Background and Objectives: Migraine is one of the major headache disorders. Epidemiological studies have shown its high prevalence and negative impact on personal and socioeconomic aspects. It is currently ranked 19th by the “World Health Organization” amongst all diseases, leading to disability worldwide. Inflammatory mediators, which include adipokines, have been analyzed in migraine pathophysiology. Nevertheless, their role is not well recognized. This study is aimed to assess serum high molecular weight adiponectin (HMW-ADP) levels in migraineurs: during the ictal phase, prior to, and postabortive treatment. Methods: This was a hospital-based interventional case-controlled study, checking the peripheral blood samples from migraineurs during an acute attack and after one hour of treatment with naproxen sodium (10–15 mg/kg). Age, sex, and BMI matched controls without headache were taken, and a single blood sample was drawn in them. HMW-ADP levels were evaluated by immunoassays. Results: A total of 120 patients which included 60 migraine patients along with 60 controls without headache were involved in the study. HMW-ADP was higher in migraine patients (9.89 ± 5.04 mcg/mL) than in patients without headache history (4.63 ± 2.98 mcg/mL; P = < .001); along with this, serum HMW-ADP (6.4 ± 4.09 mcg/mL; P = <.001) was found to be significantly lower in responders 60 min after acute abortive treatment. Conclusion: HMW-ADP levels were raised in migraineurs. Additionally, among responders following abortive treatment a considerable reduction in the levels was noted. These results recommend that the HMW-ADP might be a possible “novel biomarker of acute remedy response in acute migraineurs”.

Migraine is the most common headache disorder with high prevalence. Clinical features which forms basis for diagnosis are heterogenous, varying from person to person and in an individual patient from one headache to the next. In most of the migraineurs treatment is delayed, until the disease severity is high leading to significant disability and socioeconomic burden. Many patients receive various combination of prolonged therapy with no significant benefits. Identifying a biomarker for migraine might help in assessing the susceptibility, diagnosing the disease early, choosing appropriate therapeutic target and monitoring the disease course. Here in this review authors discuss most studied, promising biomarkers emerging in field of migraine. The keywords migraine, and biomarkers were used in the search engines of PubMed and Google scholar and articles identified were extensively reviewed. Genetic biomarkers ascertain susceptibility or predisposition to migraine and are valuable in diagnosis, developing novel therapeutic agents, assessing treatment response. This review briefs about most studied genetic and circulatory biomarkers of migraine. Further research into existing biomarkers with higher sample size, excluding confounding factors is necessary. Search for newer biomarkers which can be of great value in diagnosis and therapy is needed. Identifying a biomarker which is reliable, replicable, easily available and cost-effective is need of the hour in management of migraine.

Background & Objectives: Cerebral venous thrombosis (CVT) is a rare cause of stroke, occurring commonly in young adults. The variability in the clinical scenario from patient to patient and the lack of specificity of the presenting symptoms of CVT poses a diagnostic challenge. This study aims to analyze the clinical characteristics of patients diagnosed with CVT in comparison to the global profile and explore the diagnostic utility of D-dimer levels as a screening tool in patients with clinical features suspicious of underlying CVT. Methods: This was a hospital-based case-controlled study, included 50 imaging proven patients with CVT and age and sex matched healthy controls. Demographic details were collected, detailed neurological examination done at presentation and d- dimer levels were evaluated. Results: Among our study group a male preponderance was noted (60%) in discordance with the global pattern of CVT. Headache was the most common presenting feature and papilledema was noted in 98% of our patients. Additional clinical signs noted at presentation were nausea and vomiting (78%), seizures (28%), limb weakness (24%) and alteration in sensorium at presentation (14%). Risk factors were alcohol dependency (36%), postpartum period (12%) and anaemia (12%). Additionally the sensitivity of D-dimer was noted to be 90.74% with a specificity of 100% in predicting the disease. Conclusion: Our study differs from the global pattern of CVT in terms of male preponderance, higher detection of papilledema, lesser occurrence of anaemia, and a large proportion of patients with d-dimer positivity. The limitation of the study is the sample size as we cannot extrapolate our results to the population at large. However our data is in concordance with the current concept of CVT, that diagnosis is the key challenge in management.

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Background: The prevalence of dementia is increasing worldwide and with India experiencing an epidemiological transition with increasing ageing population, the prevalence in India is expected to double by 2030 adding to the already high burden of significant health care costs and caregiver fatigue. Indian population has a higher burden of elevated homocysteine levels due to multiple factors. However, studies correlating the homocysteine levels and severity of dementia in the Indian subcontinent is lacking. This study is aimed to analyse the diagnostic utility of serum total homocysteine in dementia and to examine the association between serum total homocysteine levels and severity of dementia.Methods: This was a cross-sectional hospital-based study on patients attending neurology out-patient department who satisfied the DSM-V criteria. Each participant underwent an interview of general health and function followed by a standard assessment including medical history, physical and neurological examination as well as a neuropsychological battery.Results: A total of 30 patients fulfilling the DSM-Vcriteria for Dementia were included in the study. Increasing S. Homocysteine levels were associated with lower neuropsychological compound scores with MMSE score of 20.78±2.98 and ACE-3 score of 77.40±5.60 in patients with Serum Homocysteine less than 22 Umoles/L and 18.85±2.50 and 75.55±5.06 respectively in patients with serum homocysteine levels above 22 Umoles/L. However, there was no statistically significant correlation between neurocognitive scores and serum homocysteine levels (p value 0.06 for MMSE and 0.19 for ACE-3). Also, no correlation was found between severity of dementia and serum homocysteine levels with p≥0.05 and Pearson’s correlation coefficient r=0.06.Conclusions: This study shows no significant association between serum total homocysteine levels and severity of dementia. Thus, the association of homocysteine as an independent risk factor with the diagnosis and severity of dementia needs to be re-evaluated as it might undermine the multiple mechanisms underlying the pathogenesis of dementia.