (HCs) were recruited. The blood oxygen level-dependent (BOLD) sequences of all participants were obtained using the GE 3.0 T system. We performed ReHo, ALFF (conventional band: 0.01-0.08 Hz, slow-5: 0.01-0.027 Hz, slow-4: 0.027-0.073 Hz) and seed-based to the whole brain functional connectivity (FC) analysis in the NDPH and HC groups. The sex difference analysis of ReHo, ALFF, and FC values was conducted in the NDPH group. We also conducted Pearson's correlation analysis between ReHo, ALFF, FC values and clinical characteristics (pain intensity, disease duration, HIT-6, GAD-7, PHQ-9, and PSQI scores). RESULTS Both increased ReHo (PFWE-corr = 0.012) and ALFF values (0.01-0.08 Hz, PFWE-corr = 0.009; 0.027-0.073 Hz, PFWE-corr =0.044) of the left middle occipital gyrus (MOG_L) were found in the NDPH group compared to the HC group. There was no significant difference in FC maps between the two groups. Compared to the HC group, no difference was found in ReHo (p = 0.284), ALFF (p = 0.246), and FC (p = 0.118) z scores of the MOG_L in the NDPH group. There was also no sex difference in ReHo (p = 0.288), ALFF (p = 0.859), or FC z score (p = 0.118) of the MOG_L in patients with NDPH. There was no correlation between ReHo, ALFF, FC z scores and clinical characteristics after Bonferroni correction (p < 0.05/18). CONCLUSIONS Patients with NDPH may have abnormal activation of the visual system. Abnormal visual activation may occur mainly in higher frequency band of the classical band. No sex differences in brain activity were found in patients with NDPH.
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Affiliation(s)
- Xueyan Zhang
- grid.412633.10000 0004 1799 0733Department of Neurology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road, Zhengzhou, China
| | - Wei Wang
- grid.24696.3f0000 0004 0369 153XHeadache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaoyan Bai
- grid.411617.40000 0004 0642 1244Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, China ,grid.411617.40000 0004 0642 1244Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing Neurosurgical Institute, Beijing, China
| | - Yanliang Mei
- grid.24696.3f0000 0004 0369 153XHeadache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hefei Tang
- grid.24696.3f0000 0004 0369 153XHeadache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ziyu Yuan
- grid.24696.3f0000 0004 0369 153XHeadache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xue Zhang
- grid.411617.40000 0004 0642 1244Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, China ,grid.411617.40000 0004 0642 1244Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing Neurosurgical Institute, Beijing, China
| | - Zhiye Li
- grid.411617.40000 0004 0642 1244Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, China ,grid.411617.40000 0004 0642 1244Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing Neurosurgical Institute, Beijing, China
| | - Peng Zhang
- grid.24696.3f0000 0004 0369 153XHeadache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | | | - Yaqing Zhang
- grid.24696.3f0000 0004 0369 153XHeadache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xueying Yu
- grid.24696.3f0000 0004 0369 153XHeadache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Binbin Sui
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, China.
| | - Yonggang Wang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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8
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Pohl H, Wyss P, Sandor PS, Schoenen J, Luechinger R, O'Gorman R, Riederer F, Gantenbein AR, Michels L. The longitudinal influence of tDCS on occipital GABA and glutamate/glutamine levels in episodic migraineurs. J Neurosci Res 2023; 101:815-825. [PMID: 36688271 DOI: 10.1002/jnr.25161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 12/12/2022] [Accepted: 12/15/2022] [Indexed: 01/24/2023]
Abstract
This study investigated differences in the concentration of gamma-aminobutyric acid (GABA) and the combination of glutamine and glutamate (as GLX) in the early visual cortex of patients with episodic migraine and the influence of transcranial direct current stimulation (tDCS) on GABA and GLX. In this single-blind, sham-controlled trial, we randomly assigned patients with episodic migraine to receive daily anodal tDCS or sham stimulation. In addition, we included healthy controls. We acquired proton MR spectroscopy data of the visual cortex with 3 Tesla MRI at baseline and from migraine patients directly after the stimulation period and 4 months later. In 22 migraineurs and 25 controls, the GABA and the GLX concentrations did not differ at baseline between the groups. tDCS resulted in reduced concentrations of GABA but not GLX or the migraine frequency directly after the stimulation period, but not 4 months later. The changes in the levels of GABA in the early visual cortex of patients with episodic migraine in the interictal period suggest an effect of tDCS that allowed for subsequent changes in the migraine frequency. However, we might have missed relevant variations in the concentrations of these neurotransmitters during the follow-up period, as changes in migraine frequency appeared after the first MRI and disappeared before the second.
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Affiliation(s)
- Heiko Pohl
- Department of Neurology, University of Zurich, Zurich, Switzerland.,Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland
| | - Patrik Wyss
- Department of Radiology, Swiss Paraplegic Centre, Nottwil, Switzerland
| | - Peter S Sandor
- Department of Neurology, University of Zurich, Zurich, Switzerland.,Department of Neurology and Neurorehabilitation, ZURZACH Care, Bad Zurzach, Switzerland
| | - Jean Schoenen
- Headache Research Unit, Department of Neurology-Citadelle Hospital, University of Liège, Liège, Belgium
| | - Roger Luechinger
- Institute for Biomedical Engineering, ETH Zurich and University of Zurich, Zurich, Switzerland
| | - Ruth O'Gorman
- Children's Research Center, University Children's Hospital, Zurich, Switzerland.,Center for MR-Research, University Children's Hospital, Zurich, Switzerland
| | - Franz Riederer
- Department of Neurology, University of Zurich, Zurich, Switzerland.,Karl Landsteiner Institute for Epilepsy Research and Cognitive Neurology, Vienna, Austria.,Department of Neurology, Clinic Hietzing, Vienna, Austria
| | - Andreas R Gantenbein
- Department of Neurology, University of Zurich, Zurich, Switzerland.,Department of Neurology and Neurorehabilitation, ZURZACH Care, Bad Zurzach, Switzerland
| | - Lars Michels
- Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland.,Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
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9
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Sanchez Del Rio M, Cutrer FM. Pathophysiology of migraine aura. HANDBOOK OF CLINICAL NEUROLOGY 2023; 198:71-83. [PMID: 38043972 DOI: 10.1016/b978-0-12-823356-6.00016-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Migraine aura occurs in about a third of patients with migraine and consists of a group of transient focal neurological symptoms that appear from 5 to 60min and then resolve prior to or in the early phase of a migraine headache attack. Migraine auras may consist of visual, language, unilateral sensory, or motor symptoms. There has been considerable debate as to the origins of the migrainous aura. Investigations during physiologically induced visual auras suggest that the phenomenon of cortical spreading depression or its human equivalent underpins the migraine aura. Single gene defects have been linked to relatively rare forms of the motor subtypes of aura known as familial hemiplegic migraine (FHM). These include CACNA1A (FHM1), ATP1A2 (FHM2), and SCN1A (FHM3). In the familial hemiplegic forms of migraine, the more typical forms of aura are almost always also present. Despite ample epidemiological evidence of increased heritability of migraine with aura compared to migraine without aura, identification of the specific variants driving susceptibility to the more common forms of aura has been problematic thus far. In the first genome-wide association study (GWAS) that focused migraine with aura, a single SNP rs835740 reached genome-wide significance. Unfortunately, the SNP did show statistical significance in a later meta-analysis which included GWAS data from subsequent studies. Here, we review the clinical features, pathophysiological theories, and currently available potential evidence for the genetic basis of migraine aura.
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10
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Nikolova S, Schwedt TJ. Magnetic resonance spectroscopy studies in migraine. NEUROBIOLOGY OF PAIN (CAMBRIDGE, MASS.) 2022; 12:100102. [PMID: 36531616 PMCID: PMC9755026 DOI: 10.1016/j.ynpai.2022.100102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/04/2022] [Accepted: 08/17/2022] [Indexed: 06/17/2023]
Abstract
This review summarizes major findings and recent advances in magnetic resonance spectroscopy (MRS) of migraine. A multi database search of PubMed, EMBASE, and Web of Science was performed with variations of magnetic resonance spectroscopy and headache until 20th September 2021. The search generated 2897 studies, 676 which were duplicates and 1836 were not related to headache. Of the remaining 385 studies examined, further exclusions for not migraine (n = 114), and not MRS of human brain (n = 128), and non-original contributions (n = 51) or conferences (n = 24) or case studies (n = 11) or non-English (n = 3), were applied. The manuscripts of all resulting reports were reviewed for their possible inclusion in this manuscript (n = 54). The reference lists of all included reports were carefully reviewed and articles relevant to this review were added (n = 2).Included are 56 studies of migraine with and without aura that involve magnetic resonance spectroscopy of the human brain. The topics are presented in the form of a narrative review. This review aims to provide a summary of the metabolic changes measured by MRS in patients with migraine. Despite the variability reported between studies, common findings focused on regions functionally relevant to migraine such as occipital cortices, thalamic nuclei, cerebellum and cingulate. The most reproducible results were decreased N-acetyl-aspartate (NAA) in cerebellum in patients with hemiplegic migraine and in the thalamus of chronic migraine patients. Increased lactate (Lac) in the occipital cortex was found for migraine with aura but not in subjects without aura. MRS studies support the hypothesis of impaired energetics and mitochondrial dysfunction in migraine. Although results regarding GABA and Glu were less consistent, studies suggest there might be an imbalance of these important inhibitory and excitatory neurotransmitters in the migraine brain. Multinuclear imaging studies in migraine with and without aura, predominantly investigating phosphorous, report alterations of PCr in occipital, parietal, and posterior brain regions. There have been too few studies to assess the diagnostic relevance of sodium imaging in migraine.
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Affiliation(s)
| | - Todd J. Schwedt
- Corresponding author at: 5777 East Mayo Blvd, Phoenix, AZ 85054, USA.
