Decreased Brain GABA Levels in Patients with Migraine Without Aura: An Exploratory Proton Magnetic Resonance Spectroscopy Study

Wu, Xiaojuan; Han, Shuting; Yang, Yang; Dai, Hui; Wu, Peng; Zhao, Hongru; Jin, Xiaohong; Li, Yonggang

doi:10.1016/j.neuroscience.2022.02.010

Cited by 13 publications

(8 citation statements)

References 44 publications

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“…This result does not support the hypothesis that an imbalance of excitatory and inhibitory neurotransmitters in the occipital lobe plays an essential role in the pathophysiology of episodic migraine. Moreover, we did not find a correlation between concentrations of GABA and the number of migraine days—unlike Wu and co‐workers, who studied the anterior cingulate cortex and the medial prefrontal lobe (Wu et al, 2022). Hence, it is possible that migraine attacks directly influence GABA concentrations only in specific brain regions or do so only in patients with migraine without aura—our sample comprised a higher proportion of migraineurs with aura.…”

Section: Discussioncontrasting

confidence: 91%

The longitudinal influence of tDCS on occipital GABA and glutamate/glutamine levels in episodic migraineurs

Pohl

Wyss

Sándor

et al. 2023

J of Neuroscience Research

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This study investigated differences in the concentration of gamma-aminobutyric acid (GABA) and the combination of glutamine and glutamate (as GLX) in the early visual cortex of patients with episodic migraine and the influence of transcranial direct current stimulation (tDCS) on GABA and GLX. In this single-blind, sham-controlled trial, we randomly assigned patients with episodic migraine to receive daily anodal tDCS or sham stimulation. In addition, we included healthy controls. We acquired proton MR spectroscopy data of the visual cortex with 3 Tesla MRI at baseline and from migraine patients directly after the stimulation period and 4 months later. In 22 migraineurs and 25 controls, the GABA and the GLX concentrations did not differ at baseline between the groups. tDCS resulted in reduced concentrations of GABA but not GLX or the migraine frequency directly after the stimulation period, but not 4 months later.The changes in the levels of GABA in the early visual cortex of patients with episodic migraine in the interictal period suggest an effect of tDCS that allowed for subsequent changes in the migraine frequency. However, we might have missed relevant variations in the concentrations of these neurotransmitters during the follow-up period, as changes in migraine frequency appeared after the first MRI and disappeared before the second.

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Section: Discussioncontrasting

confidence: 91%

The longitudinal influence of tDCS on occipital GABA and glutamate/glutamine levels in episodic migraineurs

Pohl

Wyss

Sándor

et al. 2023

J of Neuroscience Research

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“…Lastly, a single voxel MRS scan will be collected using the GABA-edited MEGA-PRESS sequence [ 93 ] with the following parameters: TR = 2000 ms, TE = 68 ms, acquisition bandwidth = 2000 Hz, pulse placement edit-on/edit-off = 1.9/7.5 ppm, number of excitations edit-on/edit-off = 64/64 for a total of 128 averages. The voxel will be positioned over the bilateral ACC (35 × 20x20mm) using the T1 images and according to previous literature [ 94 , 95 ]. Two MEGA-PRESS acquisitions edited with GABA will be acquired (4.36 min each) as well as two water-unsuppressed reference scans (0.48 min each).…”

Section: Methodsmentioning

confidence: 99%

A naturalistic study comparing the efficacy of unilateral and bilateral sequential theta burst stimulation in treating major depression – the U-B-D study protocol

