Serum L-arginine and dimethylarginine levels in migraine patients with brain white matter lesions

Erdélyi-Bótor, Szilvia; Komáromy, Hedvig; Kamson, David Olayinka; Kovács, Norbert; Perlaki, Gábor; Orsi, G.; Molnár, Tihamér; Illés, Zsolt; Nagy, Lajos; Kéki, Sándor; Deli, Gabriella; Bosnyák, Edit; Trauninger, Anita; Pfund, Zoltán

doi:10.1177/0333102416651454

Cited by 25 publications

(17 citation statements)

References 44 publications

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“…CBF is significantly lower in migraine with aura subjects with high white matter hyperintensity load. 67 In a prospective study, Erdelyi-Botor and colleagues 68 measured the serum L-arginine, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) in migraine patients in a headache-free period. The results demonstrate that patients with migraine with WMHs showed higher ADMA concentrations than lesion-free patients and controls; SDMA serum levels of lesional migraineurs were higher than in non-lesional patients.…”

Section: New Development Discussionmentioning

confidence: 99%

Migraine and stroke

2017

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Migraines are generally considered a relatively benign neurological condition. However, research has shown an association between migraines and stroke, and especially between migraine with aura and ischaemic stroke. Patients can also suffer from migrainous infarction, a subset of ischaemic stroke that often occurs in the posterior circulation of younger women. The exact pathogenesis of migrainous infarct is not known, but it is theorised that the duration and local neuronal energy level from cortical spreading depression may be a key factor. Other factors contributing to migrainous infarct may include vascular, inflammatory, endothelial structure, patent foramen ovale, gender, oral contraceptive pill use and smoking. Vasoconstrictors such as the triptan and ergot class are commonly used to treat migraines and may also play a role. Migraine is also shown to be correlated to haemorrhagic stroke, although studies do not demonstrate causation versus association, and further studies are warranted. There are also some rare genetic diseases such as cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy, retinal vasculopathy with cerebral leukodystrophy and others, which can cause both migraines and infarcts. On imaging, many migraineurs are found to have white matter changes similar to those seen in patients with stroke. These may be caused in part by alterations in resting cerebral blood flow and vasoconstrictor use. In treating patients with migraines, it is important to identify and modify any vascular risk factors such as hypertension, smoking, oral contraceptive pill use and lifestyle factors. Further studies will determine if more aggressive treatment of migraines can ultimately lead to fewer strokes in this population.

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Section: New Development Discussionmentioning

confidence: 99%

Migraine and stroke

2017

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“…Additionally, the risk for ischemic stroke was reported to be higher in patients with migraine with aura than with migraine without aura [23]. In contrast, other studies did not show differences in prevalence of WMLs between MWA and MWOA patients [24]. Zhang et al [25] described that, although no differences were observed in WMLs in MA and MWOA groups, substantially lower cerebral blood flow found in association with high WMLs load suggests that WMLs in MWA may be associated with alteration in resting cerebral blood flow.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, we did not observe any differences in WMLs between MA and MWOA groups. However, it is possible that other factors, such as L-arginine, dimethylarginine levels [24] and D-dimer levels as well as headache attack frequencies [26], might have affected WMLs independent of the presence or absence of auras.…”

Section: Discussionmentioning

confidence: 99%

The relationship between right-to-left shunt and brain white matter lesions in Japanese patients with migraine: a single center study

et al. 2017

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BackgroundThere may be a link between right-to-left shunt (RLs) and brain white matter lesions (WMLs) in patients with migraine. In this study, we assessed the relationship between WMLs and RLs in Japanese migraine patients.MethodsA total of 107 consecutive patients with migraine with (MA) and without aura (MWOA) were included in this study. Contrast transcranial Doppler ultrasound was used to detect RLs. WMLs were graded using brain magnetic resonance imaging based on well-established criteria.FindingsThe prevalence of RLs was significantly increased in the WMLs positive group (n = 24) compared with the WMLs negative group (n = 83) (75.0% vs. 47.0%, p = 0.015). In prevalence of WMLs between MA and MWOA patients, there were no statistical differences (p = 0.410). Logistic regression analysis adjusted by age and disease duration of migraine identified an RLs-positive status as the sole determinant for the presence of WMLs (OR = 6.15; 95% CI 1.82–20.8; p = 0.003)ConclusionOur study suggests a possible link between RLs and WMLs in Japanese patients with migraine.

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“…Although dysfunction of the Larginine/nitric oxide (NO) pathway has been associated with oxidative stress and endothelial dysfunction in migraine, its role in WML development has not been specifically investigated. Elevated L-arginine serum levels (an NO substrate) might reflect an increased demand for NO synthesis [28]. WMLs are also correlated with cognitive decline and nitro-oxidative stress [29].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of oxidative stress in migraine patients with visual aura - the experience of an Rehabilitation Hospital

Bulboacă¹,

Cluj-Napoca²,

Dogaru³

et al. 2018

Balneo

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Background: Although there are previous studies regarding the migraine pathophysiology, the clinical entity of migraine with aura can have an different pathophysiological mechanism compared with migraine without aura. One of the most important mechanism in migraine is represented by increasing of oxidative stress. The aim of this study was to study the levels of two oxidative stress molecules: nitric oxide (NO) and malondialdehyde (MDA) in migraine with visual aura compared with migraine without aura. Material and Method: a Control group (healthy volunteers) of 37 patients and 58 patient with migraine divided in Group 1 (migraine with visual aura) and Group 2 (migraine without aura) were taken in the study. All the patient were assessed regarding the age, body mass index, blood pressure, basal glycaemia, smoking/non-smoking status, C reactive protein and fibrinogen. Visual aura was assessed regarding transitive negative visual symptoms or positive visual symptoms. Oxidative status was assessed by measurements of the plasma levels of NO and MDA. Results; C reactive protein was significantly increased in both group 1 and 2 compared with control group, but with no statistical difference between group 1 and 2. Oxidative stress (NO and MDA) was significantly increased in both group 1 and 2 compared with control group. There was also found a statistical difference regarding NO and MDA levels between group 1 and 2. Conclusions; patients with visual aura have more intense oxidative stress that can contribute to cortical spreading depression mechanism involved in migraine pathophysiology. This difference between oxidative status in migraine with aura compared with migraine without aura can influence different clinical presentation of these patients. consequently, this difference can be a guide for further individualized therapies for migraine patients.

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Serum L-arginine and dimethylarginine levels in migraine patients with brain white matter lesions

Cited by 25 publications

References 44 publications

Migraine and stroke

Migraine and stroke

The relationship between right-to-left shunt and brain white matter lesions in Japanese patients with migraine: a single center study

Evaluation of oxidative stress in migraine patients with visual aura - the experience of an Rehabilitation Hospital

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