CSF GLUTAMATE LEVELS ARE DECRESED IN CHRONIC MIGRAINE PATIENTS USING TRIPTANS Peres MFP, Vieira DSS, Zukerman E, Soares CAS, Alonso EO, Faulhaber MHW Hospital Israelita Albert Einstein, Instituto de Ensino e Pesquisa. B053. View this poster at www.cefaleias.com.br.
CHRONIC MIGRAINE PATIENTS USING TRIPTANS
Peres MFP, Vieira DSS, Zukerman E, Soares CAS, Alonso EO, Faulhaber MHW
Hospital Israelita Albert Einstein, Instituto de Ensino e Pesquisa.
View this poster at
Introduction: Chronic migraine (CM) is a common and debilitating condition. There has been a great impact in migraine acute treatment with the new 5HT1b - 5HT1d agonists. There is a putative role of glutamate in migraine pathophysiology. Little is known about the role of glutamate neurotransmission in acute medication overuse and chronic migraine. Objective: The objective of this study was to analyze cerebrospinal fluid glutamate levels in chronic migraine patients with use analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs), ergotamines, with or no overuse, and triptans.
Patients and Methods: We studied 20 patients (eight using analgesics, NSAIDs and ergotamines, with overuse, five without overuse and seven using triptans). The patients were diagnosed with chronic migraine according to the International Headache Society diagnostic criteria (2003). They underwent a lumbar puncture in order to rule out idiopathic intracranial hypertension. Cerebrospinal fluid (CSF) glutamate levels were measured by high-performance liquid chromatography.
Results: CSF glutamate levels were lower in chronic migraine patients using triptans compared to patients using others medications with or no overuse (0,19 0,06 vs 0,34 0,23 micromols/l) p<0,02. Discussion: Our study shows decreased glutamate levels in the CSF of chronic migraine patients using triptans (equally divided into riza, suma zolmi and naratriptan) compared to patients using analgesics, NSAIDs and ergotamine. The hypothesis of increase in the glutamategic system activity in chronic migraine patients is supported by this study. Triptans may be involved in the modulation of glutamate, decreasing their levels in migraine.
Triptans Analgesics No overuse