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11
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Elusive amines: migraine depends on biochemical abnormalities. Neurol Sci 2022; 43:6299-6304. [DOI: 10.1007/s10072-022-06241-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/24/2022] [Indexed: 10/17/2022]
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Lei M, Zhang J, Wu D. A Functional Magnetic Resonance Imaging Study on Activation of Anterior Cingulate Cortex at Episode and Interictal Phases in Migraine. J BIOMATER TISS ENG 2022. [DOI: 10.1166/jbt.2022.2815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
<sec> <title>Objective:</title> By using amplitude of low-frequency fluctuations (ALFF) we have analyzed activationsin brain regions at different phases in migraineurs. </sec> <sec> <title>Methods:</title> Participants
included 41 patients with migraine, 19 in episode and 22 in interictal phase, and 22 controls in the healthy condition. To analyze the brain function of patients and controls, ALFF was used for performing the post-processing in the resting state by scores of Montreal Cognitive Assessment (MoCA)
scale, Mini-Mental State Examination (MMSE), Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D). </sec> <sec> <title>Results:</title> The comparison between groups of patients with migraine in the episode or interictal phases,
and healthy controls showed that both episode and interictal migraine groups had the similar HAM-A and HAM-D scores (P > 0.05), but higher than that in controls (P < 0.01). For ALFF values of Episode and Interictal groups, the Montreal Neurological Institute (MNI) coordinates
of the decreased ALFF were (−9, 42, 9), the voxel size = 215, including the bilateral anterior cingulate cortex (ACC), T =−4.15, without significant differences. Patients in Interictal group were with a stronger activation at MNI coordinates (12, 51, 12), in the bilateral
ACC, voxel size = 90, T =3.87. </sec> <sec> <title>Conclusion:</title> ACC plays an adaptive, regulatory role in migraine and is related to multiple brain regions, which may mediate activation through descending anti-nociceptive pathways. ACC is related
to opioid receptor and glutamate excitatory regulation. </sec>
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Affiliation(s)
- Ming Lei
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
| | - Junjian Zhang
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
| | - Dongmei Wu
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
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Wu X, Han S, Yang Y, Dai H, Wu P, Zhao H, Jin X, Li Y. Decreased brain GABA levels in patients with migraine without aura: an exploratory proton magnetic resonance spectroscopy study. Neuroscience 2022; 488:10-19. [PMID: 35182698 DOI: 10.1016/j.neuroscience.2022.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 11/17/2022]
Abstract
Increasing neurophysiological studies had revealed that regional excitation-inhibition imbalance in the brain played a key role in the pathogenesis of migraine. This study aimed to explore the alterations in gamma-aminobutyric acid (GABA) and glutamate/glutamine complex (Glx) levels in the anterior cingulate gyrus (ACC) and medial prefrontal lobe (mPFC) of patients with migraine without aura (MWoA) and investigate the correlation between neurotransmitter levels and clinical indicators. A total of 28 patients with MWoA and 28 sex-, age-, and education level-matched healthy controls (HCs) underwent single-voxel proton magnetic resonance spectroscopy scanning at 3.0 Tesla. MEscher-Garwood Point RESolved Spectroscopy (MEGA-PRESS) sequence was performed to acquire the spectral data of GABA and Glx in the ACC and mPFC. The clinical indicators and anxiety-depression states of all participants were assessed. The acquired GABA signal contained the overlapping signals of macromolecules and homocarnosine, hence expressed as GABA+. The creatine (Cr) signal was applied as an endogenous reference. We observed that GABA+/Cr levels were significantly lower in ACC and mPFC of patients with MWoA than of HCs, with no significant difference in Glx levels. Negative correlations between GABA+/Cr levels and attack frequency were found in the ACC and mPFC regions of patients. These results suggested that there might be a close relationship between ACC and mPFC GABAergic neurons abnormalities and the pathophysiological mechanisms of MWoA. It might be beneficial to targeted treatment for patients with MWoA.
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Affiliation(s)
- Xiaojuan Wu
- Department of Radiology, The First Affiliated Hospital of Soochow University, No.188, Shizi Road, Suzhou City, Jiangsu Province 215000, China
| | - Shuting Han
- Department of Radiology, The First Affiliated Hospital of Soochow University, No.188, Shizi Road, Suzhou City, Jiangsu Province 215000, China
| | - Yang Yang
- Department of Radiology, The First Affiliated Hospital of Soochow University, No.188, Shizi Road, Suzhou City, Jiangsu Province 215000, China
| | - Hui Dai
- Department of Radiology, The First Affiliated Hospital of Soochow University, No.188, Shizi Road, Suzhou City, Jiangsu Province 215000, China
| | - Peng Wu
- Philips Healthcare, Shanghai 200072, China
| | - Hongru Zhao
- Department of Neurology, The First Affiliated Hospital of Soochow University, No.188, Shizi Road, Suzhou City, Jiangsu Province 215000, China.
| | - Xiaohong Jin
- Department of Pain Management, The First Affiliated Hospital of Soochow University, No. 899 Pinghai Road, Suzhou City, Jiangsu Province 215000, China.
| | - Yonggang Li
- Department of Radiology, The First Affiliated Hospital of Soochow University, No.188, Shizi Road, Suzhou City, Jiangsu Province 215000, China.
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Stankewitz A, Schulz E. Intrinsic network connectivity reflects the cyclic trajectory of migraine attacks. NEUROBIOLOGY OF PAIN (CAMBRIDGE, MASS.) 2022; 11:100085. [PMID: 35243179 PMCID: PMC8861450 DOI: 10.1016/j.ynpai.2022.100085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/28/2022] [Accepted: 02/05/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Episodic migraine is considered to be cyclic in nature, triggered by the hypothalamus. To assess the natural trajectory of intrinsic networks over an entire migraine cycle, we designed a longitudinal intra-individual study using functional magnetic resonance imaging (fMRI). METHODS Intrinsic network connectivity was assessed for 12 migraineurs in 82 sessions including spontaneous, untriggered headache attacks and follow-up recordings towards the next attack. RESULTS We found cyclic changes in the visual, auditory, and somatosensory networks, in limbic networks (e.g. thalamo-insular, parahippocampal), and in the salience network (anterior insula and dorsal anterior cingulate cortex). Connectivity changes also extended to further cortical networks, such as the central executive network, the default mode network, as well as subcortical networks. Almost all of these network connectivity changes followed the trajectory of a linear increase over the pain-free interval that peaked immediately prior to the headache, and "dropped" to the baseline level during the headache. These network alterations are associated with a number of cortical functions that may explain the variety of ictal and pre-ictal physiological and psychological migraine symptoms. CONCLUSION Our results suggest that migraine disease is associated with widespread cyclic alterations of intrinsic networks that develop before the headache is initiated, i.e. during the interictal and premonitory phase. The increasing magnitude of connectivity within these networks towards the next attack may reflect an increasing effort to maintain network integrity.
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Affiliation(s)
- Anne Stankewitz
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Enrico Schulz
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
- Department of Medical Psychology, Ludwig-Maximilians-Universität München, Munich, Germany
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15
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Dai W, Liu RH, Qiu E, Liu Y, Chen Z, Chen X, Ao R, Zhuo M, Yu S. Cortical mechanisms in migraine. Mol Pain 2021; 17:17448069211050246. [PMID: 34806494 PMCID: PMC8606910 DOI: 10.1177/17448069211050246] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Migraine is the second most prevalent disorder in the world; yet, its underlying mechanisms are still poorly understood. Cumulative studies have revealed pivotal roles of cerebral cortex in the initiation, propagation, and termination of migraine attacks as well as the interictal phase. Investigation of basic mechanisms of the cortex in migraine not only brings insight into the underlying pathophysiology but also provides the basis for designing novel treatments. We aim to summarize the current research literatures and give a brief overview of the cortex and its role in migraine, including the basic structure and function; structural, functional, and biochemical neuroimaging; migraine-related genes; and theories related to cortex in migraine pathophysiology. We propose that long-term plasticity of synaptic transmission in the cortex encodes migraine.
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Affiliation(s)
- Wei Dai
- Department of Neurology, Chinese PLA General Hospital, Beijing, China.,Chinese PLA Medical School, Beijing, China
| | - Ren-Hao Liu
- Center for Neuron and Disease, Frontier Institutes of Science and Technology, 12480Xi'an Jiaotong University, Xi'an, China
| | - Enchao Qiu
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Yinglu Liu
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Zhiye Chen
- Department of Neurology, Chinese PLA General Hospital, Beijing, China.,Department of Radiology, Chinese PLA General Hospital, Beijing, China
| | - Xiaoyan Chen
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Ran Ao
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Min Zhuo
- Center for Neuron and Disease, Frontier Institutes of Science and Technology, 12480Xi'an Jiaotong University, Xi'an, China.,International Institute for Brain Research, Qingdao International Academician Park, Qingdao, China.,Department of Physiology, 1 King's College Circle, University of Toronto, Toronto, ON, Canada
| | - Shengyuan Yu
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
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16
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Younis S, Hougaard A, Christensen CE, Vestergaard MB, Paulson OB, Larsson HBW, Ashina M. Interictal pontine metabolism in migraine without aura patients: A 3 Tesla proton magnetic resonance spectroscopy study. Neuroimage Clin 2021; 32:102824. [PMID: 34619653 PMCID: PMC8498457 DOI: 10.1016/j.nicl.2021.102824] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 11/01/2022]
Abstract
In the pons, glutamatergic mechanisms are involved in regulating inhibitory descending pain modulation, serotoninergic neurotransmission as well as modulating the sensory transmission of the trigeminovascular system. Migraine involves altered pontine activation and structural changes, while biochemical, genetic and clinical evidence suggests that altered interictal pontine glutamate levels may be an important pathophysiological feature of migraine abetting to attack initiation. Migraine without aura patients were scanned outside attacks using a proton magnetic resonance spectroscopy protocol optimized for the pons at 3 Tesla. The measurements were performed on two separate days to increase accuracy and compared to similar repeated measurements in healthy controls. We found that interictal glutamate (i.e. Glx) levels in the pons of migraine patients (n = 33) were not different from healthy controls (n = 16) (p = 0.098), while total creatine levels were markedly increased in patients (9%, p = 0.009). There was no correlation of glutamate or total creatine levels to migraine frequency, days since the last attack, usual pain intensity of attacks or disease duration. In conclusion, migraine is not associated with altered interictal pontine glutamate levels. However, the novel finding of increased total creatine levels suggests that disequilibrium in the pontine energy metabolism could be an important feature of migraine pathophysiology.
