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Antineuronal antibodies in migraine patients with white matter lesions
Recai Türkoğlu1, Erdem Tüzün, Sema Içöz
1Department of Neurology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
Abstract:
Magnetic resonance imaging (MRI) studies occasionally display focal hyperintense lesions within the white matter of migraine patients. No immunological factors associated with these lesions have been defined so far. To investigate the relationship between MRI lesions and antineuronal antibody response, 17 migraine patients with white matter lesions (WML), 19 migraine patients without WML, 20 multiple sclerosis patients with WML and with no headache history, and 20 healthy individuals were enrolled, and their sera were examined by indirect immunohistochemistry for the presence of immunoglobulin G (IgG) reacting with the rat brain tissue. Migraine patients with and without WML essentially showed identical demographic and clinical features and frequencies of systemic autoantibodies. However, migraine patients with WML displayed a significantly higher frequency of antineuronal antibodies than those without WML (12/17 vs. 2/19, p = .0004). Serum IgG of migraine patients predominantly reacted with the cytoplasm of neurons and the molecular layer of cerebellum. None of the multiple sclerosis patients and healthy controls displayed antineuronal antibodies. Our results imply the involvement of inflammation in migraine pathogenesis.
Insights
Migraine patients with white matter lesions show a higher frequency of antineuronal antibodies. This suggests inflammation may play a role in migraine pathogenesis, differentiating them from healthy individuals.
Area of Science:
- Neurology
- Immunology
- Neuroimaging
Background:
- Focal hyperintense white matter lesions are occasionally observed in migraine patients via Magnetic Resonance Imaging (MRI).
- The immunological factors associated with these white matter lesions (WML) in migraine remain undefined.
- Understanding the link between WML and immune responses is crucial for migraine research.
Purpose of the Study:
- To investigate the association between white matter lesions (WML) in migraine patients and the presence of antineuronal antibodies.
- To determine if antineuronal antibodies are specific to migraine patients with WML compared to those without, multiple sclerosis patients, and healthy controls.
- To explore the potential role of inflammation in migraine pathogenesis.
Main Methods:
- Sera from 17 migraine patients with WML, 19 migraine patients without WML, 20 multiple sclerosis patients with WML, and 20 healthy controls were analyzed.
- Indirect immunohistochemistry was employed to detect immunoglobulin G (IgG) antibodies reacting with rat brain tissue.
- Demographic, clinical features, and systemic autoantibody frequencies were compared across groups.
Main Results:
- Migraine patients with WML showed a significantly higher frequency of antineuronal antibodies (12/17) compared to migraine patients without WML (2/19).
- The antineuronal antibodies in migraine patients predominantly targeted neuronal cytoplasm and the cerebellar molecular layer.
- No antineuronal antibodies were detected in multiple sclerosis patients or healthy controls.
Conclusions:
- The presence of antineuronal antibodies in migraine patients with WML suggests an autoimmune or inflammatory component in their condition.
- These findings imply that inflammation may be involved in the pathogenesis of migraine, particularly in cases with associated white matter lesions.
- Antineuronal antibodies could serve as a potential biomarker for a subset of migraine patients.
