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Current Evidence on Potential Uses of MicroRNA Biomarkers for Migraine: From Diagnosis to Treatment. Mol Diagn Ther 2019; 23:681-694. [DOI: 10.1007/s40291-019-00428-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Zielman R, Postma R, Verhoeven A, Bakels F, van Oosterhout WPJ, Meissner A, van den Maagdenberg AMJM, Terwindt GM, Mayboroda OA, Ferrari MD. Metabolomic changes in CSF of migraine patients measured with 1H-NMR spectroscopy. MOLECULAR BIOSYSTEMS 2017; 12:3674-3682. [PMID: 27734045 DOI: 10.1039/c6mb00424e] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Migraine is a common episodic brain disorder. Treatment options and diagnosis are hampered by an incomplete understanding of disease pathophysiology and the lack of objective diagnostic markers. The aim of this study was to identify biochemical differences characteristic for different subtypes of migraine in cerebrospinal fluid (CSF) of migraine patients using an exploratory 1H-NMR-based metabolomics approach. METHODS CSF was obtained, in between migraine attacks, via lumbar puncture from patients with hemiplegic migraine, migraine with aura, migraine without aura, and healthy controls. Metabolite concentrations were measured by quantitative 1H-NMR spectroscopy. Multivariate data analysis was used to find the optimal set of predictors, generalized linear models (GLM) were used to ascertain the differential significance of individual metabolites. RESULTS In CSF samples from 18 patients with hemiplegic migraine, 38 with migraine with aura, 27 migraine without aura, and 43 healthy controls, nineteen metabolites were identified and quantified. Hemiplegic migraine patients could be discriminated from healthy controls using supervised multivariate modelling with 2-hydroxybutyrate and 2-hydroxyisovalerate as the most discriminant metabolites. Univariate GLM analysis showed 2-hydroxybutyrate to be lower in hemiplegic migraine compared with healthy controls; no significant differences were observed for other metabolites. It was not possible to discriminate migraine with and without aura from healthy controls based on their metabolic profile. CONCLUSIONS Using an exploratory 1H-NMR metabolomics analysis we identified metabolites that were able to discriminate hemiplegic migraine patients from healthy controls. The lower levels of 2-hydroxybutyrate found in patients with hemiplegic migraine could indicate a dysregulation of the brain's energy metabolism. An experimental confirmation in vitro or in animal models will be required to confirm or discard this hypothesis. Migraine with and migraine without aura patients did not reveal a metabolic profile different from healthy controls.
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Affiliation(s)
- Ronald Zielman
- Department of Neurology, Leiden University Medical Center, P.O. 9600, 2300 WB, Leiden, The Netherlands.
| | - Rudmer Postma
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, The Netherlands
| | - Aswin Verhoeven
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, The Netherlands
| | - Floor Bakels
- Department of Neurology, Leiden University Medical Center, P.O. 9600, 2300 WB, Leiden, The Netherlands.
| | | | - Axel Meissner
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, The Netherlands
| | - Arn M J M van den Maagdenberg
- Department of Neurology, Leiden University Medical Center, P.O. 9600, 2300 WB, Leiden, The Netherlands. and Department of Human genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Center, P.O. 9600, 2300 WB, Leiden, The Netherlands.
| | - Oleg A Mayboroda
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, The Netherlands
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Center, P.O. 9600, 2300 WB, Leiden, The Netherlands.
