This study evaluates biochemical and metabolic imbalances that may result in a collection of dysfunctional pathways that are distinct in migraineurs. The high sensitivity and spectral dispersion available to 1H MRS at 21.1 T expanded metabolic profiling in an animal model of migraine to include total creatine (tCr), choline (Cho), N-acetyl-aspartate (NAA), myoinositol (mI), lactate (Lac), taurine (Tau), aspartate (Asp), Glx, a mixture of glutamate, glutamine and GABA, and Gly, the latter identified as a mixture of glycine, glutamine, and glutamate. For the migraine analogue, Lac, Gly and Tau increased while tCr decreased temporally and in comparison to saline controls.
Animal Model: To induce a migraine analogue in rodents, 17 anesthetized Sprague-Dawley male rats were administered an in situ intraperitoneal injection of either nitroglycerine (NTG, N=11) to induce central sensitization (CS) related to migraine or saline (N=6) as a control.
MRS protocol: All scans were performed using the 21.1-T, 900-MHz ultra-wide bore at the National High Magnetic Field Laboratory, Tallahassee, FL. A home-guilt linear 1H/23Na birdcage coil was used for all acquisitions. A highly selective Relaxation Enhanced MRS (RE-MRS)2 sequence was utilized to target upfield metabolites from a (4-mm)3 voxel, without water suppression. Selective excitation was accomplished with a 5-ms 10-lobe, sinc-shaped pulse, and a 5-ms 180° refocusing pulse derived from the Shinnar-LeRoux algorithm (SLR), exciting a band between 0-4 ppm without touching the water resonance. 3D spectroscopic localization was achieved using six 5-ms adiabatic pulses with localization by an adiabatic selective refocusing (3D LASER) methodology. A total of 14 scans (10 min/scan) were acquired from pre-injection to 2.5-h post injection.
Data Analysis: Data was acquired as a partial echo, and magnitude spectra were generated after apodization (10-Hz exponential line broadening) and Fourier transform. No modeling or deconvolution of spectral components was performed. This raw data time course was normalized to the NAA peak (found experimentally to be static in NTG and saline over all data points) and was further referenced to the pre-injection value. Individual time points from all animals in the NTG and saline groups based on these time series were averaged to determine trends and significance. A mixed model ANOVA with repeated measures was used to conduct the with-in subject and between subject analysis.
These metabolic changes (rapid increase in lactate with a subsequent relative increase in taurine compared to controls) indicate that an altered metabolic profile results from NTG. The rapid elevation of lactate may reflect increased neural activity and associated ionic imbalances, alteration in glucose metabolism and/or vasodilation at the early stage of CS in the migraine analogue. The elevated levels of taurine may be evidence of reactive neuroprotective and osmoregulatory mechanisms. These metabolic substrates reflect the physiological cascade involved in CS. Elevated lactate and taurine may be biomarkers in future studies to investigate chronic migraine progression and intervene clinically.
1. Harrington M, Fonteh A, Cowan R, Perrine K, Pogoda J, Biringer R, Huhmer A. Cerebrospinal fluid sodium increases in migraine. Headache 2006;46(7):1128-35.
2. Shemesh N, Rosenberg JT, Dumez J, Muniz JA, Grant SC, Frydman L. Metabolic properties in stroked rats revealed by relaxation-enhanced magnetic resonance spectroscopy at ultrahigh fields. Nat Commun 2014;5:4958.