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Affiliation(s)
- Samaira Younis
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Anders Hougaard
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Casper E Christensen
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Mark B Vestergaard
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Olaf B Paulson
- Neurobiology Research Unit, Department of Neurology, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Henrik B W Larsson
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet Glostrup, Glostrup, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Messoud Ashina
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
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17
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Peek AL, Leaver AM, Foster S, Oeltzschner G, Puts NA, Galloway G, Sterling M, Ng K, Refshauge K, Aguila MER, Rebbeck T. Increased GABA+ in People With Migraine, Headache, and Pain Conditions- A Potential Marker of Pain. THE JOURNAL OF PAIN 2021; 22:1631-1645. [PMID: 34182103 DOI: 10.1016/j.jpain.2021.06.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 05/25/2021] [Accepted: 06/04/2021] [Indexed: 11/27/2022]
Abstract
Treatment outcomes for migraine and other chronic headache and pain conditions typically demonstrate modest results. A greater understanding of underlying pain mechanisms may better inform treatments and improve outcomes. Increased GABA+ has been identified in recent studies of migraine, however, it is unclear if this is present in other headache, and pain conditions. We primarily investigated GABA+ levels in the posterior cingulate gyrus (PCG) of people with migraine, whiplash-headache and low back pain compared to age- and sex-matched controls, GABA+ levels in the anterior cingulate cortex (ACC) and thalamus formed secondary aims. Using a cross-sectional design, we studied people with migraine, whiplash-headache or low back pain (n = 56) and compared them with a pool of age- and sex-matched controls (n = 22). We used spectral-edited magnetic resonance spectroscopy at 3T (MEGA-PRESS) to determine levels of GABA+ in the PCG, ACC and thalamus. PCG GABA+ levels were significantly higher in people with migraine and low back pain compared with controls (eg, migraine 4.89 IU ± 0.62 vs controls 4.62 IU ± 0.38; P = .02). Higher GABA+ levels in the PCG were not unique to migraine and could reflect a mechanism of chronic pain in general. A better understanding of pain at a neurochemical level informs the development of treatments that target aberrant brain neurochemistry to improve patient outcomes. PERSPECTIVE: This study provides insights into the underlying mechanisms of chronic pain. Higher levels of GABA+ in the PCG may reflect an underlying mechanism of chronic headache and pain conditions. This knowledge may help improve patient outcomes through developing treatments that specifically address this aberrant brain neurochemistry.
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Affiliation(s)
- Aimie L Peek
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia; NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, Queensland, Australia.
| | - Andrew M Leaver
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Sheryl Foster
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Department of Radiology, Westmead Hospital, New South Wales, Australia
| | - Georg Oeltzschner
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland
| | - Nicolaas A Puts
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK; MRC Centre for Neurodevelopmental Disorders, King's College London, UK
| | - Graham Galloway
- The University of Queensland, Brisbane, Queensland, Australia; Translational Research Institute, Woolloongabba, Queensland, Australia
| | - Michele Sterling
- NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, Queensland, Australia; RECOVER Injury Research Centre, Herston, Queensland, Australia
| | - Karl Ng
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Department of Neurology, Royal North Shore Hospital, New South Wales, Australia
| | - Kathryn Refshauge
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | | | - Trudy Rebbeck
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia; NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, Queensland, Australia
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O’Hare L, Asher JM, Hibbard PB. Migraine Visual Aura and Cortical Spreading Depression-Linking Mathematical Models to Empirical Evidence. Vision (Basel) 2021; 5:30. [PMID: 34200625 PMCID: PMC8293461 DOI: 10.3390/vision5020030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/15/2021] [Accepted: 05/24/2021] [Indexed: 01/10/2023] Open
Abstract
This review describes the subjective experience of visual aura in migraine, outlines theoretical models of this phenomenon, and explores how these may be linked to neurochemical, electrophysiological, and psychophysical differences in sensory processing that have been reported in migraine with aura. Reaction-diffusion models have been used to model the hallucinations thought to arise from cortical spreading depolarisation and depression in migraine aura. One aim of this review is to make the underlying principles of these models accessible to a general readership. Cortical spreading depolarisation and depression in these models depends on the balance of the diffusion rate between excitation and inhibition and the occurrence of a large spike in activity to initiate spontaneous pattern formation. We review experimental evidence, including recordings of brain activity made during the aura and attack phase, self-reported triggers of migraine, and psychophysical studies of visual processing in migraine with aura, and how these might relate to mechanisms of excitability that make some people susceptible to aura. Increased cortical excitability, increased neural noise, and fluctuations in oscillatory activity across the migraine cycle are all factors that are likely to contribute to the occurrence of migraine aura. There remain many outstanding questions relating to the current limitations of both models and experimental evidence. Nevertheless, reaction-diffusion models, by providing an integrative theoretical framework, support the generation of testable experimental hypotheses to guide future research.
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Affiliation(s)
- Louise O’Hare
- Division of Psychology, Nottingham Trent University, Nottingham NG1 4FQ, UK
| | - Jordi M. Asher
- Department of Psychology, University of Essex, Colchester CO4 3SQ, UK; (J.M.A.); (P.B.H.)
| | - Paul B. Hibbard
- Department of Psychology, University of Essex, Colchester CO4 3SQ, UK; (J.M.A.); (P.B.H.)
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Adult occipital lobe epilepsy: 12-years on. J Neurol 2021; 268:3926-3934. [PMID: 33900448 DOI: 10.1007/s00415-021-10557-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/05/2021] [Accepted: 04/09/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Occipital lobe epilepsies (OLE) comprise 5-10% of focal epilepsies in surgical and paediatric series; with little data from adult medical cohorts. This longitudinal study examined OLE patients, to characterise prevalence, semiology, co-morbidity and prognosis in a neurology outpatient setting. METHODS 24 adult OLE patients identified over 12 months from 1548 patients in a neurologist's service were followed over 12 years. RESULTS 92% of these OLE patients had simple visual hallucinations, misdiagnosed in 40% of cases. 75% had co-morbid interictal migraine and 38% had visual field defects. Only 33% achieved long-term remission, and only 2 /10 (20%) of OLE patients with a structural aetiology were seizure-free. The two patients with migralepsy achieved remission. CONCLUSION Adult OLE accounted for 7.7% of focal epilepsies in this cohort, misdiagnosed or misclassified in 40%. Most patients had co-existing migraine. A minority had migralepsy characterised by a longer aura and good prognosis. Remission rates were lower than that of childhood OLE and general adult epilepsy populations, strengthening the argument for considering epilepsy surgery in drug-resistant OLE patients with a structural cause. Precision medicine will potentially refine diagnosis and management in those OLE patients without an identified cause but is predicated on accurate clinical phenotyping.
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Abstract
Migraine is a prevalent primary headache disorder and is usually considered as benign. However, structural and functional changes in the brain of individuals with migraine have been reported. High frequency of white matter abnormalities, silent infarct-like lesions, and volumetric changes in both gray and white matter in individuals with migraine compared to controls have been demonstrated. Functional magnetic resonance imaging (MRI) studies found altered connectivity in both the interictal and ictal phase of migraine. MR spectroscopy and positron emission tomography studies suggest abnormal energy metabolism and mitochondrial dysfunction, as well as other metabolic changes in individuals with migraine. In this review, we provide a brief overview of neuroimaging studies that have helped us to characterize some of these changes and discuss their limitations, including small sample sizes and poorly defined control groups. A better understanding of alterations in the brains of patients with migraine could help not only in the diagnosis but may potentially lead to the optimization of a targeted anti-migraine therapy.
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21
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Bell T, Stokoe M, Khaira A, Webb M, Noel M, Amoozegar F, Harris AD. GABA and glutamate in pediatric migraine. Pain 2021; 162:300-308. [PMID: 33326202 PMCID: PMC7737876 DOI: 10.1097/j.pain.0000000000002022] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/07/2020] [Accepted: 07/14/2020] [Indexed: 12/17/2022]
Abstract
Migraine is one of the top 5 most prevalent childhood diseases; however, effective treatment strategies for pediatric migraine are limited. For example, standard adult pharmaceutical therapies are less effective in children and can carry undesirable side effects. To develop more effective treatments, improved knowledge of the biology underlying pediatric migraine is necessary. One theory is that migraine results from an imbalance in cortical excitability. Magnetic resonance spectroscopy (MRS) studies show changes in GABA and glutamate levels (the primary inhibitory and excitatory neurotransmitters in the brain, respectively) in multiple brain regions in adults with migraine; however, they have yet to be assessed in children with migraine. Using MRS and GABA-edited MRS, we show that children (7-13 years) with migraine and aura had significantly lower glutamate levels in the visual cortex compared to controls, the opposite to results seen in adults. In addition, we found significant correlations between metabolite levels and migraine characteristics; higher GABA levels were associated with higher migraine burden. We also found that higher glutamate in the thalamus and higher GABA/Glx ratios in the sensorimotor cortex were associated with duration since diagnosis, i.e., having migraines longer. Lower GABA levels in the sensorimotor cortex were associated with being closer to their next migraine attack. Together, this indicates that GABA and glutamate disturbances occur early in migraine pathophysiology and emphasizes that evidence from adults with migraine cannot be immediately translated to pediatric sufferers. This highlights the need for further mechanistic studies of migraine in children, to aid in development of more effective treatments.
