title: Migraine in patients with systemic lupus erythematosus is associated with reduced cerebral grey matter volume but not with measures of glial activation or anti-NR2 or anti-P antibodies.
abstract: OBJECTIVE
  Migraine is frequent in patients with systemic lupus erythematosus (SLE), but the pathogenesis and pathophysiology are poorly understood. Migraine is assumed to be a consequence of abnormal neuronal excitability. Based on the hypothesis that the threshold for migraine is lower in SLE patients due to cerebral disturbances, whether structural abnormalities of the brain or relevant biomarkers are associated with headaches in SLE was investigated.
  
  
  METHODS
  Sixty-seven SLE patients and age- and gender-matched healthy subjects participated. Volumes of grey matter (GM) and white matter (WM) were estimated from cerebral magnetic resonance images with SPM8 software. Anti-NR2 and anti-P antibodies and protein S100B were measured in cerebrospinal fluid.
  
  
  RESULTS
  In regression analyses, larger GM volumes in SLE patients reduced the odds for headache in general [odds ratio (OR) 0.98, P = 0.048] and for migraine in particular (OR 0.95, P = 0.004). No localized loss of GM was observed. Larger WM volumes in patients increased the odds for migraine (OR 1.04, P = 0.007). These findings could not be confirmed in healthy subjects. Neither anti-NR2 and anti-P antibodies nor S100B were associated with headaches in SLE patients.
  
  
  CONCLUSIONS
  Systemic lupus erythematosus patients with migraine have a diffuse reduction in GM compared to patients without migraine. This finding was not observed in healthy subjects with migraine, and selected biomarkers did not indicate specific pathophysiological processes in the brain. These findings indicate that unknown pathogenic processes are responsible for the increased frequency of migraine in SLE patients.
authors.affiliation: Department of Neurology, Stavanger University Hospital, Stavanger, Norway.
authors.forename: A B
authors.initials: AB
authors.lastname: Tjensvoll
authors.affiliation: Department of Internal Medicine, Stavanger University Hospital, Stavanger, Norway.
authors.forename: M B
authors.initials: MB
authors.lastname: Lauvsnes
authors.affiliation: Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Hirohata
authors.affiliation: Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: M K
authors.initials: MK
authors.lastname: Beyer
authors.affiliation: Department of Radiology, Stavanger University Hospital, Stavanger, Norway.
authors.forename: O J
authors.initials: OJ
authors.lastname: Greve
authors.affiliation: Department of Pathology, Stavanger University Hospital, Stavanger, Norway.
authors.forename: I
authors.initials: I
authors.lastname: Kvivik
authors.affiliation: Division of Research and Human Resources, Stavanger University Hospital, Stavanger, Norway.|Department of Mathematics and Natural Sciences, University of Stavanger, Stavanger, Norway.
authors.forename: J T
authors.initials: JT
authors.lastname: Kvaløy
authors.affiliation: Department of Internal Medicine, Stavanger University Hospital, Stavanger, Norway.
authors.forename: E
authors.initials: E
authors.lastname: Harboe
authors.affiliation: Department of Internal Medicine, Stavanger University Hospital, Stavanger, Norway.|Department of Clinical Science, University of Bergen, Bergen, Norway.
authors.forename: L G
authors.initials: LG
authors.lastname: Gøransson
authors.affiliation: Department of Internal Medicine, Stavanger University Hospital, Stavanger, Norway.|Department of Clinical Science, University of Bergen, Bergen, Norway.
authors.forename: R
authors.initials: R
authors.lastname: Omdal
mesh_terms: D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000134:cerebrospinal fluid*; D002556:Cerebrospinal Fluid Proteins / Q000032:analysis*; D005260:Female; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000134:cerebrospinal fluid / Q000150:complications / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000134:cerebrospinal fluid / Q000209:etiology / Q000473:pathology; D009457:Neuroglia / Q000378:metabolism*; D016194:Receptors, N-Methyl-D-Aspartate / Q000276:immunology; D012269:Ribosomal Proteins / Q000276:immunology; D064568:S100 Calcium Binding Protein beta Subunit / Q000134:cerebrospinal fluid; D066127:White Matter / Q000473:pathology; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D002556:Cerebrospinal Fluid Proteins; D016194:Receptors, N-Methyl-D-Aspartate; D012269:Ribosomal Proteins; D064568:S100 Calcium Binding Protein beta Subunit
keywords: MRI; S100B; anti-NR2; anti-P; autoimmune disease; headache; migraine; systemic lupus erythematosus