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Blum CA, Winzeler B, Nigro N, Schuetz P, Biethahn S, Kahles T, Mueller C, Timper K, Haaf K, Tepperberg J, Amort M, Huber A, Bingisser R, Sándor PS, Nedeltchev K, Müller B, Katan M, Christ-Crain M. Copeptin for risk stratification in non-traumatic headache in the emergency setting: a prospective multicenter observational cohort study. J Headache Pain 2017; 18:21. [PMID: 28197843 PMCID: PMC5307398 DOI: 10.1186/s10194-017-0733-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 02/07/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the emergency setting, non-traumatic headache is a benign symptom in 80% of cases, but serious underlying conditions need to be ruled out. Copeptin improves risk stratification in several acute diseases. Herein, we investigated the value of copeptin to discriminate between serious secondary headache and benign headache forms in the emergency setting. METHODS Patients presenting with acute non-traumatic headache were prospectively enrolled into an observational cohort study. Copeptin was measured upon presentation to the emergency department. Primary endpoint was serious secondary headache defined by a neurologic cause requiring immediate treatment of the underlying disease. Secondary endpoint was the combination of mortality and hospitalization within 3 months. Two board-certified neurologist blinded to copeptin levels verified the endpoints after a structured 3-month-telephone interview. RESULTS Of the 391 patients included, 75 (19%) had a serious secondary headache. Copeptin was associated with serious secondary headache (OR 2.03, 95%CI 1.52-2.70, p < 0.0001). Area under the curve (AUC) for copeptin to identify the primary endpoint was 0.70 (0.63-0.76). After adjusting for age > 50, focal-neurological abnormalities, and thunderclap onset of symptoms, copeptin remained an independent predictive factor for serious secondary headache (OR 1.74, 95%CI 1.26-2.39, p = 0.001). Moreover, copeptin improved the AUC of the multivariate logistic clinical model (p-LR-test < 0.001). Even though copeptin values were higher in patients reaching the secondary endpoint, this association was not significant in multivariate logistic regression. CONCLUSIONS Copeptin was independently associated with serious secondary headache as compared to benign headaches forms. Copeptin may be a promising novel blood biomarker that should be further validated to rule out serious secondary headache in the emergency department. TRIAL REGISTRATION Study Registration on 08/02/2010 as NCT01174901 at clinicaltrials.gov.
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Affiliation(s)
- Claudine Angela Blum
- Division of Endocrinology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland. .,Internal Medicine, Medical University Clinic, Kantonsspital Aarau, Tellstrasse, CH-5001, Aarau, Switzerland.
| | - Bettina Winzeler
- Division of Endocrinology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Nicole Nigro
- Division of Endocrinology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Philipp Schuetz
- Internal Medicine, Medical University Clinic, Kantonsspital Aarau, Tellstrasse, CH-5001, Aarau, Switzerland
| | - Silke Biethahn
- Department of Neurology, Medical University Clinic, Kantonsspital Aarau, Aarau, Switzerland
| | - Timo Kahles
- Department of Neurology, Medical University Clinic, Kantonsspital Aarau, Aarau, Switzerland
| | - Cornelia Mueller
- Division of Endocrinology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Katharina Timper
- Division of Endocrinology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland.,Max-Planck-Institute for Metabolism Research, Cologne, Germany
| | - Katharina Haaf
- Department of Neurology, Medical University Clinic, Kantonsspital Aarau, Aarau, Switzerland
| | - Janina Tepperberg
- Department of Neurology, Medical University Clinic, Kantonsspital Aarau, Aarau, Switzerland
| | - Margareth Amort
- Clinic of Neurology, University Hospital Basel, Basel, Switzerland
| | - Andreas Huber
- Center of Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Roland Bingisser
- Emergency Department, University Hospital Basel, Basel, Switzerland
| | | | - Krassen Nedeltchev
- Department of Neurology, Medical University Clinic, Kantonsspital Aarau, Aarau, Switzerland
| | - Beat Müller
- Internal Medicine, Medical University Clinic, Kantonsspital Aarau, Tellstrasse, CH-5001, Aarau, Switzerland
| | - Mira Katan
- Clinic of Neurology, University Hospital Zürich, Zürich, Switzerland
| | - Mirjam Christ-Crain
- Division of Endocrinology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland
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Ambrosini A, Kisialiou A, Coppola G, Finos L, Magis D, Pierelli F, Schoenen J. Visual and auditory cortical evoked potentials in interictal episodic migraine: An audit on 624 patients from three centres. Cephalalgia 2016; 37:1126-1134. [DOI: 10.1177/0333102416665224] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background Many studies report a habituation deficit of visual evoked potentials (VEP) and/or increased intensity dependence of auditory evoked cortical potentials (IDAP) in episodic migraine patients between attacks. These findings have a pathophysiological interest, but their diagnostic utility is not known. Aims To perform an audit on a large database of interictal VEP and IDAP recordings in episodic migraine patients and evaluate their diagnostic accuracy. Methods We pooled data for VEP habituation and IDAP measured in 624 episodic migraineurs (EM) and 360 healthy volunteers (HV) from three centers. Thresholds were calculated by Receiver Operating Curve analysis and used to calculate sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR-) and the accuracy of each test, using ICHD diagnostic criteria as the gold standard. Results In EM, VEP habituation was significantly lower than in HV, and IDAP slopes were significantly steeper. VEP (five blocks of 50 responses), VEP (six blocks of 100 responses) and IDAP had respectively 61.0%, 61.4% and 45.7% sensitivity, and 77.9%, 77.9% and 87.2% specificity. Their positive (LR+) and negative (LR-) likelihood ratios were respectively 2.760, 2.778, 3.570 and 0.500, 0.495, 0.623, with diagnostic accuracies of 65.3%, 69.0% and 54.3%. In combined VEP + IDAP recordings, an abnormality of at least one test had 83.4% sensitivity, 66.7% specificity, 2.504 LR+, 0.249 LR− and 81.1% accuracy. Conclusions In this large database, VEP habituation is significantly reduced and IDAP increased in episodic migraine patients between attacks. Taken alone, neither VEP nor IDAP has sufficient diagnostic accuracy. However, when both tests are performed in the same patient, an abnormality of at least one of them is highly predictive of interictal episodic migraine.
