The analyzes of the neuromediators in internal juguler venous blood and the changes in the scan of brain stem with magnetic rezonance spectroscopy in migraine patients with or without aura

THE ANALYZES OF THE NEUROMEDİATORS IN INTERNAL JUGULER VENOUS BLOOD AND THE CHANGES IN THE SCAN OF BRAIN STEM WITH MAGNETIC REZONANCE SPECTROSCOPY IN MIGRAINE PATIENTS WITH OR WITHOUT AURADr. Gökhan GÜRELDepartment of Neurology, School of Medicine, Dokuz Eylul UniversityMigraine; is a common syndrome that causes socio-economical loses and reduces the quality of life. However, etiology and pathogenesis are not well known yet. It?s very important to resarch with a model which is the most similar to spontaneous headache attacks to clear the etio-pathogenesis .In the present study, patients diagnosed as migraine with or without aura and healthy controls were underwent visually stimulated headache. Before and after the stimulation, biomarkers of sterile neurogenic inflammation (Calcitonin gene related peptide ?CGRP?, substance P, neurokinin A, serotonin ve leukotriene B4) were tested from the blood samples of internal juguler veins which indicates the possible cerebral metabolic changes and trigeminovasculary activation. After the visual stimulation, the changes in level of lactate, N-acetyl aspartate (NAA), choline (Cho) at brain stem (pons and mesencephalon) were scanned by magnetic resonance spectroscopy that indicates the lack of energy and metabolic change.After visual stimulation, all migraine patients had headache without aura. Leukotriene B4 (LTB4) concentration increased significantly in internal juguler vein during headache in migraine group. We did not determine significant change in other neurometabolite concentrations during headache. After visual stimulation MRS scans indicated that lactate, NAA and Cho in brainstem were significantly higher compared to reference brain areas in migraine group.In conclusion, only migraine group had headaches after the visual stimulation; which were similar to spontaneous attacks. The increased level of LTB4 during headache indicated that it could be used as an indicator of neurogenic inflammation and trigeminal activation. Furthermore, antagonisation of LTB4 during attacks could be used as a new treatment method. The increased levels of lactate, NAA and Cho at brain stem indicated energy consumption in neurons and the metabolic activation for compensation.Present study is the most extensive one that takes part in literature. Results are engrossing and impressive; however it needs to be confirmed with further studies. Also, it has feature to illuminate the other studies.Key words: Migraine headache, experimental model, visual stimulation, jugular venous blood, neuromediators, MR spectroscopy