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Affiliation(s)
- Tiffany Bell
- Department of Radiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Mehak Stokoe
- Department of Radiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Akashroop Khaira
- Department of Radiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Megan Webb
- Department of Radiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Melanie Noel
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Farnaz Amoozegar
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Ashley D. Harris
- Department of Radiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
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22
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Dehghan A, Saatchian E, Sobhani M, Montazerabadi A. Neurochemical metabolite alterations of the occipital lobe in migraine without aura by proton magnetic resonance spectroscopy. Neuroradiol J 2020; 33:410-415. [PMID: 32573358 PMCID: PMC7482038 DOI: 10.1177/1971400920932793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Migraine without aura is the most common type of migraine headache, accounting for about 80% of all migraines. The aim of the present investigation was to determine the neurochemical metabolite alterations in the occipital lobe of patients suffering from migraine without aura using proton magnetic resonance spectroscopy (1H-MRS). METHODS Fifteen patients suffering from migraine without aura with an occipital plaque and 16 healthy controls were included in this study. Changes in the neurochemical metabolites in the occipital lobe were assessed using 1H-MRS. The ratios of N-acetylaspartate (NAA) to creatine (Cr), choline (Cho) to Cr and myo-inositol (MI) to NAA were measured by voxel volume at 8 cm3. RESULTS The mean NAA/Cr ratio decreased significantly in patients compared to controls. Cho/Cr and MI/NAA ratios increased significantly in patients. In addition, the duration of the disease and the frequency of headache attacks were significantly associated with a decrease in the NAA/Cr ratio and an increase in the Cho/Cr ratio. CONCLUSIONS Migraine without aura shows a significant association with changes in neurochemical metabolites detectable by 1H-MRS in the occipital lobe of patients. In addition, changes in metabolic ratios showed a significant relationship with the duration of the disease and the frequency of headache attacks.
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Affiliation(s)
- Alireza Dehghan
- Medical Physics Research Centre, Mashhad University of Medical Sciences, Iran
| | - Erfan Saatchian
- Medical Physics Research Centre, Mashhad University of Medical Sciences, Iran
| | - Mohammadreza Sobhani
- Neurology Department, Faculty of Medicine, Gonabad University of Medical Sciences, Iran
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Abstract
This literature review provides an overview of the research using magnetic resonance imaging (MRI) in pediatric migraine and compares findings with the adult migraine literature. A literature search using PubMed was conducted using all relevant sources up to February 2019. Using MRI methods to categorize and explain pediatric migraine in comparison with adult migraine is important, in order to recognize and appreciate the differences between the two entities, both clinically and physiologically. We aim to demonstrate the differences and similarities between pediatric and adult migraine using data from white matter and gray matter structural studies, cerebral perfusion, metabolites, and functional MRI (fMRI) studies, including task-based and resting-state blood oxygen level-dependent studies. By doing this we identify areas that need further research, as well as possible areas where intervention could alter outcomes.
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Peek AL, Rebbeck T, Puts NAJ, Watson J, Aguila MER, Leaver AM. Brain GABA and glutamate levels across pain conditions: A systematic literature review and meta-analysis of 1H-MRS studies using the MRS-Q quality assessment tool. Neuroimage 2020; 210:116532. [DOI: 10.1016/j.neuroimage.2020.116532] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 12/06/2019] [Accepted: 01/08/2020] [Indexed: 12/24/2022] Open
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Tolner EA, Chen SP, Eikermann-Haerter K. Current understanding of cortical structure and function in migraine. Cephalalgia 2019; 39:1683-1699. [PMID: 30922081 PMCID: PMC6859601 DOI: 10.1177/0333102419840643] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 02/28/2019] [Accepted: 03/04/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To review and discuss the literature on the role of cortical structure and function in migraine. DISCUSSION Structural and functional findings suggest that changes in cortical morphology and function contribute to migraine susceptibility by modulating dynamic interactions across cortical and subcortical networks. The involvement of the cortex in migraine is well established for the aura phase with the underlying phenomenon of cortical spreading depolarization, while increasing evidence suggests an important role for the cortex in perception of head pain and associated sensations. As part of trigeminovascular pain and sensory processing networks, cortical dysfunction is likely to also affect initiation of attacks. CONCLUSION Morphological and functional changes identified across cortical regions are likely to contribute to initiation, cyclic recurrence and chronification of migraine. Future studies are needed to address underlying mechanisms, including interactions between cortical and subcortical regions and effects of internal (e.g. genetics, gender) and external (e.g. sensory inputs, stress) modifying factors, as well as possible clinical and therapeutic implications.
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Affiliation(s)
- Else A Tolner
- Departments of Neurology and Human Genetics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Shih-Pin Chen
- Insitute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei
- Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei
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26
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Faragó P, Tóth E, Kocsis K, Kincses B, Veréb D, Király A, Bozsik B, Tajti J, Párdutz Á, Szok D, Vécsei L, Szabó N, Kincses ZT. Altered Resting State Functional Activity and Microstructure of the White Matter in Migraine With Aura. Front Neurol 2019; 10:1039. [PMID: 31632336 PMCID: PMC6779833 DOI: 10.3389/fneur.2019.01039] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 09/13/2019] [Indexed: 01/18/2023] Open
Abstract
Introduction: Brain structure and function were reported to be altered in migraine. Importantly our earlier results showed that white matter diffusion abnormalities and resting state functional activity were affected differently in the two subtypes of the disease, migraine with and without aura. Resting fluctuation of the BOLD signal in the white matter was reported recently. The question arising whether the white matter activity, that is strongly coupled with gray matter activity is also perturbed differentially in the two subtypes of the disease and if so, is it related to the microstructural alterations of the white matter. Methods: Resting state fMRI, 60 directional DTI images and high-resolution T1 images were obtained from 51 migraine patients and 32 healthy volunteers. The images were pre-processed and the white matter was extracted. Independent component analysis was performed to obtain white matter functional networks. The differential expression of the white matter functional networks in the two subtypes of the disease was investigated with dual-regression approach. The Fourier spectrum of the resting fMRI fluctuations were compared between groups. Voxel-wise correlation was calculated between the resting state functional activity fluctuations and white matter microstructural measures. Results: Three white matter networks were identified that were expressed differently in migraine with and without aura. Migraineurs with aura showed increased functional connectivity and amplitude of BOLD fluctuation. Fractional anisotropy and radial diffusivity showed strong correlation with the expression of the frontal white matter network in patients with aura. Discussion: Our study is the first to describe changes in white matter resting state functional activity in migraine with aura, showing correlation with the underlying microstructure. Functional and structural differences between disease subtypes suggest at least partially different pathomechanism, which may necessitate handling of these subtypes as separate entities in further studies.
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Affiliation(s)
- Péter Faragó
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary.,Central European Institute of Technology, Brno, Czechia
| | - Eszter Tóth
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - Krisztián Kocsis
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - Bálint Kincses
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - Dániel Veréb
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - András Király
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary.,Central European Institute of Technology, Brno, Czechia
| | - Bence Bozsik
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - János Tajti
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - Árpád Párdutz
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - Délia Szok
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary
| | - László Vécsei
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary.,MTA-SZTE, Neuroscience Research Group, Szeged, Hungary
| | - Nikoletta Szabó
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary.,Central European Institute of Technology, Brno, Czechia
| | - Zsigmond Tamás Kincses
- Department of Neurology, Faculty of Medicine, Interdisciplinary Excellent Centre, University of Szeged, Szeged, Hungary.,Department of Radiology, Faculty of Medicine, University of Szeged, Szeged, Hungary
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27
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Chan YM, Pitchaimuthu K, Wu QZ, Carter OL, Egan GF, Badcock DR, McKendrick AM. Relating excitatory and inhibitory neurochemicals to visual perception: A magnetic resonance study of occipital cortex between migraine events. PLoS One 2019; 14:e0208666. [PMID: 31291247 PMCID: PMC6619596 DOI: 10.1371/journal.pone.0208666] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 06/06/2019] [Indexed: 01/03/2023] Open
Abstract
Certain perceptual measures have been proposed as indirect assays of brain neurochemical status in people with migraine. One such measure is binocular rivalry, however, previous studies have not measured rivalry characteristics and brain neurochemistry together in people with migraine. This study compared spectroscopy-measured levels of GABA and Glx (glutamine and glutamate complex) in visual cortex between 16 people with migraine and 16 non-headache controls, and assessed whether the concentration of these neurochemicals explains, at least partially, inter-individual variability in binocular rivalry perceptual measures. Mean Glx level was significantly reduced in migraineurs relative to controls, whereas mean occipital GABA levels were similar between groups. Neither GABA levels, nor Glx levels correlated with rivalry percept duration. Our results thus suggest that the previously suggested relationship between rivalry percept duration and GABAergic inhibitory neurotransmitter concentration in visual cortex is not strong enough to enable rivalry percept duration to be reliably assumed to be a surrogate for GABA concentration, at least in the context of healthy individuals and those that experience migraine.
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Affiliation(s)
- Yu Man Chan
- Department of Optometry & Vision Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kabilan Pitchaimuthu
- Department of Optometry & Vision Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Qi-Zhu Wu
- Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
| | - Olivia L. Carter
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Gary F. Egan
- Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
| | - David R. Badcock
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - Allison M. McKendrick
- Department of Optometry & Vision Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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28
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Ellingson BM, Hesterman C, Johnston M, Dudeck NR, Charles AC, Villablanca JP. Advanced Imaging in the Evaluation of Migraine Headaches. Neuroimaging Clin N Am 2019; 29:301-324. [PMID: 30926119 PMCID: PMC8765285 DOI: 10.1016/j.nic.2019.01.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The use of advanced imaging in routine diagnostic practice appears to provide only limited value in patients with migraine who have not experienced recent changes in headache characteristics or symptoms. However, advanced imaging may have potential for studying the biological manifestations and pathophysiology of migraine headaches. Migraine with aura appears to have characteristic spatiotemporal changes in structural anatomy, function, hemodynamics, metabolism, and biochemistry, whereas migraine without aura produces more subtle and complex changes. Large, controlled, multicenter imaging-based observational trials are needed to confirm the anecdotal evidence in the literature and test the scientific hypotheses thought to underscore migraine pathophysiology.
