Elevated S100B and Neuron Specific Enolase Levels in Patients with Migraine-without Aura: Evidence for Neurodegeneration?

Abstract

Although migraine has mainly been considered as a benign disease, there is cumulative evidence of silent changes in the brain, brainstem, or cerebellum and subtle subclinical cerebellar dysfunction. In this study, in order to investigate a possible neuronal and/or glial damage at the cellular level in migraine, we measured and compared serum levels of S100B which is a protein marker of glial damage or activation, and neuron specific enolase (NSE) which is a marker of neuronal damage, in migraine patients and control subjects. Serum levels of S100B and NSE were measured in blood samples from 41 patients with migraine-without aura taken during a migraine attack (ictal) and in the attack-free period between migraine attacks (interictal) and 35 age- and sex-matched controls. Patients with migraine-without aura had significantly higher ictal serum levels of S100B and NSE (P < 0.05, for both) than control subjects; whereas in the interictal phase, there was a significant increment only in S100B levels (P < 0.05) compared to controls. On the other hand, serum levels of S100B and NSE in ictal and interictal blood samples did not differ significantly. The findings of increased ictal serum S100B and NSE levels together with increased interictal levels of S100B suggested that migraine might be associated with glial and/or neuronal damage in the brain and a prolonged disruption of blood-brain barrier. Increased interictal serum levels of S100B might point out to an insidious and slow damaging process in migraine patients.

Serum Protein S100β is a Diagnostic Biomarker for Distinguishing Posterior Circulation Stroke from Vertigo of Nonvascular Causes

“…In a recent study [7], S100β failed to distinguish between stroke and ‘stroke mimics'. Stroke mimics in that study consisted of other CNS disorders, including brain tumors and epileptic seizures, which may also increase S100β levels [7,30,31]. Furthermore, no control group of patients without CNS disorders was examined.…”

Blood biomarkers for brain injury: What are we measuring?

“…Most notably, Shahim et al reported that in 35 concussed ice hockey players, there was no difference in serum NSE from pre-season baseline levels to post-concussion values, (Shahim et al, 2014) suggesting that current assays to detect NSE may not be sensitive enough to observe serum fluctuations after mTBI. However, increased serum levels of NSE have also been reported after hypoperfusion, liver and kidney damage, femur fracture, and migraine, potentially limiting its utility as a biomarker for TBI (Pelinka et al, 2005, 2004b; Yilmaz et al, 2011). …”

Macro- and microstructural alterations in migraine and cluster headache

“…Elevated MMP activity was also detected in human migraineurs [89]. Other markers of neuronal (neuron specific enolase) and glial (S100B) damage was also found in migraineurs [90]. There seems, therefore, to be some evidence for biochemical changes potentially involved in the disintegration of white matter fibre bundles that might be reflected by reduction of FA, increase of MD, and augmented perpendicular diffusivity.…”

“…Reduction of FA and AD reflect axonal loss [93][94][95], while increased perpendicular diffusivity seems to be a sign of demyelination [93,94]. The serum markers of neuronal and glial damage reported recently [90] might indicate combined damage.…”