Francisco Bermejo Martínez

Neuroexcitatory Amino Acid Levels in Plasma and Cerebrospinal Fluid During Migraine Attacks

A current hypothesis for migraine suggests that neuroexcitatory amino acids may participate in the triggering of attacks. To investigate this possibility we measured glutamic and aspartic acid level in plasma and cerebrospinal fluid (CSF) of patients with common and classic migraine during attacks, making comparisons with controls suffering from stress. Plasma levels of amino acids in migraine patients were lower than in controls. CSF concentrations of glutamic acid were higher in migraineurs than in controls. Our results suggest an excess of neuroexcitatory amino acids in the CNS of migraine patients during attacks, possibly favoring a state of neuronal hyperexcitability.

Endothelial progenitor cells A new key for endothelial dysfunction in migraine

Objective: We aimed to study endothelial function with biochemical and ultrasonographic markers and its relation with endothelial progenitor cells (EPCs) in patients with migraine. Methods: We performed a case-control study including 47 patients with episodic migraine (International Headache Society 2004 criteria) and 23 control subjects. We analyzed flow-mediated dilation (FMD) in the dominant brachial artery, calcitonin gene−related peptide (CGRP), and vascular endothelial growth factor (VEGF) levels by ELISA, nitric oxide stable metabolites (NOx) by high-performance liquid chromatography, and EPCs in peripheral blood samples, obtained during interictal periods (n = 47) and migraine attacks (n = 19). Frequency, severity, duration of attacks, and time of evolution of migraine were also recorded. Results: Patients with migraine showed lower numbers of EPCs than control subjects (9.4 ± 5.0 vs 17.9 ± 6.0 colony forming unit−endothelial cells [CFU-ECs]; p < 0.0001) and higher levels of CGRP (164.2 ± 139.1 vs 37.1 ± 38.5 pg/mL), VEGF (473.4 ± 398.7 vs 72.6 ± 56.6 pg/mL), and NOx (1225.2 ± 466.1 vs 671.9 ± 358.6 μM) (all p < 0.05). During attacks, higher levels for CGRP (298.2 ± 100.3 pg/mL) and NOx (1,656.8 ± 259.5 μM) and lower numbers of EPC (7.2 ± 3.2 CFU-ECs) were observed (all p < 0.05). No changes were found for FMD in interictal periods or during headache. In relation to clinical parameters, EPCs decreased with the time of evolution of migraine (r = −0.592; p < 0.0001). Conclusions: Patients with migraine show reduced numbers of EPCs and increased levels of CGRP, NOx, and VEGF than control subjects. Furthermore, EPC counts decrease as migraine progresses in time. These findings suggest altered endothelial function in patients with migraine.

Magnetic resonance imaging of muscles in myotonic dystrophy

The MR findings in 27 patients with myotonic dystrophy were compared with those observed in 11 patients with other muscular dystrophies: six with limb-girdle dystrophy, three with facioscapulohumeral muscular dystrophy and two with Becker-type muscular dystrophy. Clinical status was graded into 10 stages. The MR study was performed at the medium third of the thigh, with a slice thickness of 7.5 mm (TR: 750/TE: 25 for T1; TR: 2200/TE: 30/90 for DP/T2). Muscle signal intensity was evaluated with a four-point grading scale using subcutaneous fat as a reference. Statistical analysis was done using the Mann-Whitney-Wilcoxons test and simple linear regression. In the myotonic dystrophy group, 81.4% of the patients showed an abnormal signal at the crural muscle level, adopting a semilunar shape around the anteroexternal side of the femur. The presence and intensity of this hyperintense signal correlated positively with the duration of disease (r = 0.54) and the clinical stage (r = 0.69). Of the 11 patients with other muscular dystrophies, only three (27.2%) showed hyperintense signal at the crural muscle level. MR imaging of patients with muscle disease may contribute to the in vivo study of muscular dystrophy, its differential diagnosis and the detection of asymptomatic patients.

CEREBROSPINAL FLUID TYROSINE AND 3,4-DIHYDROXYPHENYLACETIC ACID LEVELS IN MIGRAINE PATIENTS

We studied biochemical parameters related with central dopaminergic neurotransmission in migraine patients during crisis. We determined tyrosine and 3,4-dihydroxyphenylacetic acid (DOPAC) levels in cerebrospinal fluid (CSF) of 47 patients, 29 suffering migraine without aura and 18 suffering migraine with aura, comparing them with 27 control subjects. Tyrosine levels did not differ significantly between patients and controls. The CSF concentration of DOPAC was 0.73±0.55 ng/ml in the control population, 3.84±2.08 ng/ml in patients with migraine without aura and 3.30±l.49ng/ml in patients suffering migraine with aura. The concentration of DOPAC correlated positively with the intensity of headache. These results suggest that patients with migraine have a central dopaminergic hyperfunction, probably related to a coexisting central dysfunction of noradrenergic neurotransmision.

