慢性偏头痛患者脑脊液谷氨酸盐水平

Cerebrospinal fluid glutamate levels in chronic migraine

Both preclinical and clinical data link glutamate to the migraine pathophisiol ogy. Altered plasma, platelets and cerebrospinal (CSF) glutamate levels have bee n reported in migraine patients. Chronic migraine is comorbid with several condi tions. 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 chroni c migraine patients, with and without fibromyalgia, compared to age sex matched controls. CSF glutamate levels were measured by HPLC. CSF glutamate demonstrate d significantly higher levels in patients with fibromyalgia compared to those wi thout fibromyalgia. Patients overall had higher CSF glutamate levels than contro ls. Mean pain score correlated with glutamate levels in chornic migraine patient s. Tender points, the hallmark of fibromyalgia, can be considered as pressure al lodynia, 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 sen sitization process. This subtype of patients may respond to medications modulati ng glutamate receptors. Headache intensity correlate with glutamate levels in ch ronic migraine patients.