5HT₂Receptors in Cerebral Cortex of Migraineurs Studied Using PET and¹⁸F-Fluorosetoperone

Abstract

Since the brain 5HT2 receptors might be implicated in migraine pathogenesis, we have used positron emission tomography and 18F-fluorosetoperone, a 5HT2 specific radioligand, to investigate in vivo the cortical 5HT2 receptors in migraine subjects. Nine migraineurs who had either migraine with and without aura (n = 5) or only migraine without aura (n = 4) were studied between attacks. Twelve unmedicated healthy subjects of similar mean age were used as controls. Brain radioactivity was measured after 18F-setoperone IV injection for 90 min. A decrease of the regional specific distribution volumes (SDV) of the ligand was observed both in migraineurs and in controls. The age adjusted group means of SDV did not differ between patients and controls for the whole and for the right or left frontal, temporal, parietal and occipital cortex. These results suggest that cortical 5HT2 receptors may be unaltered between attacks in migraine sufferers.

Increased brain serotonin synthesis in migraine

“…One previous PET study addressed 5-HT2 receptors in migraineurs using the tracer [ 18 F]-fluorosetoperone. 29 This study did not find whole-brain or regional differences in [ 18 F]-fluorosetoperone binding in nine migraine patients (5 with and 4 without aura) compared with healthy controls. In contrast, we found that patients with migraine show a significantly higher serotonin synthesis capacity across all brain regions.…”

Hypothalamic involvement and activation in cluster headache

“…Moreover, the frequency and pattern of pathologic findings at orbital phlebography in cervicogenic headache, migraine, and tension-type headache was comparable with that in cluster headache [78]. Given that we have observed vasodilatation in large vessels in cluster headache [22,79] and increased signal in the region of the [57] 1997 Migraine with and without aura 11 No global blood flow changes Chabriat et al [60] 1995 Migraine with and without aura 9…”

Serotonergic mechanisms in the migraine brain – a systematic review

“…One study employed brain PET imaging of the 5-HT 2 receptors and the specific distribution volume as the quantification method and reported no difference in cortical binding between migraine patients and controls (38). The cortical density of the excitatory 5-HT 2 receptor, which is involved in pain processing (21), is thus not altered interictally in migraine patients.…”