Cerebral energetic metabolism of individuals with migraine through 31P-MRS: A systematic review

Abstract

Introduction: Migraine has a neurological origin and is characterized by failure of central modulation leading to neuronal hyperexcitability. Among the factors related to such excitability is the mitochondrial dysfunction that has been considered since the 1980s. Objective: To investigate changes in the cerebral energetic metabolism of individuals with migraine through phosphorus magnetic resonance spectroscopy (31P-MRS). Methods: It was searched articles on Pubmed, Web of Science and Science Direct betweenof June, 2018 and February, 2019. There was no restriction regarding the year of publication and language. The combination of the descriptors used for this systematic review was: Migraine AND Magnetic resonance spectroscopy [MESH]. The inclusion criteria chosen were: original articles using 31P-MRS in individuals diagnosed with migraine (with and/or without aura); studies with adults between 18 and 60 years of age diagnosed with episodic or chronic migraine; with control group of individuals without migraine and without pathologies or conditions that would interfere in the results. Excluded were articles: incomplete or unpublished; animal studies; and research protocol articles. Results: Of the 319 articles found, nine were selected. The sample totaled 216 individuals with migraine (53.7% without aura) and 233 healthy individuals in the control group. It was verified a reduction of phosphocreatine, phosphorylation potential, Mg2+ and ATP, whereas it was observed increase of inorganic phosphate and ADP. Conclusion: There are alterations in cerebral energetic metabolism in individuals with migraine, revealing mitochondrial dysfunction. However, it is needed more studies with higher quality and analysis of the relationships with the socio-demographic and clinical variables.