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Affiliation(s)
- Benjamin M Ellingson
- UCLA Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Boulevard, Suite 615, Los Angeles, CA 90024, USA; Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Boulevard, Suite 615, Los Angeles, CA 90024, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095, USA; UCLA Brain Research Institute (BRI), David Geffen School of Medicine, University of California Los Angeles, 695 Charles E Young Dr S, Los Angeles, CA 90095, USA; UCLA Brain Tumor Imaging Laboratory (BTIL), Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, 924 Westwood Boulevard, Suite 615, Los Angeles, CA 90024, USA; UCLA Brain Tumor Imaging Laboratory (BTIL), Department of Psychiatry, David Geffen School of Medicine, University of California, Los Angeles, 924 Westwood Boulevard, Suite 615, Los Angeles, CA 90024, USA.
| | - Chelsea Hesterman
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, 710 Westwood Plaza, Los Angeles, CA 90095-1769, USA
| | - Mollie Johnston
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, 710 Westwood Plaza, Los Angeles, CA 90095-1769, USA
| | - Nicholas R Dudeck
- UCLA Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Boulevard, Suite 615, Los Angeles, CA 90024, USA; Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Boulevard, Suite 615, Los Angeles, CA 90024, USA
| | - Andrew C Charles
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, 710 Westwood Plaza, Los Angeles, CA 90095-1769, USA
| | - Juan Pablo Villablanca
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Boulevard, Suite 615, Los Angeles, CA 90024, USA
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29
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Kurcyus K, Annac E, Hanning NM, Harris AD, Oeltzschner G, Edden R, Riedl V. Opposite Dynamics of GABA and Glutamate Levels in the Occipital Cortex during Visual Processing. J Neurosci 2018; 38:9967-9976. [PMID: 30282724 PMCID: PMC6234295 DOI: 10.1523/jneurosci.1214-18.2018] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 06/22/2018] [Accepted: 09/19/2018] [Indexed: 11/21/2022] Open
Abstract
Magnetic resonance spectroscopy (MRS) measures the two most common inhibitory and excitatory neurotransmitters, GABA and glutamate, in the human brain. However, the role of MRS-derived GABA and glutamate signals in relation to system-level neural signaling and behavior is not fully understood. In this study, we investigated levels of GABA and glutamate in the visual cortex of healthy human participants (both genders) in three functional states with increasing visual input. Compared with a baseline state of eyes closed, GABA levels decreased after opening the eyes in darkness and Glx levels remained stable during eyes open but increased with visual stimulation. In relevant states, GABA and Glx correlated with amplitude of fMRI signal fluctuations. Furthermore, visual discriminatory performance correlated with the level of GABA, but not Glx. Our study suggests that differences in brain states can be detected through the contrasting dynamics of GABA and Glx, which has implications in interpreting MRS measurements.SIGNIFICANCE STATEMENT GABA and glutamate are the two most abundant neurotransmitters in human brain. Their interaction, known as inhibitory-excitatory balance, plays a crucial role in establishing spontaneous and stimulus-driven brain activity. Yet, the relationship between magnetic resonance spectroscopy (MRS)-derived levels of both metabolites and fMRI is still a matter of dispute. In this work, we study GABA and glutamate in three states of visual processing and in relation to fMRI and visual discriminatory performance in healthy people. We found that states of visual processing can be detected through the contrasting dynamics of GABA and glutamate and their correlation with fMRI signals. We also demonstrated that GABA, but not glutamate, in the visual system predicts visual performance. Our results provide insights into MRS-derived GABA and glutamate measurements.
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Affiliation(s)
- Katarzyna Kurcyus
- Department of Neuroradiology, Klinikum rechts der Isar der Technischen Universität München, 81675 Munich, Germany,
| | - Efsun Annac
- Department of General and Experimental Psychology, Ludwig-Maximilians-Universität München, 80802 Munich, Germany
- Graduate School of Systemic Neurosciences, Ludwig-Maximilians-Universität München, 82152 Munich, Germany
| | - Nina M Hanning
- Department of General and Experimental Psychology, Ludwig-Maximilians-Universität München, 80802 Munich, Germany
- Graduate School of Systemic Neurosciences, Ludwig-Maximilians-Universität München, 82152 Munich, Germany
| | - Ashley D Harris
- Department of Radiology, University of Calgary, Calgary, Alberta T2N 1N4, Canada
| | - Georg Oeltzschner
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland 21287, and
| | - Richard Edden
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland 21287, and
| | - Valentin Riedl
- Department of Neuroradiology, Klinikum rechts der Isar der Technischen Universität München, 81675 Munich, Germany,
- Department of Nuclear Medicine, Klinikum rechts der Isar der Technischen Universität München, 81675 Munich, Germany
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30
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Veréb D, Szabó N, Tuka B, Tajti J, Király A, Faragó P, Kocsis K, Tóth E, Kincses B, Bagoly T, Helyes Z, Vécsei L, Kincses ZT. Correlation of neurochemical and imaging markers in migraine: PACAP38 and DTI measures. Neurology 2018; 91:e1166-e1174. [PMID: 30135251 DOI: 10.1212/wnl.0000000000006201] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 06/26/2018] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To examine whether interictal plasma pituitary adenylate cyclase-activating peptide 38-like immunoreactivity (PACAP38-LI) shows correlation with the microstructural integrity of the white matter in migraine. METHODS Interictal plasma PACAP38-LI was measured by radioimmunoassay in 26 patients with migraine (24 women) who underwent diffusion tensor imaging afterward using a 1.5-tesla magnetic resonance scanner. Data were analyzed using tract-based spatial statistics included in FMRIB's Software Library. RESULTS Interictal plasma PACAP38-LI showed significant correlation with mean diffusivity (p < 0.0179) mostly in the bilateral occipital white matter spreading into parietal and temporal white matter. Axial and radial diffusivity showed positive correlation with interictal PACAP38-LI (p < 0.0432 and p < 0.0418, respectively) in the left optic radiation and left posterior corpus callosum. Fractional anisotropy did not correlate significantly with PACAP38-LI. With disease duration as a nuisance regressor in the model, PACAP38-LI correlated with axial and mean diffusivity in the left thalamus (p < 0.01). CONCLUSION We report a link between PACAP38, a pathobiologically important neurochemical biomarker, and imaging markers of the disease that may bolster further research into the role of PACAP38 in migraine.
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Affiliation(s)
- Dániel Veréb
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - Nikoletta Szabó
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - Bernadett Tuka
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - János Tajti
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - András Király
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - Péter Faragó
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - Krisztián Kocsis
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - Eszter Tóth
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - Bálint Kincses
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - Teréz Bagoly
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - Zsuzsanna Helyes
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - László Vécsei
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary
| | - Zsigmond Tamás Kincses
- From the Departments of Neurology (D.V., N.S., J.T., A.K., P.F., K.K., E.T., B.K., L.V., Z.T.K.) and Radiology (Z.T.K.), Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary; Central European Institute of Technology (N.S., A.K.), Brno, Czech Republic; MTA-SZTE Neuroscience Research Group (B.T., L.V.), Szeged; and Department of Pharmacology and Pharmacotherapy, Faculty of Medicine (T.B., Z.H.), and János Szentágothai Research Centre & Centre for Neuroscience (Z.H.), University of Pécs, Hungary.
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Abstract
To explore alterations in γ-aminobutyric acid (GABA) levels in response to levetiracetam (LEV) treatment in patients with migraine. Patients with migraine (N=14) were treated with LEV for 12 weeks. The levels of GABA+ in the anterior cingulate cortex/medial prefrontal cortex (ACC/mPFC) and the posterior cingulate cortex (PCC) were examined by proton magnetic resonance spectroscopy before (baseline) and after treatment. LEV showed good efficacy in the reduction of headache frequency and intensity in patients with migraine. Among the 14 patients, good-quality spectral data of GABA+ in the PCC region were obtained in 11 patients. There was a significant decrease in GABA+ levels in the PCC region after LEV treatment. ACC/mPFC GABA+ was assessed by proton magnetic resonance spectroscopy in eight patients with migraine. LEV had no significant effect on GABA+ levels in the ACC/mPFC region. The decreased GABA+ levels after LEV treatment in patients with migraine suggest that GABA is a migraine biomarker.
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32
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Spee B, Ishizu T, Leder H, Mikuni J, Kawabata H, Pelowski M. Neuropsychopharmacological aesthetics: A theoretical consideration of pharmacological approaches to causative brain study in aesthetics and art. PROGRESS IN BRAIN RESEARCH 2018; 237:343-372. [PMID: 29779743 DOI: 10.1016/bs.pbr.2018.03.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Recent developments in neuroaesthetics have heightened the need for causative approaches to more deeply understand the mechanism underlying perception, emotion, and aesthetic experiences. This has recently been the topic for empirical work, employing several causative methods for changing brain activity, as well as comparative assessments of individuals with brain damage or disease. However, one area of study with high potential, and indeed a long history of often nonscientific use in the area of aesthetics and art, employing psychopharmacological chemicals as means of changing brain function, has not been systematically utilized. This chapter reviews the literature on this topic, analyzing neuroendocrinological (neurochemical) approaches and mechanisms that might be used to causatively study the aesthetic brain. We focus on four relevant neuromodulatory systems potentially related to aesthetic experience: the dopaminergic, serotonergic, cannabinoid, and the opioidergic system. We build a bridge to psychopharmacological methods and review drug-induced behavioral and neurobiological consequences. We conclude with a discussion of hypotheses and suggestions for future research.
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Affiliation(s)
- Blanca Spee
- University of Vienna, Faculty of Psychology, Vienna, Austria
| | - Tomohiro Ishizu
- University of Vienna, Faculty of Psychology, Vienna, Austria
| | - Helmut Leder
- University of Vienna, Faculty of Psychology, Vienna, Austria
| | - Jan Mikuni
- Department of Psychology, Keio University, Tokyo, Japan
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De Marchis ML, Guadagni F, Silvestris E, Lovero D, Della-Morte D, Ferroni P, Barbanti P, Palmirotta R. Genetic bases of the nutritional approach to migraine. Crit Rev Food Sci Nutr 2018. [PMID: 29517920 DOI: 10.1080/10408398.2018.1450215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Migraine is a common multifactorial and polygenic neurological disabling disorder characterized by a genetic background and associated to environmental, hormonal and food stimulations. A large series of evidence suggest a strong correlation between nutrition and migraine and indicates several commonly foods, food additives and beverages that may be involved in the mechanisms triggering the headache attack in migraine-susceptible persons. There are foods and drinks, or ingredients of the same, that can trigger the migraine crisis as well as some foods play a protective function depending on the specific genetic sensitivity of the subject. The recent biotechnological advances have enhanced the identification of some genetic factors involved in onset diseases and the identification of sequence variants of genes responsible for the individual sensitivity to migraine trigger-foods. Therefore many studies are aimed at the analysis of polymorphisms of genes coding for the enzymes involved in the metabolism of food factors in order to clarify the different ways in which people respond to foods based on their genetic constitution. This review discusses the latest knowledge and scientific evidence of the role of gene variants and nutrients, food additives and nutraceuticals interactions in migraine.