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Affiliation(s)
| | - Aliaksei Kisialiou
- Clinical and Molecular Epidemiology Unit, IRCCS San Raffaele Pisana, Rome, Italy
| | - Gianluca Coppola
- Department of Neurophysiology of Vision and Neurophthalmology, GB Bietti Foundation IRCCS, Rome, Italy
| | - Livio Finos
- Department of Developmental Psychology and Socialization, University of Padua, Italy
| | | | - Francesco Pierelli
- Headache Unit, IRCCS Neuromed, Pozzilli, IS, Italy
- Sapienza University of Rome Polo Pontino, Department of Medico-Surgical Sciences and Biotechnologies, Latina, Italy
| | - Jean Schoenen
- Headache Research Unit, University Dept of Neurology, Citadelle Hospital, Liège, Belgium
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Nagata E. [Identification of biomarkers associated with migraine]. Rinsho Shinkeigaku 2012. [PMID: 23196501 DOI: 10.5692/clinicalneurol.52.1014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The diagnosis of migraine can be difficult, even for headache specialists, because some patients do not necessarily fulfill the International Headache Society criteria for migraine. Hence, reliable disease markers of migraine are required for accurate migraine diagnosis. We performed "Omics" analysis such as transcriptomics, proteomics, and genomics utilizing the lymphoblast cell lines and serum obtained from migraineurs. We verified that αfodrin, which was among the identified 15 genes that were differentially expressed in lymphoblasts originating from patients with migraine, increased after cortical spreading depression in an animal model. We also investigated the alterations of protein expressions induced by migraine attacks using proteomics analysis. Notably, in two migraineurs, the level of apolipoprotein E protein expression during attacks was significantly higher than pre-attack levels. Recently, we have found a novel family lineage with migraine. They also exhibit severe myalgia with arms and legs. GC binding protein which binds to vitamin D was identified as the product of the causative gene in this family. Our omics approach will contribute to a better understanding of migraine pathophysiology.
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Affiliation(s)
- Eiichiro Nagata
- Department of Neurology, Tokai University School of Medicine
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Bhola R, Goadsby PJ. A trans-cultural comparison of the organisation of care at headache centres world-wide. Cephalalgia 2010; 31:316-30. [DOI: 10.1177/0333102410380756] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: The need to provide better outcomes for patients with headache, and to minimise the costs involved in doing so, has prompted the search for new modes of service delivery by exploring the service organisation and nursing role from various cultural, economic and global perspectives. Materials and Methods: This study was based on comparisons with the UK headache service up to 2007, the point at which this study was set up. This UK service was based at the National Hospital for Neurology and Neurosurgery (NHNN, UCLH Trust). Data were obtained from US headache centres in 2008 and from centres in Copenhagen, Bangkok, Sydney and Porto Alegre in 2009. Results: A comparison shows the key components of services at all centres showing the team structure and size of service. Prominent features at the centres included: team-working, regular meetings, educational input, good access and communication among team members, headache-trained neurologists, specialist nursing at most centres, and the input of psychological and physical therapists at some centres. Conclusions: The problems of tertiary headache care are very similar throughout the world and seem to transcend ethnic, cultural and economic considerations.
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Affiliation(s)
- Ria Bhola
- The National Hospital for Neurology and Neurosurgery, UK
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Abstract
Recent research suggests that migraine results from the interplay of multiple factors, and many studies have considered the relationship of migraine to systemic abnormalities. This editorial comments on recent findings relating to migraine and metabolic syndrome, and suggests some possible causes.
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Lambert GA. Looking in the wrong place? The search for an ideal migraine preventative. Drug Dev Res 2007. [DOI: 10.1002/ddr.20204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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