Platelet Models and Their Possible Usefulness in the Study of Migraine Pathogenesis

D’Andrea, Giovanni; Cananzi, A.R.; Perini, Francesco; Hasselmark, L.

doi:10.1046/j.1468-2982.1995.1504265.x

Cited by 41 publications

(25 citation statements)

References 54 publications

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“…Some authors have already reported a high prevalence of migraine in subjects with mitral valve prolapse, associated with platelet dysfunction [19]; moreover, platelets share many metabolic characteristics with endothelial cells and nitric oxide pathway [20]. It is possible that a particular genetical substrate can determine both endocardial malformation (which leads to the persistence of foramen ovale) and dysfunction of endothelium and platelets which predisposes to migraine.…”

Section: Discussionmentioning

confidence: 99%

Migraine with Aura and Right-to-Left Shunt on Transcranial Doppler: A Case-Control Study

et al. 1998

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Right-to-left shunt (RLS), usually due to patent foramen ovale, is a well-established risk factor for ischemic stroke in young patients, while the role of migraine as an independent factor is still debated. We evaluated 44 patients suffering from migraine with aura, and compared them with 73 patients younger than 50 with focal cerebral ischemia, and 50 controls, asymptomatic for cerebrovascular disease, and without a history of migraine. All the subjects underwent bilateral transcranial Doppler with injection of contrast medium in an antecubital vein. The test was performed during normal ventilation and during Valsalva maneuver, recording both the middle cerebral arteries and the basilar artery. Criteria for diagnosing RLS was the presence of at least 3 microbubbles within 15 s from injection. Eighteen out of 44 migraine patients (41%) showed RLS, as opposed to 8 of 50 controls (16%) (p < 0.005). Twenty-six out of 73 patients with cerebral ischemia had RLS (35%). We conclude that the prevalence of RLS in patients with migraine with aura is significantly higher than in normal controls, and is similar to the prevalence of RLS in young patients with stroke. These findings could be helpful in understanding the relationship between migraine and stroke.

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Section: Discussionmentioning

confidence: 99%

Migraine with Aura and Right-to-Left Shunt on Transcranial Doppler: A Case-Control Study

et al. 1998

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“…The release of 5-HT from platelet reported in some studies was probably non-specific and was considered not casually related to migraine attack [10, 27]. The finding of higher 5-HT platelet content in migraine with aura [18] was not confirmed [15, 21, 23]. Even in tension headache, platelet and plasma 5-HT are not decreased in headache-free period in comparison to control subjects [12–15, 19, 21, 28–34] (Table 2).…”

Section: Peripheral Studiesmentioning

confidence: 99%

Serotonin and migraine: a reconsideration of the central theory

Panconesi¹

2008

J Headache Pain

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The 5-hydroxytryptamine (5-HT) has been implicated in migraine pathophysiology for the past 50 years. A low central 5-HT disposition associated with an increase in 5-HT release during attack is the most convincing change of 5-HT metabolism implicated in migraine. Peripheral studies on plasma/platelet have not generally shown low 5-HT levels. Studies on 5-HT reactivity showed hypersensitivity, also expressed as reduced tachyphylaxis (habituation), which successively was evidenced as the most characteristic marker of an altered sensory neurotransmission. Even the gender and seasonal variations of 5-HT parameters seem to agree with a low 5-HT turnover with receptoral hypersensitivity. The interpretation of the effects of some serotonergic drugs and recent neuroimaging studies give major evidence for this cascade of events. Although the exact mechanism that links abnormal 5-HT neurotransmission to the manifestation of head pain has yet to be fully understood, a deficit on 5-HT descending pain inhibitory system is still probably today the most implicated in migraine pathophysiology. This short review focuses and discusses the alteration of peripheral and central 5-HT parameters in migraine patients.

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“…For many decades, migraine research thus was limited to biochemical analyses of 5)HT and its metabolites in various body fluids (blood, plasma, urine) and in platelets of migraineurs [3,9,33]. However, study results regarding the peripheral serotonergic system of migraineurs often were inconsistent, partly for methodological reasons, partly because of confounding factors (for overview see [10,11]). Moreover, the significance of these studies in order to explore alterations of the central serotonergic system in migraineurs remains a matter of debate [30].…”

mentioning

confidence: 99%

Increased serotonin transporter availability in the brainstem of migraineurs

et al. 2007

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For decades, serotonin has been speculated to play a major role in migraine pathophysiology. The central serotonergic system is located in the raphe nuclei and the adjacent reticular formation in the brainstem. Recently, radioligands targeting the brain serotonin transport protein (SERT) have been developed. We used the highly specific SERT-radioligand (123)I-ADAM [2-((2-((dimethylamino) methyl)phenyl)thio)-5-iodophenylamine] to test the hypothesis of the mesopontine serotonergic system being involved in the pathophysiology of migraine. Nineteen migraine patients and 10 healthy, age- and sex-matched controls were enrolled. The neuroimaging study was performed interictally during the pain-free interval. Single Photon Emission Computed Tomography (SPECT)-images were coregistered with MRI-scans. Region of interest (ROI)-analysis revealed a highly significant increase of (123)I-ADAM uptake in the mesopontine brainstem of migraineurs (p < 0.001). In contrast, (123)IADAM uptake in the thalamus did not differ significantly between migraineurs and controls. Our study demonstrates for the first time a significant increase of brainstem SERT-availability in migraineurs, suggesting a dysregulation of the brainstem serotonergic system. It remains to be elucidated whether the altered SERT-availability is causally related to migraine pathophysiology or whether it reflects secondary pathophysiological mechanisms.

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Platelet Models and Their Possible Usefulness in the Study of Migraine Pathogenesis

Cited by 41 publications

References 54 publications

Migraine with Aura and Right-to-Left Shunt on Transcranial Doppler: A Case-Control Study

Migraine with Aura and Right-to-Left Shunt on Transcranial Doppler: A Case-Control Study

Serotonin and migraine: a reconsideration of the central theory

Increased serotonin transporter availability in the brainstem of migraineurs

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