Cerebrospinal fluid glutamate levels in chronic migraine
Cerebrospinal fluid glutamate levels in chronic migraine
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DOI：
10.1111/j.1468-2982.2004.00750.x
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发表时间：
2004-09-01
期刊：
影响因子：
4.9
通讯作者：
Faulhaber, MHW
中科院分区：
文献类型：
--
作者：
Peres, MFP;Zukerman, E;Faulhaber, MHW
临床前和临床数据都将谷氨酸与偏头痛病理学联系起来。偏头痛患者的血浆、血小板和脑脊液（CSF）谷氨酸水平已被报道改变。慢性偏头痛与几种疾病共病。它最近已被证明慢性偏头痛合并纤维肌痛。本研究的目的是研究慢性偏头痛伴或不伴纤维肌痛患者的脑脊液谷氨酸水平。我们研究了20名慢性偏头痛患者，与年龄性别匹配的对照组相比，有或没有纤维肌痛。通过HPLC测量CSF谷氨酸水平。与无纤维肌痛的患者相比，纤维肌痛患者的CSF谷氨酸水平显著更高。总体而言，患者的CSF谷氨酸水平高于对照组。慢性偏头痛患者的平均疼痛评分与谷氨酸水平相关。压痛点是纤维肌痛的标志，可被认为是压力异常性疼痛，可能由中枢致敏作用介导，CSF谷氨酸水平升高。我们假设慢性偏头痛患者纤维肌痛，除了有更多的致残性头痛，遭受更严重的中枢致敏过程。这种亚型的患者可能对调节谷氨酸受体的药物有反应。慢性偏头痛患者的头痛强度与谷氨酸水平相关。
Both preclinical and clinical data link glutamate to the migraine pathophisiology. Altered plasma, platelets and cerebrospinal (CSF) glutamate levels have been reported in migraine patients. Chronic migraine is comorbid with several conditions. It has been recently shown chronic migraine comorbidity with fibromyalgia. The objective of this study was to study cerebrospinal fluid glutamate levels in chronic migraine patients with and without fibromyalgia. We studied 20 chronic migraine patients, with and without fibromyalgia, compared to age-sex matched controls. CSF glutamate levels were measured by HPLC. CSF glutamate demonstrated significantly higher levels in patients with fibromyalgia compared to those without fibromyalgia. Patients overall had higher CSF glutamate levels than controls. Mean pain score correlated with glutamate levels in chornic migraine patients. Tender points, the hallmark of fibromyalgia, can be considered as pressure allodynia, and is probably mediated by central sensitization, with increase in CSF glutamate levels. We postulate chronic migraine patients with fibromyalgia, in addition to have more disabling headaches, suffer from a more severe central sensitization process. This subtype of patients may respond to medications modulating glutamate receptors. Headache intensity correlate with glutamate levels in chronic migraine patients.