Interictal pontine metabolism in migraine without aura patients: A 3 Tesla proton magnetic resonance spectroscopy study

Samaira Younis, Anders Hougaard, Casper E. Christensen, Mark B. Vestergaard, Olaf B. Paulson, Henrik B.W. Larsson, Messoud Ashina*

*Corresponding author af dette arbejde

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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.

OriginalsprogEngelsk
Artikelnummer102824
TidsskriftNeuroImage: Clinical
Vol/bind32
ISSN2213-1582
DOI
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
We thank the participants for their contribution to the study as well as the Section of Biostatistics, University of Copenhagen, Denmark for statistical consulting.

Funding Information:
This work was supported by the Research Foundation of Rigshospitalet (E-23327-02) and Lundbeck Foundation (R155-2014-171). Funding sources had no influence on study design, patient inclusion or data interpretation.

Publisher Copyright:
© 2021 The Authors

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