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    Evaluation of serum transforming growth factor ?1 and C-reactive protein levels in migraine patients
    (Via Medica, 2013) Guzel, Isil; Tasdemir, Nebahat; Celik, Yusuf
    Background and purpose: Migraine is a frequent form of headache. Although many mechanisms describing onset of migraine with and without visual aura have been suggested, the aetiology of migraine headaches is still not clear. Neurogenic inflammation may play a key role in the development of migraine headaches. We evaluated the discriminative power of serum levels of C-reactive protein (CRP) and transforming growth factor beta 1 (TGF-beta 1) in patients who presented to our clinic with migraine headaches with or without visual aura. Material and methods: We designed a prospective case-control study of 51 patients with migraine (27 with migraine with aura and 24 with migraine without aura; all had headache) and compared them with 27 healthy subjects during the study period. Demographic and clinical characteristics recorded were age, sex, marital status, occupation, characteristics of headache, laboratory values, and serum CRP and TGF-beta 1 levels. Statistical analyses used Student t-test, the chi(2) test, and AN OVA followed by the post-hoc Bonferroni test for multiple comparisons. Receiver operator characteristic (ROC)-curve analysis for CRP and TGF-beta 1 was also conducted. Result: There was no difference between the groups in terms of demographic characteristics, marital status, and socioeconomic status. Statistically, white blood cell levels, serum glucose levels, triglyceride levels, high-density lipoprotein levels, and serum CRP and TGF-beta 1 were significantly higher in patients with migraine (p < 0.05). The ROC curve results in this study identified that CRP and TGF-beta 1 may discriminate patients who have different types of migraine headache. Conclusions: This study suggests that serum CRP and TGF-beta 1 levels may be diagnostic factors to differentiate migraine patients with and without aura. These findings show that neurogenic inflammation may have a role in the aetiology of migraines.
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    Serum Vitamin B12, Folic Acid and Ferritin Levels in Patients with Migraine
    (Turkish Neurological Soc, 2011) Acar, Abdullah; Evliyaoglu, Osman; Uzar, Ertugrul; Yucel, Yavuz; Cevik, Mehmet Ugur; Guzel, Isil; Colpan, Leyla
    Objective: It has been reported that disability due to migraine may be reduced with homocysteine-lowering treatment including folic acid and vitamin B12. In addition, periaqueductal gray matter iron deposits have been found recently to be increased in migraine patients. There are few studies regarding vitamin B12, folic acid, ferritin, and transferrin levels in patients with migraine. The aim of this study was to measure vitamin B12, folic acid, ferritin, and transferrin levels in patients with migraine and to compare them with the control group. Patients and Methods: Fifty-one consecutive newly diagnosed migraine patients who did not receive any vitamin supplement medication were enrolled. The study group consisted of 51 patients suffering from migraine with aura (n= 23) and migraine without aura (n= 28). The control group consisted of 28 healthy participants without history of headache, anemia or vitamin supplement. Serum vitamin B12, folic acid, ferritin, and transferrin levels were measured using a chemiluminescence method. Results: Migraine patients had significantly lower concentrations of vitamin B12 and folic acid compared with the healthy controls (for vitamin B12: 215.6 +/- 133.7 pg/mL vs. 289.9 +/- 12 pg/mL, respectively, p= 0.005; for folic acid: 6.74 (+/-) 4.31 pg/mL vs. 8.47 +/- 1.85 pg/mL, respectively, p= 0.048). The vitamin B12 levels were found to be significantly lower during attacks in migraine patients than in interictal periods (177.3 +/- 139.2 pg/mL vs. 252.5 +/- 119.5 pg/mL, p= 0.043). There were no differences in folic acid, and transferrin levels during attacks versus in the interictal period in patients with migraine (p>0.05). The ferritin levels were found to be significantly lower during attacks in migraine patients than in interictal periods (43.4 +/- 41.1 mg/mL vs. 75.4 +/- 51.7 mg/mL, respectively, p= 0.018). Conclusion: Migraine patients had lower serum vitamin B12 and folic acid levels than healthy subjects. These findings support that vitamin B12 and folic acid may have a role in migraine pathogenesis and may be included in migraine prophylaxis. Further, this study indicated that iron homeostasis is disturbed in migraine attacks.