Migraine patients show significantly higher concentrations of sodium in their cerebrospinal fluid compared to people without the condition, according to new study findings recently presented at the annual meeting of the Radiological Society of North America (RSNA).
The study is the first to use a technique called sodium MRI (magnetic resonance imaging) to evaluate migraine patients.
A migraine is a neurological condition characterized by debilitating head pain and often accompanied by nausea and vomiting. Some migraines involve vision changes or odd sensations in the body known as auras. A migraine is one of the most common headache disorders, affecting about 18 percent of women and 6 percent of men.
Currently, migraine identification is based on symptoms alone, which can sometimes result in misdiagnosis. For example, a person with a severe tension headache may be misdiagnosed as having a migraine and given the wrong type of treatment.
“It would be helpful to have a diagnostic tool supporting or even diagnosing migraine and differentiating migraine from all other types of headaches,” said study author Melissa Meyer, M.D., radiology resident at the Institute of Clinical Radiology and Nuclear Medicine, University Hospital Mannheim and Heidelberg University in Heidelberg, Germany.
Meyer and colleagues turned to a magnetic resonance technique called cerebral sodium MRI as a possible means to help in the diagnosis and understanding of migraines. Although MRIs usually rely on protons to generate an image, sodium can be visualized as well. Previous research has found that sodium plays an important role in brain chemistry.
The study involved 12 women (mean age 34) who had been clinically evaluated for a migraine and 12 healthy women of similar age to serve as a control group. The migraine group filled out a questionnaire regarding the length, intensity, and frequency of their migraine attacks and accompanying auras.
Both groups of women underwent cerebral sodium MRI. Sodium concentrations of migraine patients and healthy controls were compared and statistically analyzed.
The researchers found no statistical differences between the two groups for sodium concentrations in the gray and white matter, brainstem, and cerebellum.
However, significant differences emerged when they looked at sodium concentrations in the cerebrospinal fluid surrounding the brain and spinal cord. This fluid provides a cushion for the brain while also helping to ensure chemical stability for proper brain function.
Overall, migraine patients showed significantly higher sodium concentrations in the cerebrospinal fluid compared to the healthy control group.
“These findings might facilitate the challenging diagnosis of a migraine,” said Meyer. “As this was an exploratory study, we plan to examine more patients, preferably during or shortly after a migraine attack, for further validation.”
Scott Newsome, DO, MSCS, FAANPeer
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