Concentration of Serotonin in Blood Platelets: Effect of Reserpine in Migraineurs

Genefke, Inge Kemp; Dalsgaard‐Nielsen, T; Bryndum, B.; Fog-Møller, F.; Jensen, Joerg A.

doi:10.1111/j.1526-4610.1975.hed1502136.x

Cited by 8 publications

(6 citation statements)

References 6 publications

(6 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5‐hydroxytryptamine depletion induces migraine symptoms in humans 143 and migraineurs have been shown to have low serum and platelet 5‐HT levels between attacks 144,145 . Blood platelet and cerebrospinal fluid (CSF) levels of 5‐HT and its metabolites further decrease during a migraine attack, 144,145 which supports the hypothesis of a decrease in 5‐HT neuronal drive. Migraineurs have greater pain sensitivity in general, a symptom that has also been linked to changes in serotonergic neuronal systems originating in the NRM 138 .…”

mentioning

confidence: 97%

The Mode of Action of Migraine Triggers: A Hypothesis

Lambert

Zagami

2009

Headache

View full text Add to dashboard Cite

Objectives.-To review conjectured modes of action of migraine triggers and to present a new hypothesis about them. Background.-Migraine attacks are initiated in many migraineurs by a variety of "triggers," although in some patients no external trigger can be identified. Many triggers provoke attacks with such a short latency that only some kind of neural mechanism can explain the triggering.Results.-We present here a hypothesis that the pain of migraine has its ultimate origin in the cortex, but that the immediate generator is in the brainstem. Our hypothesis is that most migraines have triggers that produce excitation of cortical neurons and that this directly causes withdrawal of descending sensory inhibition originating in the brainstem. A wide range of evidence from the literature that cortical activation induced by a number of different mechanisms often produces headache is presented to support this notion. Several nuclei in the brainstem appear to participate in the selective control of trigeminovascular sensation through descending inhibitory mechanisms that arise in the cortex. In this review we focus on 2 of them, the periaqueductal gray matter and nucleus raphe magnus. Our own past results and those of others show that this inhibition is specific for craniovascular sensation and involves the neurotransmitter 5-hydroxytryptamine. Finally, we summarize our own recent experiments, which show that cortical activation by migraine triggers (including cortical spreading depression) inhibits neuronal discharge in the brainstem and facilitates trigeminovascular sensation. Conclusion.-If the hypothesis can be proven and the neurotransmitters involved in the hypothetical trigger pathway can be identified, it may be possible to develop novel migraine preventative therapies.Key words: migraine, migraine trigger, cerebral cortex, brainstem, trigeminovascular sensory system Abbreviations: 5-HT 5-hydroxytryptamine, CGRP calcitonin gene-related peptide, CSD cortical spreading depression, DC direct current, ECT electroconvulsive therapy, LC locus coeruleus, NO nitric oxide, NRM nucleus raphe magnus, NTS nucleus tractus solitarius, PAG periaqueductal gray matter, PET positron emission tomography, SP substance P, TMS transcranial magnetic stimulation (Headache 2009;49:253-275) In this review, we present the hypothesis that most migraines have triggers that produce excitation of cortical neurons and that this excitation directly inhibits neurons in 2 brainstem nuclei: the periaqueductal gray matter (PAG) and the nucleus raphe magnus (NRM). These nuclei then release their ongoing descending control of dura mater sensation in the trigeminal nucleus and cause normal sensory traffic from the dura to be perceived as migraine pain.Migraine is one of our most common and debilitating organic diseases, yet bafflingly has no apparent pathology. It is a condition involving the "trigeminovascular system," in which the cranial vasculature, the trigeminal sensory system, and the central nervous system all play a part. Its cardinal fe...

show abstract

mentioning

confidence: 97%

The Mode of Action of Migraine Triggers: A Hypothesis

Lambert

Zagami

2009

Headache

View full text Add to dashboard Cite

show abstract

“…We also found that this small amount of reserpine causes low blood serotonin levels for at least 10 days in almost all patients; levels were still markedly depressed at 15 days in 3 patients, confirming another report. 15 We conclude that the extreme fall in blood serotonin levels associated with small amounts of parenteral reserpine is not usually associated with severe headache. The precipitation of migraine by other investigators using larger doses of reserpine could be due to biochemical or physiologic effects other than the effect of the drug on blood serotonin.…”

Section: Discussionmentioning

confidence: 71%

“…A notable finding is the tendency toward alleviation of headache at the end of the second and third days and despite the extreme falls in whole blood serotonin due to reserpine. The induction of migraine attacks by reserpine has been reported 4,14,15 although in one series this was inconsistent. It is assumed that these attacks are provoked by serotonin depletion by the drug.…”

Section: Discussionmentioning

confidence: 97%

Migraine, Tyramine and Blood Serotonin

1976

View full text Add to dashboard Cite

SYNOPSIS Whole blood serotonin levels and headache symptoms were studied in 26 migrainous patients during a three day period with administration of tyramine the first day, reserpine the second day. No significant changes in serotonin occurred after tyramine; headache severity was not associated with change in blood serotonin, which dropped to low levels after a small dose of reserpine without precipitating migraine in most patients.

show abstract

“…During migraine attacks, increased release of serotonin from the storage granules of platelets and high amount of 5-HT metabolites in the urine samples have been reported (Genefke et al, 1975). In view of this, the effect of ST on platelet serotonin release using [ 14 C]5-HT was conducted in human platelets.…”

Section: Discussionmentioning

confidence: 98%