Metabolic changes during glucose tolerance tests in migraine attacks

Shaw, S.; Johnson, Ralph H.; Keogh, H. J.

doi:10.1016/0022-510x(77)90181-2

Cited by 18 publications

(20 citation statements)

References 14 publications

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“…In one study, 6 migraine patients underwent an intravenous glucose tolerance test during spontaneous migraine attacks as well as outside of attacks . This study reported impaired glucose tolerance and concomitant increases in ketone‐bodies and free fatty acids in patients during attacks.…”

Section: Discussionmentioning

confidence: 99%

“…4 During the interictal phase, migraineurs have an impaired insulin sensitivity and higher fasting plasma insulin levels compared to controls. [5][6][7] A decrease of insulin release has been reported during the ictal phase of migraine 8 and a polymorphism in the insulin receptor gene is associated with migraine. 9 Furthermore, susceptibility to cortical spreading depression, the presumed underlying electrophysiological phenomenon of the migraine aura, may be affected by blood glucose levels.…”

Section: Introductionmentioning

confidence: 99%

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Plasma Glucose Levels Increase During Spontaneous Attacks of Migraine With and Without Aura

et al. 2020

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Objective To investigate plasma glucose changes during the ictal state of migraine compared to the interictal state. Background Previous studies suggest abnormal glucose metabolism in migraine patients during and outside of attacks. It is not known if plasma glucose levels change during spontaneous migraine attacks. Methods Plasma glucose levels were measured during and outside of spontaneous migraine attacks with and without aura. Plasma glucose values were corrected for diurnal variation of plasma glucose by subtracting the difference between the moving average (intervals of 2 hours) and overall mean from the plasma glucose values. Results This was a sub‐study of a larger study conducted at Rigshospitalet Glostrup in the Capital Region of Denmark. Thirty‐one patients (24 F, 7 M, 13 with aura, 18 without aura) were included in the study. Mean time from attack onset to blood sampling was 7.6 hours. Mean pain at the time of investigation was 6 on a 0‐10 verbal rating scale. Plasma glucose was higher ictally compared to the interictal phase (interictal mean: 88.63 mg/dL, SD 11.70 mg/dL; ictal mean: 98.83 mg/dL, SD 13.16 mg/dL, difference 10.20 mg/dL, 95% CI = [4.30; 16.10]), P = .0014). The ictal increase was highest in patients investigated early during attacks and decreased linearly with time from onset of migraine (−1.57 mg/dL/hour from onset of attack, P = .020). The attack‐related increase in blood glucose was not affected by pain intensity or presence of aura symptoms. Conclusions We demonstrated higher plasma glucose values during spontaneous migraine attacks, independent of the presence of aura symptoms and not related to pain intensity, peaking in the early phase of attacks. Additional studies are necessary to confirm our findings and explore the possible underlying mechanisms.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Plasma Glucose Levels Increase During Spontaneous Attacks of Migraine With and Without Aura

et al. 2020

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“…In one report, migraine occurred with the onset of non-insulin-dependent diabetes mellitus (NIDDM), suggesting that a metabolic insult contributed to the CNS manifestation of headache (Split and Szydlowska, 1997). Impaired tolerance to glucose is present during migraine attacks (in patients who acted as their own controls) (Shaw et al, 1977). Such data, taken together with more recent information, suggest specific changes related to hyperinsulinemia in migraine (e.g., elevated levels of glucagon-like peptides and leptin, even in nonobese female migraineurs [Bernecker et al, 2010]).…”

Section: Downstream Effects Of Brain Changes On Systemic Physiologymentioning

confidence: 91%

Understanding Migraine through the Lens of Maladaptive Stress Responses: A Model Disease of Allostatic Load

Borsook

Maleki

Becerra

et al. 2012

Neuron

285

283

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The brain and body respond to potential and actual stressful events by activating hormonal and neural mediators and modifying behaviors to adapt. Such responses help maintain physiological stability ("allostasis"). When behavioral or physiological stressors are frequent and/or severe, allostatic responses can become dysregulated and maladaptive ("allostatic load"). Allostatic load may alter brain networks both functionally and structurally. As a result, the brain's responses to continued/subsequent stressors are abnormal, and behavior and systemic physiology are altered in ways that can, in a vicious cycle, lead to further allostatic load. Migraine patients are continually exposed to such stressors, resulting in changes to central and peripheral physiology and function. Here we review how changes in brain states that occur as a result of repeated migraines may be explained by a maladaptive feedforward allostatic cascade model and how understanding migraine within the context of allostatic load model suggests alternative treatments for this often-debilitating disease.

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“…For example, magnetic resonance spectroscopy (MRS) studies in migraine consistently show abnormalities of mitochondrial oxidative phosphorylation (OXPHOS), such as hypometabolism or decreased ATP levels (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). These findings are supported by early studies showing metabolic changes induced by fasting, glucose or insulin administration, which can even trigger migraine attacks in susceptible patients (15)(16)(17)(18)(19)(20)(21).…”

Section: Introductionmentioning

confidence: 90%

Mitochondrial function and oxidative stress markers in higher-frequency episodic migraine

Gross

Putananickal²,

Orsini³

et al. 2020

Preprint

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Introduction Increasing evidence points towards the role of mitochondrial functioning, energy metabolism, and oxidative stress in migraine. However not all previous research has been conclusive and some mitochondrial function / oxidative stress markers have not yet been examined. Methods To this end, alpha-lipoic acid (ALA), total thiols, total plasma antioxidant capacity (TAC), lipid peroxide (PerOx), oxidised LDL (oxLDL), HbA1c and lactate were determined in the serum of 32 higher frequency episodic migraineurs (5-14 migraine days/ months, 19 with aura, 28 females) in this cross-sectional study. Results The majority of patients had abnormally low ALA and lactate levels (87.5% and 78.1%, respectively). 46.9% of the patients had abnormally high PerOx values, while for thiols and TAC over one third of patients had abnormally low values (31.2% and 37.5%, respectively). 21.9% of patients had abnormally low HbA1c and none had an HbA1c level above 5.6%. oxLDL was normal in all but one patient. Discussion This study provides further evidence for a role of oxidative stress and altered metabolism in migraine pathophysiology, which might represent a suitable therapeutic target. ALA, being too low in almost 90% of patients, might represent a potential biomarker for migraine. Further research is needed to replicate these results, in particular a comparison with a control group. This study is part of the trial registration: ClinicalTrials.gov: NCT03132233, registered on 27.04.2017, https://clinicaltrials.gov/ct2/show/NCT03132233

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Metabolic changes during glucose tolerance tests in migraine attacks

Cited by 18 publications

References 14 publications

Plasma Glucose Levels Increase During Spontaneous Attacks of Migraine With and Without Aura

Plasma Glucose Levels Increase During Spontaneous Attacks of Migraine With and Without Aura

Understanding Migraine through the Lens of Maladaptive Stress Responses: A Model Disease of Allostatic Load

Mitochondrial function and oxidative stress markers in higher-frequency episodic migraine

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