Abnormal metabolites in the dorsolateral prefrontal cortex of female epilepsy patients with migraine without aura – PubMed Black Hawk Supplements

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Epilepsy and migraine without aura (MWoA) are often comorbid, but the exact mechanisms are unclear. Magnetic resonance spectroscopy (1H-MRS) may help to understand the neurometabolic mechanisms in patients with epilepsy comorbid with MWoA (EWM). In this prospective cross-sectional study, we recruited 64 female patients, including 24 with EWM, 20 with epilepsy, and 20 with MWoA, as well as 20 age-level-matched and educational-level-matched female healthy controls from our hospital between August…
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Abnormal metabolites in the dorsolateral prefrontal cortex of female epilepsy patients with migraine without aura - PubMed

. 2024 Dec 11;35(18):1155-1162.

doi: 10.1097/WNR.0000000000002110. Epub 2024 Nov 6.

Affiliations

Abnormal metabolites in the dorsolateral prefrontal cortex of female epilepsy patients with migraine without aura

Liping Wang et al. Neuroreport. .

Abstract

Epilepsy and migraine without aura (MWoA) are often comorbid, but the exact mechanisms are unclear. Magnetic resonance spectroscopy (1H-MRS) may help to understand the neurometabolic mechanisms in patients with epilepsy comorbid with MWoA (EWM). In this prospective cross-sectional study, we recruited 64 female patients, including 24 with EWM, 20 with epilepsy, and 20 with MWoA, as well as 20 age-level-matched and educational-level-matched female healthy controls from our hospital between August 2021 and November 2022. A single-voxel point-resolved spectroscopy sequence was used to acquire spectra of the bilateral dorsolateral prefrontal cortices (DLPFCs). Metabolites were quantified by linear combination model software, and the values were corrected for the partial volume effect of cerebrospinal fluid. MRS data comparisons were performed with multivariate analyses of variance. Correlation analyses were calculated between metabolites and main clinical data. The results showed that N-acetyl aspartate (NAA) was asymmetrical between the bilateral DLPFCs. Both NAA and myoinositol were significantly reduced in EWM than in healthy controls. Choline-containing compounds (Cho) were higher in MWoA than in the other three groups. Correlation analyses revealed that NAA of the right DLPFC and Cho of the bilateral DLPFCs in EWM were negatively related to migraine frequency. In addition, glutamate and glutamine (Glu and Gln, Glx) of the right DLPFC in EWM were negatively correlated with migraine severity. Our findings suggested that comorbid epilepsy and MWoA in female patients can lead to a synergistic reduction of both NAA and myoinositol, reflecting more serious injuries of neurons and glial cells.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Fig. 1
Fig. 1

(a) Metabolite concentration (Ins, myoinositol; Cho, choline-containing compounds; Cr, creatine and phosphocreatine; Glx, glutamate and glutamine; NAA, N-acetyl aspartate) estimated by LCmodel. (b), (c) and (d), respectively, correspond to the axial, coronal, and sagittal views of reference images, and white boxes represent the locations of the volumes of interest (VOIs) in the bilateral dorsolateral prefrontal cortices (DLPFCs).

Fig. 2
Fig. 2

Metabolic differences in locations [left and right dorsolateral prefrontal cortices (DLPFCs)] and groups (EP, MWoA, EWM, and HCs). (a) Metabolic differences between the left and right DLPFCs. The comparison revealed that NAA was asymmetrical, with a higher level in the left DLPFC than in the right (P = 0.031). (b) Metabolic differences among the four groups. The multiple comparison revealed that both NAA and Ins were significantly reduced in EWM when compared with HCs (P = 0.030 and 0.038). In addition, MWoA had a higher Cho level than that of HCs, EP and EWM (P = 0.036, 0.047, and 0.007). The upper edge and whisker of the rectangle represent the mean and range, respectively. Cho, choline-containing compounds; Cr, creatine and phosphocreatine; EP, epilepsy; EWM, EP comorbid with MWoA; Glx, glutamate and glutamine (Glx, Glu and Gln); HCs, healthy controls; Ins, myoinositol; L, the left DLPFC; MWoA, migraine without aura; NAA, N-acetyl aspartate; R, the right DLPFC.. P < 0.05 indicates statistical significance.

Fig. 3
Fig. 3

(a–c) Correlations between metabolite concentrations and migraine frequency in EWM. (d) Correlations between metabolite concentrations and Visual Analog Scale (VAS) score for migraine severity in EWM. Both NAA of the right DLPFC (r = −0.685, P = 0.001) and Cho of the bilateral DLPFCs (left, r = −0.485, P = 0.035; right, r = −0.593, P = 0.008) in EWM showed a negative correlation with migraine frequency. In addition, the Glx of the right DLPFC in EWM was negatively related to the VAS score for migraine severity (r = −0.476, P = 0.039). The solid line represents the linear regression line; the dotted line represents the 95% confidence interval of the linear fit. Cho, choline-containing compounds; EWM, EP comorbid with MWoA; EP, epilepsy; MWoA, migraine without aura; Glx, glutamate and glutamine (Glx, Glu and Gln); L, left DLPFC; NAA, N-acetyl aspartate; R, right DLPFC.

References

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Abnormal metabolites in the dorsolateral prefrontal cortex of female epilepsy patients with migraine without aura – PubMed