Plasma monoamines in tension-type headache.

SYNOPSIS

Platelet-Rich Plasma Serotonin Levels in Tension-Type Headache and Depression

We measured platelet-rich plasma (PRP) serotonin in patients suffering from tension-type headache, before and after treatment with amitriptyline, comparing them with a healthy control group and patients with untreated depression. We evaluated the severity of headache and depression in each group. PRP serotonin levels were higher in patients with headache than in controls and depressed patients. We observed a fall of PRP serotonin in patients with tension-type headache to similar levels after treatment as the depressed group. This fall was correlated with the improvement of headache but not with depression scales. Our data suggest that the rise of platelet serotonin levels in tension-type headache is related to pain and not depression.

Taurine levels in plasma and cerebrospinal fluid in migraine patients.

SYNOPSIS

Role of adipocytokines in the pathophysiology of migraine. A cross-sectional study.

We are writing with regard to the letter sent by Hyun Jin Min and Kyung Soo Kim (1) in connection with our recently published work in Cephalalgia, ‘‘Role of adipocytokines in the pathophysiology of migraine. A cross-sectional study’’ (2). First of all, we want to thank the authors for the attention and time devoted to the analysis of our work and all their valuable comments. We acknowledge there were two minor transcription mistakes in our paper regarding mean age and prevalence of females in Table 1 and the acronym used for high-sensitivity C-reactive protein in Table 2. In our study, there was no statistically significant difference in levels of leptin and adiponectin between patients suffering migraine with aura and migraine without aura. We did not expect to see a difference between these two groups, considering that we assume the same pathophysiology under both types of migraine and that this difference has not been previously evaluated or reported (3,4). Regarding the effect of BMI and hemodilution on adipocytokine levels, our results are already adjusted by BMI, age and sex by logistic regression analysis. Therefore, the possible effect of hemodilution on adypocitokine levels should be already controlled. Moreover, if hemodilution had an important effect on levels of leptin or adiponectin, levels of both molecules would be inversely correlated with BMI, and not positively correlated in the case of leptin and inversely correlated in the case of adiponectin. Finally, all the studies mentioned by the authors (5–7) refer to tumor markers and obesity; in our study we try to correlate adipocytokine levels with BMI, without comparing values in obese and non-obese subjects. Last, levels of adiponectin in our sample are different in patients and controls, and also different when we analyze the subgroup of chronic migraineurs (CM) and the subgroup of episodic migraineurs (EM). Mean levels of adiponectin are lower in EM patients than in healthy controls, but this difference does not have statistical signification; therefore, we should assume these values as equal. Besides, values in EM in our sample are more scattered than in healthy controls if we look at standard deviation values. This variability suggests that there may be great clinical and physiopathological variations in the group of patients that we categorize as EM compared with the CM group and healthy controls. Previous studies also report very diverse levels of adipocytokine in migraineurs and controls: Bernecker et al. did not find statistically significant differences in ADP levels between migraineurs and controls(8,9); Peterlin et al. (10) analyzed results in EM and CM separately, but did not compare episodic migraineurs and controls; a later study by Duarte et al. (11) compared EM and CM with no significant differences, and more recently Dearborn et al. (9) also found higher levels in migraineurs, including CM and EM, but again did not compare levels in EM and controls. There is also a great variability in the levels of ADP reported in the mentioned studies, probably due to the different ADP multimers and its relation to inflammation, which make the study of this molecule and its role in migraine much more complex (12).

CGRP and PTX3 as Predictors of Efficacy of Onabotulinumtoxin Type A in Chronic Migraine: An Observational Study

The aim of this study is to find a relation between several biomarkers in peripheral blood and outcome after treatment with onabotulinumtoxin A (OnabotA).

Determination of halogenated hydrocarbons in the water supply of santiago de compostela (Spain)

Abstract This study, involved the analysis of water samples from the municipal water supply. Sampling took place for one whole week a month from February to June 1987. Duplicate samples were taken from three characteristic locations in the city, sufficiently distant from one another, at three different times of the day (morning, afternoon and night). A total of 315 samples were analyzed. The results obtained showed that chloroform was the most abundant and ever present of the compounds investigated.