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Affiliation(s)
- Maria Laura De Marchis
- a Biobanca InterIstituzionale Multidisciplinare, IRCCS San Raffaele Pisana , Rome , Italy.,b Biotechnology Unit, Istituto Zooprofilattico Sperimentale del Lazio e della Toscana 'M. Aleandri' , Rome , Italy
| | - Fiorella Guadagni
- a Biobanca InterIstituzionale Multidisciplinare, IRCCS San Raffaele Pisana , Rome , Italy.,c Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University , Rome , Italy
| | - Erica Silvestris
- d Department of Biomedical Sciences & Human Oncology, University of Bari 'Aldo Moro' , Bari , Italy
| | - Domenica Lovero
- d Department of Biomedical Sciences & Human Oncology, University of Bari 'Aldo Moro' , Bari , Italy
| | - David Della-Morte
- c Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University , Rome , Italy.,e Department of Systems Medicine University of Rome "Tor Vergata" , Rome , Italy
| | - Patrizia Ferroni
- a Biobanca InterIstituzionale Multidisciplinare, IRCCS San Raffaele Pisana , Rome , Italy.,c Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University , Rome , Italy
| | - Piero Barbanti
- f Headache and Pain Unit, Department of Neurological, Motor and Sensorial Sciences, IRCCS San Raffaele Pisana , Rome , Italy
| | - Raffaele Palmirotta
- d Department of Biomedical Sciences & Human Oncology, University of Bari 'Aldo Moro' , Bari , Italy
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Niddam DM, Lai KL, Tsai SY, Lin YR, Chen WT, Fuh JL, Wang SJ. Neurochemical changes in the medial wall of the brain in chronic migraine. Brain 2017; 141:377-390. [DOI: 10.1093/brain/awx331] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 10/18/2017] [Indexed: 12/21/2022] Open
Affiliation(s)
- David M Niddam
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kuan-Lin Lai
- Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Neurology, Taipei Municipal Gandau Hospital. Taipei, Taiwan
| | - Shang-Yueh Tsai
- Graduate Institute of Applied Physics, National Chengchi University, Taipei, Taiwan
- Research Center for Mind, Brain and Learning, National Chengchi University, Taipei, Taiwan
| | - Yi-Ru Lin
- Department of Electronic and Computer Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Wei-Ta Chen
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jong-Ling Fuh
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
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Ferrari A, Rustichelli C, Baraldi C. Glutamate receptor antagonists with the potential for migraine treatment. Expert Opin Investig Drugs 2017; 26:1321-1330. [PMID: 29050521 DOI: 10.1080/13543784.2017.1395411] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Preclinical, clinical, and other (e.g., genetic) evidence support the concept that migraine susceptibility may at least partially result from a glutamatergic system disorder. Therefore, the receptors of the glutamatergic system are considered relatively new targets for investigational drugs to treat migraine. Investigational and established glutamate receptor antagonists (GluRAs) have been shown to possess antinociceptive properties in preclinical models of trigeminovascular nociception and have been evaluated in clinical trials. This review focuses on preclinical and clinical studies of GluRAs for the treatment of migraine. Areas covered: A PubMed database search (from 1987 to December 2016) and a review of published studies on GluRAs in migraine were conducted. Expert opinion: All published clinical trials of investigational GluRAs have been unsuccessful in establishing benefit for acute migraine treatment. Clinical trial results contrast with the preclinical data, suggesting that glutamate (Glu) does not play a decisive role after the attack has already been triggered. These antagonists may instead be useful for migraine prophylaxis. Improving patient care requires further investigating and critically analyzing the role of Glu in migraine, designing experimental models to study more receptors and their corresponding antagonists, and identifying biomarkers to facilitate trials designed to target specific subgroups of migraine patients.
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Affiliation(s)
- Anna Ferrari
- a Unit of Medical Toxicology, Headache and Drug Abuse Centre; Department of Diagnostic, Clinical and Public Health Medicine , University of Modena and Reggio Emilia , Modena , Italy
| | - Cecilia Rustichelli
- b Department of Life Sciences , University of Modena and Reggio Emilia , Modena , Italy
| | - Carlo Baraldi
- a Unit of Medical Toxicology, Headache and Drug Abuse Centre; Department of Diagnostic, Clinical and Public Health Medicine , University of Modena and Reggio Emilia , Modena , Italy
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Zielman R, Wijnen JP, Webb A, Onderwater GLJ, Ronen I, Ferrari MD, Kan HE, Terwindt GM, Kruit MC. Cortical glutamate in migraine. Brain 2017. [DOI: 10.1093/brain/awx130] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Faragó P, Tuka B, Tóth E, Szabó N, Király A, Csete G, Szok D, Tajti J, Párdutz Á, Vécsei L, Kincses ZT. Interictal brain activity differs in migraine with and without aura: resting state fMRI study. J Headache Pain 2017; 18:8. [PMID: 28124204 PMCID: PMC5267588 DOI: 10.1186/s10194-016-0716-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 12/20/2016] [Indexed: 01/03/2023] Open
Abstract
Background Migraine is one of the most severe primary headache disorders. The nature of the headache and the associated symptoms during the attack suggest underlying functional alterations in the brain. In this study, we examined amplitude, the resting state fMRI fluctuation in migraineurs with and without aura (MWA, MWoA respectively) and healthy controls. Methods Resting state functional MRI images and T1 high-resolution images were acquired from all participants. For data analysis we compared the groups (MWA-Control, MWA-MWoA, MWoA-Control). The resting state networks were identified by MELODIC. The mean time courses of the networks were identified for each participant for all networks. The time-courses were decomposed into five frequency bands by discrete wavelet decomposition. The amplitude of the frequency-specific activity was compared between groups. Furthermore, the preprocessed resting state images were decomposed by wavelet analysis into five specific frequency bands voxel-wise. The voxel-wise amplitudes were compared between groups by non-parametric permutation test. Results In the MWA-Control comparison the discrete wavelet decomposition found alterations in the lateral visual network. Higher activity was measured in the MWA group in the highest frequency band (0.16–0.08 Hz). In case of the MWA-MWoA comparison all networks showed higher activity in the 0.08–0.04 Hz frequency range in MWA, and the lateral visual network in in higher frequencies. In MWoA-Control comparison only the default mode network revealed decreased activity in MWoA group in the 0.08–0.04 Hz band. The voxel-wise frequency specific analysis of the amplitudes found higher amplitudes in MWA as compared to MWoA in the in fronto-parietal regions, anterior cingulate cortex and cerebellum. Discussion The amplitude of the resting state fMRI activity fluctuation is higher in MWA than in MWoA. These results are in concordance with former studies, which found cortical hyperexcitability in MWA.
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Affiliation(s)
- Péter Faragó
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary
| | - Bernadett Tuka
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary.,MTA-SZTE Neuroscience Research Group, Szeged, Hungary
| | - Eszter Tóth
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary
| | - Nikoletta Szabó
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - András Király
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary
| | - Gergő Csete
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary
| | - Délia Szok
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary
| | - János Tajti
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary
| | - Árpád Párdutz
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary
| | - László Vécsei
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary.,MTA-SZTE Neuroscience Research Group, Szeged, Hungary
| | - Zsigmond Tamás Kincses
- Department of Neurology, Neuroimaging Research Group, Albert Szent-Györgyi, Clinical Center, University of Szeged, Semmelweis u. 6, H-6725, Szeged, Hungary. .,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.
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Acute Exposure to Pacific Ciguatoxin Reduces Electroencephalogram Activity and Disrupts Neurotransmitter Metabolic Pathways in Motor Cortex. Mol Neurobiol 2016; 54:5590-5603. [PMID: 27613284 DOI: 10.1007/s12035-016-0093-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 09/01/2016] [Indexed: 12/14/2022]
Abstract
Ciguatera fish poisoning (CFP) is a common human food poisoning caused by consumption of ciguatoxin (CTX)-contaminated fish affecting over 50,000 people worldwide each year. CTXs are classified depending on their origin from the Pacific (P-CTXs), Indian Ocean (I-CTXs), and Caribbean (C-CTXs). P-CTX-1 is the most toxic CTX known and the major source of CFP causing an array of neurological symptoms. Neurological symptoms in some CFP patients last for several months or years; however, the underlying electrophysiological properties of acute exposure to CTXs remain unknown. Here, we used CTX purified from ciguatera fish sourced in the Pacific Ocean (P-CTX-1). Delta and theta electroencephalography (EEG) activity was reduced remarkably in 2 h and returned to normal in 6 h after a single exposure. However, second exposure to P-CTX-1 induced not only a further reduction in EEG activities but also a 2-week delay in returning to baseline EEG values. Ciguatoxicity was detected in the brain hours after the first and second exposure by mouse neuroblastoma assay. The spontaneous firing rate of single motor cortex neuron was reduced significantly measured by single-unit recording with high spatial resolution. Expression profile study of neurotransmitters using targeted profiling approach based on liquid chromatography-tandem mass spectrometry revealed an imbalance between excitatory and inhibitory neurotransmitters in the motor cortex. Our study provides a possible link between the brain oscillations and neurotransmitter release after acute exposure to P-CTX-1. Identification of EEG signatures and major metabolic pathways affected by P-CTX-1 provides new insight into potential biomarker development and therapeutic interventions.
