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The co-occurrence of multiple sclerosis and migraine headache: the serotoninergic link
1NeurCommunication Research Laboratory, Danbury, CT 06811.
Abstract:
The occurrence of migraine headaches in patients with multiple sclerosis (MS) has been recognized for quite some time but the significance of this association to the pathogenesis of MS largely has been ignored. Several reports have documented that migraine headaches may occur during exacerbation of symptoms and may even herald the onset of relapse in MS. We present three MS patients in whom migraine headaches developed during a period of relapse. As migraine has been linked to changes in serotonin (5-HT) functions, the emergence of migraine headaches coincident with the onset of relapse implicates dysregulation of the 5-HT system in the pathophysiology of MS. This hypothesis is plausible considering the evidence that MS patients are serotonergically depleted and that 5-HT is involved in maintaining the integrity of the blood brain barrier, disruption of which is believed to occur in the initial stages of exacerbation of MS symptoms. Furthermore, this hypothesis may have potential therapeutic implications in the treatment of exacerbations of MS and possibly in the prevention of relapse in the disease.
Insights
Migraine headaches may signal multiple sclerosis (MS) relapses. This suggests serotonin system dysfunction may play a role in MS exacerbations and relapse prevention.
Area of Science:
- Neurology
- Neuroimmunology
Background:
- The association between migraine headaches and multiple sclerosis (MS) is recognized but its role in MS pathogenesis is understudied.
- Migraine occurrence has been linked to MS symptom exacerbations and may precede relapses.
Observation:
- Three cases of multiple sclerosis (MS) patients experiencing migraine headaches during relapse periods are presented.
- Migraine onset during MS relapse suggests a connection to the serotonin (5-HT) system.
Findings:
- The emergence of migraines during MS relapse implicates serotonin (5-HT) system dysregulation in MS pathophysiology.
- Evidence suggests MS patients have reduced serotonin levels.
- Serotonin (5-HT) is crucial for maintaining blood-brain barrier integrity, which is disrupted during MS exacerbations.
Implications:
- The serotonin (5-HT) hypothesis offers potential therapeutic strategies for treating MS exacerbations.
- This understanding may aid in preventing future relapses in multiple sclerosis (MS) patients.