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- Title
Investigating macrophage-mediated inflammation in migraine using ultrasmall superparamagnetic iron oxide-enhanced 3T magnetic resonance imaging.
- Authors
Khan, Sabrina; Amin, Faisal Mohammad; Fliedner, Frederikke Petrine; Christensen, Casper Emil; Tolnai, Daniel; Younis, Samaira; Olinger, Anne Christine Rye; Birgens, Henrik; Daldrup-Link, Heike; Kjær, Andreas; Larsson, Henrik Bo Wiberg; Lindberg, Ulrich; Ashina, Messoud
- Abstract
<bold>Background: </bold>Initiating mechanisms of migraine headache remain poorly understood and a biomarker of migraine does not exist. Inflammation pertaining to the wall of cerebral arteries and brain parenchyma has been suggested to play a role in migraine pathophysiology.<bold>Objective: </bold>We conducted the first experimental human study to investigate macrophage-mediated inflammation as a possible biomarker of migraine.<bold>Methods: </bold>Using ultrasmall superparamagnetic iron oxide (USPIO)-enhanced 3T magnetic resonance imaging (MRI), we investigated the presence of macrophages in cerebral artery walls and in brain parenchyma of patients with migraine without aura. We used the phosphodiesterase-3-inhibitor cilostazol as an experimental migraine trigger, and investigated both patients who received sumatriptan treatment, and patients who did not. To validate our use of USPIO-enhanced MRI, we included a preclinical mouse model with subcutaneous capsaicin injection in the trigeminal V1 area. The study is registered at ClinicalTrials.gov with the identifier NCT02549898.<bold>Results: </bold>A total of 28 female patients with migraine without aura underwent a baseline MRI scan, ingested cilostazol, developed a migraine-like attack, and underwent an USPIO-enhanced MRI scan > 24 hours after intravenous administration of USPIO. Twelve patients treated their attack with 6 mg s.c. sumatriptan, while the remaining 16 patients received no migraine-specific rescue medication. The preclinical model confirmed that USPIO-enhanced MRI detects macrophage-mediated inflammation. In patients, however, migraine attacks were not associated with increased USPIO signal on the pain side of the head compared to the non-pain side.<bold>Conclusion: </bold>Our findings suggest that migraine without aura is not associated with macrophage-mediated inflammation specific to the head pain side.
- Subjects
MAGNETIC resonance imaging; MIGRAINE; CEREBRAL arteries; MACROPHAGES; INFLAMMATION; FERRIC oxide
- Publication
Cephalalgia, 2019, Vol 39, Issue 11, p1407
- ISSN
0333-1024
- Publication type
journal article
- DOI
10.1177/0333102419848122