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Dobrynina LA, Kalashnikova LA, Bakulin IS, Kremneva EI, Krotenkova MV, Shamtieva KV. [Posterior reversible encephalopathy syndrome due to hypocalcemia: a description of a case and an analysis of a pathogenic role of electrolyte disturbances]. Zh Nevrol Psikhiatr Im S S Korsakova 2016; 116:70-77. [PMID: 27500881 DOI: 10.17116/jnevro20161167170-77] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Afemale patient with recurrent posterior reversible encephalopathy syndrome, severe hypocalcemia due to extirpation of the parathyroid glands is described. The disease was characterized by the acute development of headache, seizures, cognitive and behavioral disorders, mental confusion, transitory blood pressure increasing. The vasogenic edema in the posterior parts of the brain, detected by CT at the first exacerbation,was completely regressed. The residual neurological deficit and MRI changes remained after the recurrent exacerbations. Main clinical features of PRESare explained by hypocalcemia and accompanying electrolyte disturbances.The reported case shows the necessity to study blood electrolytes in patients with PRES to clarify their pathogenic role and the necessity of drug correction.
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Becerra L, Veggeberg R, Prescot A, Jensen JE, Renshaw P, Scrivani S, Spierings ELH, Burstein R, Borsook D. A 'complex' of brain metabolites distinguish altered chemistry in the cingulate cortex of episodic migraine patients. NEUROIMAGE-CLINICAL 2016; 11:588-594. [PMID: 27158591 PMCID: PMC4846856 DOI: 10.1016/j.nicl.2016.03.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 03/14/2016] [Accepted: 03/28/2016] [Indexed: 12/22/2022]
Abstract
Despite the prevalence of migraine, the pathophysiology of the disease remains unclear. Current understanding of migraine has alluded to the possibility of a hyperexcitable brain. The aim of the current study is to investigate human brain metabolite differences in the anterior cingulate cortex (ACC) during the interictal phase in migraine patients. We hypothesized that there may be differences in levels of excitatory neurotransmitters and/or their derivatives in the migraine cohort in support of the theory of hyperexcitability in migraine. 2D J-resolved proton magnetic resonance spectroscopy (1H-MRS) data were acquired on a 3 Tesla (3 T) MRI from a voxel placed over the ACC of 32 migraine patients (MP; 23 females, 9 males, age 33 ± 9.6 years) and 33 healthy controls (HC; 25 females, 8 males, age 32 ± 9.6 years). Amplitude correlation matrices were constructed for each subject to evaluate metabolite discriminability. ProFit-estimated metabolite peak areas were normalized to a water reference signal to assess subject differences. The initial analysis of variance (ANOVA) was performed to test for group differences for all metabolites/creatine (Cre) ratios between healthy controls and migraineurs but showed no statistically significant differences. In addition, we used a multivariate approach to distinguish migraineurs from healthy subjects based on the metabolite/Cre ratio. A quadratic discriminant analysis (QDA) model was used to identify 3 metabolite ratios sufficient to minimize minimum classification error (MCE). The 3 selected metabolite ratios were aspartate (Asp)/Cre, N-acetyl aspartate (NAA)/Cre, and glutamine (Gln)/Cre. These findings are in support of a ‘complex’ of metabolite alterations, which may underlie changes in neuronal chemistry in the migraine brain. Furthermore, the parallel changes in the three-metabolite ‘complex’ may confer more subtle but biological processes that are ongoing. The data also support the current theory that the migraine brain is hyperexcitable even in the interictal state. 3 T MRI was used to acquire 2D J-resolved proton magnetic resonance spectroscopy. Metabolite alterations are reported in the anterior cingulate cortex of episodic migraineurs. The complex of metabolites may reflect multiple chemical changes in migraineurs. The observed chemical changes support the theory that the brain of migraineurs is hyperexcitable.
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Affiliation(s)
- L Becerra
- Pain/Analgesia Imaging Neuroscience (P.A.I.N.) Group, Department of Anesthesia Critical Care and Pain Medicine, Boston Children's Hospital, Center for Pain and the Brain, Harvard Medical School, Waltham, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA; Departments of Psychiatry and Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02114, USA
| | - R Veggeberg
- Pain/Analgesia Imaging Neuroscience (P.A.I.N.) Group, Department of Anesthesia Critical Care and Pain Medicine, Boston Children's Hospital, Center for Pain and the Brain, Harvard Medical School, Waltham, MA, USA; Brain Imaging Center, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - A Prescot
- Department of Radiology, University of Utah, School of Medicine, Salt Lake City, UT, USA; VISN 19 MIRECC, Salt Lake City, UT, USA
| | - J E Jensen
- Brain Imaging Center, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - P Renshaw
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA; VISN 19 MIRECC, Salt Lake City, UT, USA
| | - S Scrivani
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - E L H Spierings
- Department of Neurology, Tufts Medical Center, Boston, MA, USA
| | - R Burstein
- Anesthesia and Critical Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - D Borsook
- Pain/Analgesia Imaging Neuroscience (P.A.I.N.) Group, Department of Anesthesia Critical Care and Pain Medicine, Boston Children's Hospital, Center for Pain and the Brain, Harvard Medical School, Waltham, MA, USA; Departments of Psychiatry and Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02114, USA; Brain Imaging Center, McLean Hospital, Harvard Medical School, Belmont, MA, USA.
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Abstract
The pathogenesis of migraine as well as cluster headache (CH) is yet a debated question. In this review, we discuss the possible role of the of tyrosine and tryptophan metabolism in the pathogenesis of these primary headaches. These include the abnormalities in the synthesis of neurotransmitters: high level of DA, low level of NE and very elevated levels of octopamine and synephrine (neuromodulators) in plasma of episodic migraine without aura and CH patients. We hypothesize that the imbalance between the levels of neurotransmitters and elusive amines synthesis is due to a metabolic shift directing tyrosine toward an increased decarboxylase and reduced hydroxylase enzyme activities. The metabolic shift of the tyrosine is favored by a state of neuronal hyperexcitability and a reduced mitochondrial activity present in migraine. In addition we present biochemical studies performed in chronic migraine and chronic tension-type headache patients to verify if the same anomalies of the tyrosine and tryptophan metabolism are present in these primary headaches and, if so, their possible role in the chronicity process of CM and CTTH. The results show that important abnormalities of tyrosine metabolism are present only in CM patients (very high plasma levels of DA, NE and tryptamine). Tryptamine plasma levels were found significantly lower in both CM and CTTH patients. In view of this, we propose that migraine and, possibly, CH attacks derive from neurotransmitter and neuromodulator metabolic abnormalities in a hyperexcitable and hypoenergetic brain that spread from the frontal lobe, downstream, resulting in abnormally activated nuclei of the pain matrix. The low tryptamine plasma levels found in CM and CTTH patients suggest that these two primary chronic headaches are characterized by a common insufficient serotoninergic control of the pain threshold.
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Arngrim N, Schytz HW, Britze J, Amin FM, Vestergaard MB, Hougaard A, Wolfram F, de Koning PJH, Olsen KS, Secher NH, Larsson HBW, Olesen J, Ashina M. Migraine induced by hypoxia: an MRI spectroscopy and angiography study. Brain 2015; 139:723-37. [DOI: 10.1093/brain/awv359] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 10/16/2015] [Indexed: 01/03/2023] Open
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Noruzzadeh R, Modabbernia A, Aghamollaii V, Ghaffarpour M, Harirchian MH, Salahi S, Nikbakht N, Noruzi N, Tafakhori A. Memantine for Prophylactic Treatment of Migraine Without Aura: A Randomized Double-Blind Placebo-Controlled Study. Headache 2015; 56:95-103. [DOI: 10.1111/head.12732] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Rezvan Noruzzadeh
- Iranian Center of Neurological Research; Tehran University of Medical Sciences, Tehran, Iran
| | | | - Vajiheh Aghamollaii
- Neurology Department, Roozbeh Hospital; Tehran University of Medical Sciences
| | - Majid Ghaffarpour
- Iranian Center of Neurological Research; Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sarvenaz Salahi
- Iranian Center of Neurological Research; Tehran University of Medical Sciences, Tehran, Iran
| | - Nikta Nikbakht
- Iranian Center of Neurological Research; Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Noruzi
- Iranian Center of Neurological Research; Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Tafakhori
- Iranian Center of Neurological Research; Tehran University of Medical Sciences, Tehran, Iran
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Aguila MER, Lagopoulos J, Leaver AM, Rebbeck T, Hübscher M, Brennan PC, Refshauge KM. Elevated levels of GABA+ in migraine detected using (1) H-MRS. NMR IN BIOMEDICINE 2015; 28:890-897. [PMID: 25997981 DOI: 10.1002/nbm.3321] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 04/09/2015] [Accepted: 04/09/2015] [Indexed: 06/04/2023]
Abstract
γ-Aminobutyric acid (GABA) has been implicated in several pain conditions, yet no study has systematically evaluated GABA levels in migraine using (1) H-MRS. The accurate detection, separation and quantification of GABA in individuals with migraine could elucidate the role of this neurotransmitter in migraine pathophysiology. Such information may eventually be useful in the diagnosis and development of more effective treatments for migraine. The aims of this study were therefore to compare the concentration of GABA+ in individuals with migraine with that in asymptomatic individuals, and to determine the diagnostic potential of GABA+ in the classification of those with or without migraine. In this case-control study, GABA+ levels in the brain were determined in 19 participants with migraine and 19 matched controls by (1) H-MRS using Mescher-Garwood point-resolved spectroscopy (MEGA-PRESS) sequence. The diagnostic accuracy of GABA+ for the detection of migraine and the optimal cut-off value were determined by receiver operating characteristic analysis. GABA+ levels were significantly higher (p = 0.002) in those with migraine [median, 1.41 institutional units (IU); interquartile range, 1.31-1.50 IU] than in controls (median, 1.18 IU; interquartile range, 1.12-1.35 IU). The GABA+ concentration appears to have good accuracy for the classification of individuals with or without migraine [area under the curve (95% confidence interval), 0.837 (0.71-0.96); p < 0.001]. The optimal GABA+ cut-off value for migraine was 1.30 IU, with a sensitivity of 84.2%, specificity of 68.4% and positive likelihood ratio of +2.67. The outcomes of this study suggest altered GABA metabolism in migraine. These results add to the scarce evidence on the putative role of GABA in migraine and provide a basis to further explore the causal relationship between GABA+ and the pathophysiology of migraine. This study also demonstrates that GABA+ concentration has good diagnostic accuracy for migraine. These findings offer new research and practice directions for migraine diagnosis.
