ABSTRACT

Objective:

Migraine is a common chronic disease, characterised by the recurrence of disabling headache attack, and autonomic nervous system dysfunction. Integrated neurovascular theories have been appropriated in the migraine physiopathology. Vascular changes are responsible for the formation of migraine symptoms. Migraine association is remarkable in young cerebral ischemia cases. Hyperhomocysteinemia is an independent risk factor for vascular diseases such as thrombosis, atherosclerosis, myocardial infarct and ischemic stroke. High homocysteine levels in some patients with this pathology have been determined. Therefore, we investigated hyperhomocysteinemia, which is a probable causal factor of the relationship between migraine and ischemic stroke in patients with migraine with or without aura.

Methods:

Sixty-six migraine patients who fullfilled International Headache Classification- II criteria of migraine with or without aura and 66 sex and age matched controls were included this study. Plasma homocysteine levels were compared in both groups.

Results:

Mean age for both patient and control groups was 35 and there were 21 men and 45 women cases in each group. As average homocysteine levels compared in both groups there was no significant difference (p=0.227). There were 29 migraine with aura and 37 migraine without aura patients in the patient group. Mean homocysteine levels are 11.99 in migraine with aura, and 10.16 in migraine without aura (p=0.223). 8 cases of migraine with aura (27.6% of migraine with aura) and 6 cases of migraine without aura (16.2% of migraine without aura) had homocystein levels above the upper limit. Mean homocysteine levels of male patients were significantly higher than female patients (p=0.02). We did not determine any statistically significant differences between migraine types in terms of age, number of attacks and attack duration. Within the group who had a positive family history, the number of patients with aura was 21 and without aura was 18. On the other hand, in the negative family history group, the number of patients with aura was 8 and without aura was 19. In comparison between the number of attacks, we established that the number of attacks were significantly higher in women than men (p=0.015) and attack durations were significantly longer in women than men (p=0.11). Mean homocysteine levels were compared between the control group, the group of patients with aura and the group without aura. No statistical difference was determined in both groups (p=0.664).

Conclusion:

In this study we detected no significant difference of hyperhomocysteinemia conditions between either the groups of patients with aura and without aura or the control group and all migraine patients. This conclusion may be due to the small patient population and this indicates the necessity for larger population studies. (JAREM 2011; 1: 4-7)