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Abstract
Objective: To evaluate ictal adipokine levels in episodic migraineurs and their association with pain severity and treatment response.
Methods: This was a double-blind, placebo-controlled trial evaluating peripheral blood specimens from episodic migraineurs at acute pain onset and 30 to 120 minutes after treatment with sumatriptan/naproxen sodium vs placebo. Total adiponectin (T-ADP), ADP multimers (high molecular weight [HMW], middle molecular weight, and low molecular weight [LMW]), leptin, and resistin levels were evaluated by immunoassays.
Results: Thirty-four participants (17 responders, 17 nonresponders) were included. In all participants, pretreatment pain severity increased with every quartile increase in both the HMW:T-ADP ratio (coefficient of variation [CV] 0.51; 95% confidence interval [CI]: 0.08, 0.93; p = 0.019) and resistin levels (CV 0.58; 95% CI: 0.21, 0.96; p = 0.002), but was not associated with quartile changes in leptin levels. In responders, T-ADP (CV −0.98; 95% CI: −1.88, −0.08; p = 0.031) and resistin (CV −0.95; 95% CI: −1.83, −0.07; p = 0.034) levels decreased 120 minutes after treatment as compared with pretreatment. In addition, in responders, the HMW:T-ADP ratio (CV −0.04; 95% CI: −0.07, −0.01; p = 0.041) decreased and the LMW:T-ADP ratio (CV 0.04; 95% CI: 0.01, 0.07; p = 0.043) increased at 120 minutes after treatment. In nonresponders, the LMW:T-ADP ratio (CV −0.04; 95% CI: −0.07, −0.01; p = 0.018) decreased 120 minutes after treatment. Leptin was not associated with treatment response.
Conclusions: Both pretreatment migraine pain severity and treatment response are associated with changes in adipokine levels. Adipokines represent potential novel migraine biomarkers and drug targets.
GLOSSARY
- ADP=
- adiponectin;
- CI=
- confidence interval;
- CV=
- coefficient of variation;
- HMW=
- high molecular weight;
- ICHD-2=
- International Classification of Headache Disorders, second edition;
- IL-6=
- interleukin 6;
- LEP=
- leptin;
- LMW=
- low molecular weight;
- MMW=
- middle molecular weight;
- NRS=
- numeric rating scale;
- suma/nap=
- sumatriptan/naproxen sodium;
- T-ADP=
- total adiponectin;
- TNF-α=
- tumor necrosis factor α
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at Neurology.org
- Received August 11, 2014.
- Accepted in final form December 18, 2014.
- © 2015 American Academy of Neurology
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