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Published on: June 2, 2014
Evidences of Reduced Antioxidant Activity in Patients With Chronic Migraine and Medication-Overuse Headache
Cinzia Lucchesi1, Filippo Baldacci1, Martina Cafalli1
1Department of Clinical and Experimental Medicine, Institute of Neurology, University of Pisa, Pisa, Italy.
Background:
Migraine is a complex multifactorial, neurobiological disorder, whose pathogenesis is not fully understood, nor are the mechanisms associated with migraine transformation from episodic to chronic pattern. A possible role of impaired oxidative mitochondrial metabolism in migraine pathogenesis has been hypothesized, and increased levels of peripheral markers of oxidative stress have been reported in migraine patients, although the literature data are limited and heterogeneous.
Objectives:
The aim of this cross-sectional study was to determine plasmatic levels of advanced oxidation protein products, ferric-reducing antioxidant power and total plasmatic thiol groups, all plasmatic markers related to oxidative stress, in a sample of chronic migraine patients and medication-overuse headache, compared to a control group of healthy subjects.
Methods:
Thirty-three patients with a diagnosis of both chronic migraine and medication-overuse headache (International Classification of Headache Disorders,3rd edition, beta version) and 33 healthy, headache-free subjects were enrolled. Patients with comorbid/coexisting conditions were excluded, as well as patients in treatment with migraine preventive drugs. Plasmatic levels of advanced oxidation protein products, ferric-reducing antioxidant power, and total thiol groups were determined in migraine patients and controls; moreover, oxidative stress biomarkers were compared in migraine patients with triptan compared to non-steroidal anti-inflammatory drug overuse.
Results:
The statistical analysis showed significantly lower levels of ferric-reducing antioxidant power and total plasmatic thiol groups, both expression of antioxidant power, in patients with chronic migraine and medication-overuse headache compared to controls (respectively, ferric antioxidant power median [interquartile range] 0.53 [0.22] vs 0.82 [0.11] mmol/L, P < .001; total thiol groups 0.25 [0.08] vs 0.51 [0.11] μmol/L, P < .001). Moreover, no statistically significant differences in oxidative stress biomarkers were detected between patients with triptan and nonsteroidal anti-inflammatory drug overuse.
Conclusions:
The data from the present study suggest that antioxidant capacity is lower in chronic migraine patients and medication-overuse headache compared to healthy headache-free subjects, with no differences between patients with triptan or nonsteroidal anti-inflammatory drug overuse. Further investigation is certainly necessary in order to define the causal or consequential role of an imbalance between pro-oxidants and antioxidant defenses in migraine pathogenesis and "chronification" and the possible therapeutic implications in clinical practice.
Insights
Chronic migraine patients exhibit reduced antioxidant capacity compared to healthy individuals. This study found lower ferric-reducing antioxidant power and total thiol groups in migraineurs, suggesting a role for oxidative stress in the condition.
Area of Science:
- Neuroscience
- Biochemistry
- Clinical Neurology
Background:
- Migraine is a complex neurobiological disorder with unclear pathogenesis, particularly the transition to chronic patterns.
- Oxidative mitochondrial metabolism impairment is hypothesized in migraine, with mixed evidence on peripheral oxidative stress markers.
Purpose of the Study:
- To assess plasmatic levels of advanced oxidation protein products, ferric-reducing antioxidant power, and total thiol groups in chronic migraine patients with medication-overuse headache (MOH).
- To compare these oxidative stress markers against a control group of healthy subjects.
Main Methods:
- A cross-sectional study involving 33 chronic migraine with MOH patients and 33 healthy controls.
- Exclusion of patients with comorbidities or on preventive treatments.
- Measurement of plasmatic advanced oxidation protein products, ferric-reducing antioxidant power, and total thiol groups.
- Comparison of biomarkers between triptan and NSAID overuse groups.
Main Results:
- Significantly lower ferric-reducing antioxidant power (0.53 vs. 0.82 mmol/L) and total plasmatic thiol groups (0.25 vs. 0.51 μmol/L) were observed in chronic migraine with MOH patients compared to controls (P < .001 for both).
- No significant differences in oxidative stress biomarkers were found between patients overusing triptans versus NSAIDs.
Conclusions:
- Antioxidant capacity is diminished in chronic migraine with MOH patients compared to healthy individuals.
- The study suggests a potential role for reduced antioxidant defenses in migraine chronification.
- Further research is needed to clarify the causal relationship and therapeutic implications.
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