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Cortical glutamate and gamma-aminobutyric acid over the course of a provoked migraine attack, a 7 Tesla magnetic resonance spectroscopy study

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posted on 2023-06-10, 02:30 authored by Gerrit L J Onderwater, Jannie P Wijnen, Chloé Najac, Robin M van Dongen, Itamar RonenItamar Ronen, Andrew Webb, Ronald Zielman, Erik W van Zwet, Michel D Ferrari, Hermien E Kan, Mark C Kruit, Gisela M Terwindt
Enhanced activity of the glutamatergic system has been linked to migraine pathophysiology. The present study aimed to assess the involvement of the glutamatergic system in the onset of attacks. We provoked attacks by infusion of glyceryl trinitrate (GTN; 0.5 µg/kg/min over 20 min) in 24 female episodic migraineurs without aura and 13 female age-matched healthy controls. Over the course of a single day participants were scanned three times at fixed time slots (baseline before GTN infusion, 90 min and 270 min after start of GTN infusion). Single-volume proton magnetic resonance spectra (1H–MRS) were acquired at 7 Tesla from a volume of interest (VOI, 2x2x3 cm) in the visual cortex. We assessed the concentrations of glutamate, its major precursor glutamine, and its product gamma-aminobutyric acid (GABA) over the course of a provoked attack. The preictal state was defined as the period after GTN infusion until the migraine-like headache started, independent of possible experienced premonitory symptoms, and the ictal state was defined as the period with provoked migraine-like headache. Data were analyzed using a linear mixed-effect model for repeated measures. Glutamate and glutamine levels did not change from interictal to the preictal and ictal state. GABA levels increased from interictal towards the preictal state for migraine patients compared with healthy controls. We conclude that high resolution 7T MRS is able to show changes in the glutamatergic system towards a triggered migraine attack, by revealing an increased GABA concentration associated with the onset of a migraine attack.

History

Publication status

  • Published

File Version

  • Published version

Journal

NeuroImage: Clinical

ISSN

2213-1582

Publisher

Elsevier

Volume

32

Page range

1-11

Article number

a102889

Event location

Netherlands

Department affiliated with

  • BSMS Neuroscience Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2022-02-01

First Open Access (FOA) Date

2022-02-01

First Compliant Deposit (FCD) Date

2022-02-01

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