Association between serum bilirubin and migraine in children and adolescents

Abstract

Background: Migraine in children and adolescents is very common and can be associated with equivalents, psychiatric disorders, or abnormal electroencephalogram findings. Neurogenic inflammation is involved in migraine pathogenesis where pro-inflammatory cytokines play a significant role. Recent studies have demonstrated that serum bilirubin can be considered as an antioxidant and cytoprotective agent and that its concentration may be influenced in migraine by neurogenic inflammation. Various studies have observed reduced serum bilirubin in migrainous adults, and few studies investigated the association between serum bilirubin and migraine in children and adolescents. Objectives: To study the association between serum bilirubin and migraine in children and adolescents. Patients and method: Serum samples were collected from 40 migrainous children and adolescents and from 40 controls. Total, direct, and indirect bilirubin concentrations were measured. Headache features, migraine equivalents, psychiatric comorbidity, and electroencephalogram findings were documented in migraineurs. Results: Serum total, direct, and indirect bilirubin concentrations were significantly lower in migraineurs than controls. This was statistically significant associated with abnormal electroencephalogram findings during headachefree periods and not statistically significant associated with any headache feature, abnormal electroencephalogram findings during headache attacks, or psychiatric comorbidity. Conclusion: Serum bilirubin concentration is lower in migrainous children and adolescents compared to control, with no association with specific migraine type or features, and thus may be considered a useful marker for neurogenic inflammation in migraine.