Increased brain serotonin synthesis in migraine.
OBJECTIVE
To measure brain serotonin synthesis with PET using the tracer alpha-[11C]methyl-L-tryptophan in migraine patients.


BACKGROUND
Although the cause of migraine remains poorly understood, there is considerable evidence to support a role of the neurotransmitter serotonin in the pathophysiology of migraine.


METHODS
We studied 11 women (aged 33+/-7.7 years) with a diagnosis of migraine according to International Headache Society criteria and 8 healthy women (aged 29+/-9.2 years). Five patients were studied before and after chronic treatment with propranolol or nadolol.


RESULTS
Serotonin synthesis capacity (K-complex) values in migraine patients were higher than those measured in controls throughout the brain (p = 0.016); mean K-complex for whole brain was 0.0077 + 0.0020 mL/g/min in patients with migraine and 0.0054+/-0.0003 mL/g/min in controls. The regional pattern did not differ between the two groups. However, the K-complex for whole brain in the subgroup of migraine patients with aura (n = 3) did not differ from that of the control group (p = 0.32). In the five patients studied twice (before and after treatment), we found a trend of increased whole-brain K-complex after drug treatment (p = 0.06).


CONCLUSIONS
Our findings indicating increased brain serotonin synthesis capacity in migraine patients are consistent with previous reports of systemic alteration of serotonin metabolism in patients without aura. Our results also suggest that the mechanism of action of beta-adrenergic antagonists for migraine prophylaxis may involve regulation of serotonin synthesis.
Chugani
D C
DC
Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University School of Medicine 48201, USA.
Niimura
K
K
Chaturvedi
S
S
Muzik
O
O
Fakhouri
M
M
Lee
M L
ML
Chugani
H T
HT
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism*; D005260:Female; D006801:Humans; D008875:Middle Aged; D008881:Migraine Disorders / Q000378:metabolism* / Q000517:prevention & control; D009248:Nadolol / Q000627:therapeutic use; D011433:Propranolol / Q000627:therapeutic use; D011877:Radionuclide Imaging; D012016:Reference Values; D012701:Serotonin / Q000096:biosynthesis*
D000319:Adrenergic beta-Antagonists; D012701:Serotonin; D009248:Nadolol; D011433:Propranolol