Migraine and erythrocyte biology: a review

Abstract

Summary Migraine is a common disabling headache disorder that is conventionally classified according to the presence or absence of aura. The pathogenesis of this disorder entails a complex interplay of neurovascular factors, that trigger reduction of cerebral blood flow followed by reactive vasodilatation. Despite major emphasis has been placed on the investigation of putative biomarkers that could predict response to specific treatments and prophylaxis, less focus has been directed at the association between migraine and erythrocytosis. Erythrocytosis is typically accompanied by hyperviscosity, that is now considered a crucial determinant in the pathogenesis of migraine. The results of some epidemiological investigations are in substantial agreement to confirm the existence of a significant relationship between increased haemoglobin levels and migraine, whereas some case reports have also reported an effective improvement of symptoms after reduction of erythrocyte count by therapeutic venesection. Interesting evidence has recently emerged from the assessment of red blood cell distribution width (RDW), a simple and inexpensive measure of anysocytosis that has been also associated with a variety of ischaemic and thrombotic disorders other than migraine. The aim of this review was to provide an overview of the current clinical and epidemiological evidence linking migraine and erythrocyte biology.

Anti-Migraine Effect of the Herbal Combination of Chuanxiong Rhizoma and Cyperi Rhizoma and UPLC-MS/MS Method for the Simultaneous Quantification of the Active Constituents in Rat Serum and Cerebral Cortex

“…As we know, cerebral vascular dysfunction is always induced by abnormal levels of vasoactive substances, such as ET-1, NO and NOS. Recent studies have highlighted a potentially important role for the biological endothelial function in the migraine pathophysiology [26]. It involved the most potent endothelial-derived constricting factor, ET-1, and its endothelial counterpart, NO, in the vascular changes during migraine attacks [27].…”

Hematological Risk Factors for High-Altitude Headache in Chinese Men Following Acute Exposure at 3,700 m

“…Numerous researchers have suggested that hematological changes are closely associated with various diseases, including myelodysplastic syndrome, laryngeal squamous cell cancer, stable coronary artery disease, stroke, and acute pulmonary embolism (Nayak et al, 2011 ; List et al, 2012 ; Zorlu et al, 2012 ; Ayhan et al, 2013 ; Sahin et al, 2015 ; Soderholm et al, 2015 ; Hsueh et al, 2017 ). Moreover, recent studies have indicated that migraine conditions may be related to some hematological parameters, especially high hemoglobin levels and broad red blood cell distribution width (Celikbilek et al, 2013 ; Lippi et al, 2014 ). Thus, hematological changes are an attractive area for improving our understanding of HAH, although we are not aware of any studies that have examined this issue.…”

Increased hemoglobin and plateletcrit levels indicating hemoconcentration in pediatric patients with migraine

“…There is also evidence that erythrocyte is a modulator in the metabolism of NO, a potent vasodilator agent. [ 12 ] The increased frequency of migraine in essential thrombocythemia supports the fact that the increased platelets can also lead to headache. Migraine is the most common vaso-occlusive symptom in essential thrombocythemia.…”

“…However, several studies have underlined the relationship between increased hemoglobin and headache. [ 12 ] In a population study conducted on female patients, the likelihood of migraine was reported to decrease in patients with a hemoglobin level of <11.5g/dL. [ 13 ] Headaches associated with chronic altitude sickness and polycythemia have also been associated with higher hemoglobin levels.…”