title: Comparison of oxidative stress among migraineurs, tension-type headache subjects, and a control group.
abstract: BACKGROUND
  A primary headache, particularly migraine, is associated with oxidative stress during the attack. However, data regarding the interictal state in migraineurs and in those with tension-type headache (TTH) is limited.
  
  
  OBJECTIVE
  (1) To assess the oxidative stress in migraineurs and TTH subjects in between the episodes and (2) to see if there is a difference in the degree of oxidative stress in the different subtypes of migraine and TTH.
  
  
  METHODS
  Fifty migraineurs, 50 patients with TTH, and 50 control subjects were included in this study after screening for the exclusion criteria. Diagnosis of headache was made according to the International Classification of Headache Disorders (ICHD)-2 criteria. A venous blood sample was collected from the antecubital vein at least 3 days after the last attack of headache. The sample was centrifuged immediately and the plasma was stored at -70 degrees C. The ferric reducing activity of plasma (FRAP) and the malondialdehyde (MDA) levels were assessed using colorimetric methods. Statistical analysis was done with the help of SPSS for Windows, v 11.0. One way ANOVA with post hoc Tukey test, independent sample t test, univariate regression, and multivariate regression analysis were done as indicated.
  
  
  RESULTS
  Migraineurs had higher values of MDA and FRAP than the subjects in the other two groups (P<0.001). No difference was observed between the TTH group and the control group. FRAP levels were significantly higher in subjects who had mixed migraine (migraine with aura and without aura) as compared to those with only migraine without aura (mean difference 196.1; 95% CI = 27.3 to 364.9; P = 0.01). Similarly, oxidative stress was significantly higher in patients with episodic TTH as compared to those with chronic TTH (FRAP t = 3.16; P = 0.003 and MDA t = 2.75; P = 0.008).
  
  
  CONCLUSIONS
  This study suggests that oxidative stress continues even between headache episodes in migraineurs but not in those with TTH. This could probably be consequent to the different pathophysiological mechanisms of TTH and migraine.
authors.affiliation: Departments of Psychiatry, University College of Medical Sciences and GTB Hospital, Dilshad Garden, Delhi-110 095, India.
authors.forename: Ravi
authors.initials: R
authors.lastname: Gupta
authors.forename: Rahul
authors.initials: R
authors.lastname: Pathak
authors.forename: Manjeet Singh
authors.initials: MS
authors.lastname: Bhatia
authors.forename: Basu Deb
authors.initials: BD
authors.lastname: Banerjee