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Affiliation(s)
- Maria-Eliza R Aguila
- The University of Sydney Faculty of Health Sciences, Lidcombe, NSW, Australia
- University of the Philippines College of Allied Medical Professions, Manila, Philippines
| | - Jim Lagopoulos
- Brain and Mind Research Institute, Sydney Medical School, Camperdown, NSW, Australia
| | - Andrew M Leaver
- The University of Sydney Faculty of Health Sciences, Lidcombe, NSW, Australia
| | - Trudy Rebbeck
- The University of Sydney Faculty of Health Sciences, Lidcombe, NSW, Australia
| | - Markus Hübscher
- The University of Sydney Faculty of Health Sciences, Lidcombe, NSW, Australia
- Neuroscience Research Australia and The University of New South Wales, Randwick, NSW, Australia
| | - Patrick C Brennan
- The University of Sydney Faculty of Health Sciences, Lidcombe, NSW, Australia
| | - Kathryn M Refshauge
- The University of Sydney Faculty of Health Sciences, Lidcombe, NSW, Australia
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Bridge H, Stagg CJ, Near J, Lau CI, Zisner A, Cader MZ. Altered neurochemical coupling in the occipital cortex in migraine with visual aura. Cephalalgia 2015; 35:1025-30. [PMID: 25631169 DOI: 10.1177/0333102414566860] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Accepted: 12/06/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Visual aura is present in about one-third of migraine patients and triggering by bright or flickering lights is frequently reported. METHOD Using migraine with visual aura patients, we investigated the neurochemical profile of the visual cortex using magnetic resonance spectroscopy. Specifically, glutamate/creatine and GABA/creatine ratios were quantified in the occipital cortex of female migraine patients. RESULTS GABA levels in the occipital cortex of migraine patients were lower than that of controls. Glutamate levels in migraine patients, but not controls, correlated with the blood-oxygenation-level-dependent (BOLD) signal in the primary visual cortex during visual stimulation. CONCLUSION Migraine with visual aura appears to disrupt the excitation-inhibition coupling in the occipital cortex.
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Affiliation(s)
- Holly Bridge
- Nuffield Department of Clinical Neuroscience, University of Oxford, UK Oxford Centre for Functional MRI of the Brain (FMRIB), University of Oxford, UK
| | - Charlotte J Stagg
- Nuffield Department of Clinical Neuroscience, University of Oxford, UK Oxford Centre for Functional MRI of the Brain (FMRIB), University of Oxford, UK Oxford Centre for Human Brain Activity, University of Oxford, UK
| | - Jamie Near
- Douglas Mental Health University Institute and Department of Psychiatry, McGill University, Canada
| | - Chi-ieong Lau
- Department of Neurology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Aimee Zisner
- Oxford Centre for Functional MRI of the Brain (FMRIB), University of Oxford, UK
| | - M Zameel Cader
- Nuffield Department of Clinical Neuroscience, University of Oxford, UK Oxford Headache Centre, John Radcliffe Hospital, Oxford, UK
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Fayed N, Andrés E, Viguera L, Modrego PJ, Garcia-Campayo J. Higher glutamate+glutamine and reduction of N-acetylaspartate in posterior cingulate according to age range in patients with cognitive impairment and/or pain. Acad Radiol 2014; 21:1211-7. [PMID: 24981958 DOI: 10.1016/j.acra.2014.04.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 02/11/2014] [Accepted: 04/14/2014] [Indexed: 01/03/2023]
Abstract
RATIONALE AND OBJECTIVES The aim of the study was to analyze 1) whether the metabolite levels in the posterior cingulate cortex (PCC) are different in healthy individuals compared to a group of patients with cognitive impairment and/or pain and 2) whether there exists a correlation between brain metabolites and the age of a patient. MATERIALS AND METHODS Two hundred seven patients with cognitive impairment and/or pain (66 mild cognitive impairment, 54 fibromyalgia, 36 Alzheimer disease, 33 interictal migraine, 10 somatization disorder, and 8 after trigeminal neuralgia, and 193 healthy participants adjusted for gender and age. Proton magnetic resonance spectroscopy (MRS) of the brain was performed with the voxel placed in the ventral PCC and postprocessed with LCModel (Stephen Provencher, Oakville, Ontario, Canada). RESULTS Using linear regression and adjusting for gender and age, mean brain metabolite values for the pathological group, when compared to healthy controls, were significantly lower in N-acetylaspartate (P=.003) and N-acetylaspartate/creatine (P=.015) and significantly greater in glutamate+glutamine (P<.001) and glutamate+glutamine/creatine (P<.000). All metabolites were significantly correlated with age: glutamate, glutamate+glutamine, N-acetylaspartate, and their creatine ratios exhibited a negative correlation, whereas myoinositol and choline exhibited a positive correlation. CONCLUSIONS Although the number of patients is relatively small with heterogeneous state of disease, MRS in PCC may serve as a useful noninvasive tool for diagnostic of patients with cognitive impairment and pain.
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Clark D, Institoris Á, Kozák G, Bere Z, Tuor U, Farkas E, Bari F. Impact of aging on spreading depolarizations induced by focal brain ischemia in rats. Neurobiol Aging 2014; 35:2803-2811. [PMID: 25044075 DOI: 10.1016/j.neurobiolaging.2014.06.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 05/27/2014] [Accepted: 06/10/2014] [Indexed: 11/25/2022]
Abstract
Spreading depolarization (SD) contributes to the ischemic damage of the penumbra. Although age is the largest predictor of stroke, no studies have examined age dependence of SD appearance. We characterized the electrophysiological and hemodynamic changes in young (6 weeks old, n = 7), middle-aged (9 months old, n = 6), and old (2 years old, n = 7) male Wistar rats during 30 minutes of middle cerebral artery occlusion (MCAO), utilizing multimodal imaging through a closed cranial window over the ischemic cortex: membrane potential changes (with a voltage-sensitive dye), cerebral blood volume (green light reflectance), and cerebral blood flow (CBF, laser-speckle imaging) were observed. The initial CBF drop was similar in all groups, with a significant further reduction during ischemia in old rats (p < 0.01). Age reduced the total number of SDs (p < 0.05) but increased the size of ischemic area displaying prolonged SD (p < 0.01). The growth of area undergoing prolonged SDs positively correlated with the growth of ischemic core area (p < 0.01) during MCAO. Prolonged SDs and associated hypoperfusion likely compromise cortical tissue exposed to even a short focal ischemia in aged rats.
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Affiliation(s)
- Darren Clark
- Department of Medical Physics and Informatics, School of Medicine, University of Szeged, Szeged, Hungary; Department of Clinical Neurosciences, University of Calgary, Calgary, Canada.
| | - Ádám Institoris
- Department of Physiology, University of Szeged, Szeged, Hungary
| | - Gábor Kozák
- Department of Medical Physics and Informatics, School of Medicine, University of Szeged, Szeged, Hungary
| | - Zsófia Bere
- Department of Physiology, University of Szeged, Szeged, Hungary
| | - Ursula Tuor
- Department of Clinical Neurosciences, University of Calgary, Calgary, Canada; Department of Physiology and Pharmacology, University of Calgary, Calgary, Canada; Department of Radiology, University of Calgary, Calgary, Canada
| | - Eszter Farkas
- Department of Medical Physics and Informatics, School of Medicine, University of Szeged, Szeged, Hungary
| | - Ferenc Bari
- Department of Medical Physics and Informatics, School of Medicine, University of Szeged, Szeged, Hungary
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García-Martín E, Martínez C, Serrador M, Alonso-Navarro H, Navacerrada F, Agúndez JA, Jiménez-Jiménez FJ. SLC1A2 rs3794087 variant and risk for migraine. J Neurol Sci 2014; 338:92-5. [DOI: 10.1016/j.jns.2013.12.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 12/10/2013] [Accepted: 12/11/2013] [Indexed: 01/23/2023]
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Gasparini CF, Sutherland HG, Haupt LM, Griffiths LR. Genetic analysis of GRIA2 and GRIA4 genes in migraine. Headache 2013; 54:303-12. [PMID: 24512576 DOI: 10.1111/head.12234] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2013] [Indexed: 01/03/2023]
Abstract
BACKGROUND Migraine is a brain disorder affecting ∼12% of the Caucasian population. Genes involved in neurological, vascular, and hormonal pathways have all been implicated in predisposing individuals to developing migraine. The migraineur presents with disabling head pain and varying symptoms of nausea, emesis, photophobia, phonophobia, and occasionally visual sensory disturbances. Biochemical and genetic studies have demonstrated dysfunction of neurotransmitters: serotonin, dopamine, and glutamate in migraine susceptibility. Glutamate mediates the transmission of excitatory signals in the mammalian central nervous system that affect normal brain function including cognition, memory and learning. The aim of this study was to investigate polymorphisms in the GRIA2 and GRIA4 genes, which encode subunits of the ionotropic AMPA receptor for association in an Australian Caucasian population. METHODS Genotypes for each polymorphism were determined using high resolution melt analysis and the RFLP method. RESULTS Statistical analysis showed no association between migraine and the GRIA2 and GRIA4 polymorphisms investigated. CONCLUSIONS Although the results of this study showed no significant association between the tested GRIA gene variants and migraine in our Australian Caucasian population further investigation of other components of the glutamatergic system may help to elucidate if there is a relationship between glutamatergic dysfunction and migraine.
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Affiliation(s)
- Claudia F Gasparini
- Genomics Research Centre, Griffith Health Institute, Griffith University, Gold Coast, QLD, Australia
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