Investigating macrophage-mediated inflammation in migraine using ultrasmall superparamagnetic iron oxide-enhanced 3T magnetic resonance imaging
Research output: Contribution to journal › Journal article › Research › peer-review
Background: 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. Objective: We conducted the first experimental human study to investigate macrophage-mediated inflammation as a possible biomarker of migraine. Methods: 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. Results: 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. Conclusion: Our findings suggest that migraine without aura is not associated with macrophage-mediated inflammation specific to the head pain side.
Original language | English |
---|---|
Journal | Cephalalgia |
Volume | 39 |
Issue number | 11 |
Pages (from-to) | 1407-1420 |
Number of pages | 14 |
ISSN | 0333-1024 |
DOIs | |
Publication status | Published - 2019 |
- dura mater, ferumoxytol, Headache, inflammation, meningeal nociceptor, USPIO
Research areas
ID: 236663975