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Magnetic resonance spectroscopy in migraine: what have we learned so far?

Harmen Reyngoudt (UGent) , Eric Achten (UGent) and Koen Paemeleire (UGent)
(2012) CEPHALALGIA. 32(11). p.845-859
Author
Organization
Abstract
Objective: To summarize and evaluate proton (H-1) and phosphorus (P-31) magnetic resonance spectroscopy (MRS) findings in migraine. Methods: A thorough review of H-1 and/or P-31-MRS studies in any form of migraine published up to September 2011. Results: Some findings were consistent in all studies, such as a lack of ictal/interictal brain pH change and a disturbed energy metabolism, the latter of which is reflected in a drop in phosphocreatine content, both in the resting brain and in muscle following exercise. In a recent interictal study ATP was found to be significantly decreased in the occipital lobe of migraine with aura patients, reinforcing the concept of a mitochondrial component to the migraine threshold, at least in a subgroup of patients. In several studies a correlation between the extent of the energy disturbance and the clinical phenotype severity was apparent. Less consistent but still congruent with a disturbed energy metabolism is an observed lactate increase in the occipital cortex of several migraine subtypes (MwA, migraine with prolonged aura). No increases in brain glutamate levels were found. Conclusion: The combined abnormalities found in MRS studies imply a mitochondrial component in migraine neurobiology. This could be due to a primary mitochondrial dysfunction or be secondary to, for example, alterations in brain excitability. The extent of variation in the data can be attributed to both the variable clinical inclusion criteria used and the variation in applied methodology. Therefore it is necessary to continue to optimize MRS methodology to gain further insights, especially concerning lactate and glutamate.
Keywords
H-1-MRS, P-31-MRS, brain, migraine, migraine without aura, migraine with aura, migraine with prolonged aura, migrainous stroke, basilar-type migraine, familial hemiplegic migraine, sporadic hemiplegic migraine, brain metabolism, muscle metabolism, ATP, phosphocreatine, lactate, N-acetylaspartate, glutamate, HUMAN VISUAL-CORTEX, BRAIN ENERGY-METABOLISM, FAMILIAL HEMIPLEGIC MIGRAINE, GENOME-WIDE ASSOCIATION, PROTON MR SPECTROSCOPY, SKELETAL-MUSCLE BIOENERGETICS, RANDOMIZED CONTROLLED-TRIAL, HIGH-DOSE RIBOFLAVIN, IN-VIVO, CLUSTER HEADACHE

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Citation

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MLA
Reyngoudt, Harmen, Eric Achten, and Koen Paemeleire. “Magnetic Resonance Spectroscopy in Migraine: What Have We Learned so Far?” CEPHALALGIA 32.11 (2012): 845–859. Print.
APA
Reyngoudt, H., Achten, E., & Paemeleire, K. (2012). Magnetic resonance spectroscopy in migraine: what have we learned so far? CEPHALALGIA, 32(11), 845–859.
Chicago author-date
Reyngoudt, Harmen, Eric Achten, and Koen Paemeleire. 2012. “Magnetic Resonance Spectroscopy in Migraine: What Have We Learned so Far?” Cephalalgia 32 (11): 845–859.
Chicago author-date (all authors)
Reyngoudt, Harmen, Eric Achten, and Koen Paemeleire. 2012. “Magnetic Resonance Spectroscopy in Migraine: What Have We Learned so Far?” Cephalalgia 32 (11): 845–859.
Vancouver
1.
Reyngoudt H, Achten E, Paemeleire K. Magnetic resonance spectroscopy in migraine: what have we learned so far? CEPHALALGIA. 2012;32(11):845–59.
IEEE
[1]
H. Reyngoudt, E. Achten, and K. Paemeleire, “Magnetic resonance spectroscopy in migraine: what have we learned so far?,” CEPHALALGIA, vol. 32, no. 11, pp. 845–859, 2012.
@article{2116950,
  abstract     = {{Objective: To summarize and evaluate proton (H-1) and phosphorus (P-31) magnetic resonance spectroscopy (MRS) findings in migraine. 
Methods: A thorough review of H-1 and/or P-31-MRS studies in any form of migraine published up to September 2011. 
Results: Some findings were consistent in all studies, such as a lack of ictal/interictal brain pH change and a disturbed energy metabolism, the latter of which is reflected in a drop in phosphocreatine content, both in the resting brain and in muscle following exercise. In a recent interictal study ATP was found to be significantly decreased in the occipital lobe of migraine with aura patients, reinforcing the concept of a mitochondrial component to the migraine threshold, at least in a subgroup of patients. In several studies a correlation between the extent of the energy disturbance and the clinical phenotype severity was apparent. Less consistent but still congruent with a disturbed energy metabolism is an observed lactate increase in the occipital cortex of several migraine subtypes (MwA, migraine with prolonged aura). No increases in brain glutamate levels were found. 
Conclusion: The combined abnormalities found in MRS studies imply a mitochondrial component in migraine neurobiology. This could be due to a primary mitochondrial dysfunction or be secondary to, for example, alterations in brain excitability. The extent of variation in the data can be attributed to both the variable clinical inclusion criteria used and the variation in applied methodology. Therefore it is necessary to continue to optimize MRS methodology to gain further insights, especially concerning lactate and glutamate.}},
  author       = {{Reyngoudt, Harmen and Achten, Eric and Paemeleire, Koen}},
  issn         = {{0333-1024}},
  journal      = {{CEPHALALGIA}},
  keywords     = {{H-1-MRS,P-31-MRS,brain,migraine,migraine without aura,migraine with aura,migraine with prolonged aura,migrainous stroke,basilar-type migraine,familial hemiplegic migraine,sporadic hemiplegic migraine,brain metabolism,muscle metabolism,ATP,phosphocreatine,lactate,N-acetylaspartate,glutamate,HUMAN VISUAL-CORTEX,BRAIN ENERGY-METABOLISM,FAMILIAL HEMIPLEGIC MIGRAINE,GENOME-WIDE ASSOCIATION,PROTON MR SPECTROSCOPY,SKELETAL-MUSCLE BIOENERGETICS,RANDOMIZED CONTROLLED-TRIAL,HIGH-DOSE RIBOFLAVIN,IN-VIVO,CLUSTER HEADACHE}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{845--859}},
  title        = {{Magnetic resonance spectroscopy in migraine: what have we learned so far?}},
  url          = {{http://dx.doi.org/10.1177/0333102412452048}},
  volume       = {{32}},
  year         = {{2012}},
}

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