Samaira Younis1, Anders Hougaard, Mark B Vestergaard, Henrik B W Larsson, Messoud Ashina. 1. aDanish Headache Center and Department of Neurology bFunctional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Abstract
PURPOSE OF REVIEW: To present an updated and streamlined overview of the metabolic and biochemical aspect of the migraine pathophysiology based on findings from phosphorous (P) and hydrogen (H) magnetic resonance spectroscopy (MRS) studies. RECENT FINDINGS: Despite of the variation in the methodology and quality of the MRS migraine studies over time, some results were consistent and reproducible. P-MRS studies suggested reduced availability of neuronal energy and implied a mitochondrial dysfunction in the migraine brain. H-MRS studies reported interictal abnormalities in the excitatory and inhibitory neurotransmitters, glutamate and γ-aminobutyric acid (GABA), suggesting persistent altered excitability in migraine patients. N-Acetylaspartate levels were decreased in migraine, probably due to a mitochondrial dysfunction and abnormal energy metabolism. The reported abnormalities may increase the susceptibility of migraine patients to excitatory stimulation, such as migraine attack triggers. SUMMARY: Several biochemical aspects of the migraine pathophysiology remain to be elucidated using MRS, such as the migraine attack, correlation to disease severity, and medication efficacy. Nevertheless, to identify a biomarker in migraine, MRS may be a valuable noninvasive technique.
PURPOSE OF REVIEW: To present an updated and streamlined overview of the metabolic and biochemical aspect of the migraine pathophysiology based on findings from phosphorous (P) and hydrogen (H) magnetic resonance spectroscopy (MRS) studies. RECENT FINDINGS: Despite of the variation in the methodology and quality of the MRS migraine studies over time, some results were consistent and reproducible. P-MRS studies suggested reduced availability of neuronal energy and implied a mitochondrial dysfunction in the migraine brain. H-MRS studies reported interictal abnormalities in the excitatory and inhibitory neurotransmitters, glutamate and γ-aminobutyric acid (GABA), suggesting persistent altered excitability in migrainepatients. N-Acetylaspartate levels were decreased in migraine, probably due to a mitochondrial dysfunction and abnormal energy metabolism. The reported abnormalities may increase the susceptibility of migrainepatients to excitatory stimulation, such as migraine attack triggers. SUMMARY: Several biochemical aspects of the migraine pathophysiology remain to be elucidated using MRS, such as the migraine attack, correlation to disease severity, and medication efficacy. Nevertheless, to identify a biomarker in migraine, MRS may be a valuable noninvasive technique.
Authors: Samaira Younis; Casper E Christensen; Mark B Vestergaard; Ulrich Lindberg; Daniel Tolnai; Olaf B Paulson; Henrik Bw Larsson; Anders Hougaard; Messoud Ashina Journal: J Cereb Blood Flow Metab Date: 2020-05-19 Impact factor: 6.200
Authors: Nastaren Abad; Jens T Rosenberg; Tangi Roussel; Dillon C Grice; Michael G Harrington; Samuel C Grant Journal: Magn Reson Med Date: 2017-09-17 Impact factor: 4.668