Raza, Neelofer (2000) The biochemistry of migraine: investigation of systems involving 5-hydroxytryptamine and magnesium. (PhD thesis), Kingston University.Full text not available from this archive.
Although the pathogenesis of migraine remains to be fully elucidated, recent studies have implicated the involvement of the neurotransmitter serotonin (5-hydroxytryptamine, 5-HT) and also magnesium. This thesis has further explored the role of 5-HT and magnesium in migraine pathogenesis and also the effects of red wine, believed to trigger migraine in some individuals. Central serotonergic functioning was investigated in migraine and tension-type headache patients by neuroendocrine challenge test, using oral fenfluramine, which stimulates the release of 5-HT from hypothalamic neurones, causing a dose dependent release of prolactin from the pituitary. Plasma prolactin was significantly raised in tension-type headache patients compared with controls, suggesting a central serotonergic supersensitivity. Fenfluramine triggered a headache in most migraine and tension-type headache patients and headache scores positively correlated with prolactin response. Temperature, also under partial control by central 5-HT mechanisms, was significantly raised in migraine patients compared with controls. These findings suggest supersensitivity in the central 5-HT system in tension-type headache, but not in migraine, however, further investigation is required in migraineurs. Plasma prolactin and cortisol measurements were used to determine if red wine acts on 5-HT centrally. No changes were found following red wine administration in controls and migraineurs, suggesting it does not. Migraineurs exhibited significantly lower mean phenolsulphotransferase (PST) P and M levels compared with controls, levels in diet sensitive patients being further reduced compared with non-diet sensitive patients and controls. Red wine is known to inhibit PST in vitro. This research demonstrated that red wine also significantly inhibited PST P in vivo in controls. Urinary magnesium (Mg[sup]2+) excretion was found to be significantly increased during attack compared with migraineurs not in attack and controls. The effect of red wine on Mg[sup]2+ homeostasis was investigated in controls by examining the effects of red wine ingestion on serum Mg[sup]2+, which did not alter, and urinary Mg[sup]2+ levels which significantly increased, implying a general release of Mg[sup]2+ from body stores. However, this also occurred after vodka and white wine ingestion, suggesting this effect is not specific to red wine. Stress is a commonly quoted migraine precipitant. Urinary Mg[sup]2+ was investigated in controls when stressed and stress free, no significant difference was found. In conclusion, this thesis has provided many observations which require further research. A significant supersensitivity in the central serotonergic system has been demonstrated in tension-type headache, but not in migraine. Furthermore, centraI release of 5-HT has been shown not to be involved in the mechanism of a red wine induced migraine attack. This thesis has also provided the first evidence of a reduced PST M and P activity in specifically red wine sensitive migraineurs. Further indication as to the general depletion of magnesium from the body during a migraine attack has also been provided.
|Item Type:||Thesis (PhD)|
|Additional Information:||In collaboration with Queen Charlotte's Hospital and Charing Cross Hospital.|
|Physical Location:||This item is held in stock at Kingston University Library.|
|Depositing User:||Automatic Import Agent|
|Date Deposited:||09 Sep 2011 21:39|
|Last Modified:||23 May 2014 13:26|
Actions (Repository Editors)
|Item Control Page|