Cerebrospinal fluid sodium increases in migraine.
BACKGROUND
Pharmaceuticals with calcium- or sodium-channel-blocking activity have proven useful for migraine prophylaxis, and calcium channel, sodium transporter, and sodium channel gene mutations have been found in familial hemiplegic migraine. However, it is not known whether calcium or sodium homeostasis is altered in migraine.


OBJECTIVE
To compare levels of sodium, calcium, potassium, and magnesium in cerebrospinal fluid (CSF) and blood plasma between migraineurs and controls.


METHODS
We recruited 20 migraineurs without aura and 11 controls prospectively, and studied migraineurs in sick (MH(+)) and well (MH(-)) states. We collected lumbar CSF and venous blood plasma, quantified elements with ion-selective electrodes or colorimetry, and determined osmolality by depression of freezing point. We compared levels of Na(+), Ca(2+), K(+), and Mg among and also within subjects who were studied in both MH(+) and MH(-) states.


RESULTS
Mean CSF Na(+) levels were increased by 3 mmol/L in MH(+) compared with MH(-) and by 4 mmol/L compared to controls (P < 0.005). In 4 subjects who were sampled in both MH(+) and MH(-) states, mean CSF Na(+) concentration increased by 2 mmol/L in the MH(+) state compared with the MH(-) state (P < 0.05). Simultaneous plasma Na(+) levels did not differ among the 3 clinical groups, nor did osmolality, total Ca and Ca(2+), K(+), and total Mg levels in CSF.


CONCLUSIONS
Compared to both controls and the MH(-) state, CSF Na(+) concentration increased in MH(+) independently from other clinical or pharmacological fluctuations, CSF concentrations of Ca(2+), Mg, and K(+), and blood plasma Na(+) levels. These results implicate a deviation of Na(+) homeostasis in migraine. The modestly elevated extracellular Na(+) in MH(+) may cause the neural changes that underlie clinical features of migraine.
Harrington
Michael G
MG
Huntington Medical Research Institutes, Molecular Neurology, Pasadena, CA 91101, USA.
Fonteh
Alfred N
AN
Cowan
Robert P
RP
Perrine
Kathy
K
Pogoda
Janice M
JM
Biringer
Roger G
RG
Hühmer
Andreas F R
AF
D002118:Calcium / Q000097:blood / Q000134:cerebrospinal fluid; D006801:Humans; D008274:Magnesium / Q000097:blood / Q000134:cerebrospinal fluid; D020326:Migraine without Aura / Q000097:blood / Q000134:cerebrospinal fluid* / Q000473:pathology; D011188:Potassium / Q000097:blood / Q000134:cerebrospinal fluid; D011446:Prospective Studies; D012964:Sodium / Q000097:blood / Q000134:cerebrospinal fluid*
D012964:Sodium; D008274:Magnesium; D011188:Potassium; D002118:Calcium