Watson,

Chaves,

Gebara

et al. 2023

BMC Psychiatry

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Background Major depressive disorder (MDD) is a prevalent mental health condition affecting millions worldwide, leading to disability and reduced quality of life. MDD poses a global health priority due to its early onset and association with other disabling conditions. Available treatments for MDD exhibit varying effectiveness, and a substantial portion of individuals remain resistant to treatment. Repetitive transcranial magnetic stimulation (rTMS), applied to the left and/or right dorsolateral prefrontal cortex (DLPFC), is an alternative treatment strategy for those experiencing treatment-resistant MDD. The objective of this study is to investigate whether this newer form of rTMS, namely theta burst stimulation (TBS), when performed unilaterally or bilaterally, is efficacious in treatment-resistant MDD. Methods In this naturalistic, randomized double-blinded non-inferiority trial, participants with a major depressive episode will be randomized to receive either unilateral (i.e., continuous TBS [cTBS] to the right and sham TBS to the left DLPFC) or bilateral sequential TBS (i.e., cTBS to the right and intermittent TBS [iTBS] to the left DLPFC) delivered 5 days a week for 4–6 weeks. Responders will move onto a 6-month flexible maintenance phase where TBS treatment will be delivered at a decreasing frequency depending on degree of symptom mitigation. Several clinical assessments and neuroimaging and neurophysiological biomarkers will be collected to investigate treatment response and potential associated biomarkers. A non-inferiority analysis will investigate whether bilateral sequential TBS is non-inferior to unilateral TBS and regression analyses will investigate biomarkers of treatment response. We expect to recruit a maximal of 256 participants. This trial is approved by the Research Ethics Board of The Royal's Institute of Mental Health Research (REB# 2,019,071) and will follow the Declaration of Helsinki. Findings will be published in peer-reviewed journals. Discussion Comprehensive assessment of symptoms and neurophysiological biomarkers will contribute to understanding the differential efficacy of the tested treatment protocols, identifying biomarkers for treatment response, and shedding light into underlying mechanisms of TBS. Our findings will inform future clinical trials and aid in personalizing treatment selection and scheduling for individuals with MDD. Trial registration The trial is registered on https://clinicaltrials.gov/ct2/home (#NCT04142996).

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“…56 Due to their poor efficacy, side effects, and low tolerability, the drugs used in preventive treatment for migraine are limited. 67 In addition to these treatment methods, nonpharmacological treatments are also applied.…”

Section: Treatment Of Migrainementioning

confidence: 99%

“…When the two treatments are compared, acute therapies offer the patient a quick and complete recovery with the fewest side effects . Due to their poor efficacy, side effects, and low tolerability, the drugs used in preventive treatment for migraine are limited . In addition to these treatment methods, non-pharmacological treatments are also applied.…”

Section: Treatment Of Migrainementioning

confidence: 99%

Migraine and Its Treatment from the Medicinal Chemistry Perspective

Pehlivanlar,

Carradori,

Simsek

2024

ACS Pharmacol. Transl. Sci.

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Migraine is a disease of neurovascular origin that affects the quality of life of more than one billion people and ranks sixth among the most common diseases in the world. Migraine is characterized by a moderate or severe recurrent and throbbing headache, accompanied by nausea, vomiting, and photo-phonophobia. It usually starts in adolescence and is twice as common in women as in men. It is classified as with or without aura and has chronic or acute treatment types according to the frequency of occurrence. In acute treatment, analgesics that relieve pain in the fastest way are preferred, while there are different options in chronic treatment. While non-specific methods were used in the treatment of migraine until the 1950s, triptans, ditans, and CGRP-receptor-dependent therapies (monoclonal antibodies and gepants) started to be used in the clinic more recently. In this Review, we focus on the synthesis, side effects, and pharmacological and pharmacokinetic properties of FDA-approved drugs used in acute and preventive-specific treatment of migraine.

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Decreased Brain GABA Levels in Patients with Migraine Without Aura: An Exploratory Proton Magnetic Resonance Spectroscopy Study

Cited by 13 publications

References 44 publications

The longitudinal influence of tDCS on occipital GABA and glutamate/glutamine levels in episodic migraineurs

The longitudinal influence of tDCS on occipital GABA and glutamate/glutamine levels in episodic migraineurs

A naturalistic study comparing the efficacy of unilateral and bilateral sequential theta burst stimulation in treating major depression – the U-B-D study protocol

Migraine and Its Treatment from the Medicinal Chemistry Perspective

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