The role of GABA in chronic migraine pathophysiology

Publicado na 3ª edição de 2008

Chronic Migraine (CM) is a common and debilitating neurological disorder. Its pathophysiology is multifactorial, with probable involvement of the main aminoacids GABA and glutamate. Gabaergic medications are used in migraine treatment including topiramate, divalproate, and propofol. Gabaergic deficiency has been thought to be related to migraine causal mechanisms. This study objective was to analyze GABA levels in the cerebrospinal fluid (CSF) of CM patients. Methods: We studied 54 CM patients diagnosed according to the International Classification of Headache Disorders, second edition (2004). Patients underwent a spinal tap with initial intracranial pressure measurement in order to exclude intracranial idiopathic hypertension, present in 5% to 14% of chronic daily headaches, CM series. CSF controls were obtained from other non painful conditions, matched for age and gender. CSF GABA levels were measured by high resolution liquid chromatography. Results: CM CSF GABA levels (0.151±0.071 ng/mL) were significantly higher than controls (0.123±0.086 ng/mL), p=0.022. Conclusion: Our study shows that GABA levels are higher in patients than controls, in favor of the probable compensatory gabaergic response hypothesis in order to balance the cortical hyperexcitability. Gabaergic medications should be better studied in headache treatment particularly in chronic migraine.

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