High asymmetric dimethylarginine, symmetric dimethylarginine and L-arginine levels in migraine patients

DOI: https://doi.org/10.1007/s10072- 017- 2970- 1

Abstract-Summary NO is synthesized from L-arginine by endothelial NO synthase (NOS).

2.2 Biology

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The aim of this study was to measure the levels of ADMA, SDMA and L-arginine

in migraine patients during the interictal period.

One hundred migraine patients and 100 healthy volunteers were recruited. The patients were in the interictal period and classified into two groups as having

migraine with aura and migraine without aura.

Their serum ADMA, SDMA and L-arginine levels were measured by high-

performance liquid chromotography (HPLC) method.

ADMA, SDMA and L-arginine levels were significantly higher in migraine

patients compared to the control group.

These results suggest that NOS inhibitors and L-arginine/NO pathway plays an

important role in migraine pathopysiology.

Extended: The aim of this study was to investigate the roles of ADMA, SDMA

and L-arginine in migraine pathopysiology.

The patients were in the interictal period and classified as having migraine with aura and migraine without aura according to the International Classification of Headache Disorders (ICHD), second edition [306].

Introduction Experimental and clinical data strongly suggests that nitric oxide (NO) plays a piv- otal role in migraine [307].

This is also supported by studies of migraine induced by substances that release

NO [269, 308].

Glyceryl trinitrate (GTN) is an exogenous nitric oxide donor and is shown to induce spontaneous-like headaches in both migraine patients and healthy volunteers. L-arginine, ADMA and symmetric dimethylarginine (SDMA) share a common

pathway for entry into the cell.

There are only few studies with inconclusive results that evaluated the role of

ADMA and other NOS inhibitors in migraine sufferers.

The aim of this study was to investigate the roles of ADMA, SDMA and

L-arginine in migraine pathopysiology.

Material and Methods One hundred prospective consecutive patients suffering from migraine and 100 healthy volunteers who were age- and gender-matched to the patient group were included to the study.

The patients were in the interictal period and classified as having migraine with aura and migraine without aura according to the International Classification of Headache Disorders (ICHD), second edition [306].

Patients with hypertension, cardiovascular diseases, diabetes mellitus, hyperlip- idemia, stroke, peripheral arterial diseases, chronic renal failure, thyroid disorders and psychiatric illness were excluded from the study as these may alter the levels of ADMA, SDMA and L-arginine [309, 310].

Blood samples from migraine patients and healthy volunteers were analysed.

Statistical Analysis All statistical analysis were performed using the Statistica 7.0 pocket programme (Installer code:31 N6YUCV38).

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2 Mechanisms

Comparisons between groups were performed using the Mann-Whitney U test. In all tests, p < 0.05 was considered statistically significant.

Results One hundred consecutive patients (85% female, 15% male) with a mean age of 33.7 ± 9.9 years (min-max; 18–65) diagnosed as migraine according to the IHS criteria were included in the study.

Subanalysis of the patients with migraine according to having prophylactic ther- apy or not revealed no difference for the levels of serum ADMA, SDMA and L-arginine (0.64 ± 0.14 μmol/L vs. 0.70 ± 0.25 μmol/L, 0.41 ± 0.09 μmol/L vs. 0.42 ± 0.08 μmol/L, 103.8 ± 34.4 μmol/L vs. 97.0 ± 40.1 μmol/L, respectively, all com- parisons p = 0.05<) ADMA levels were correlated with age and L-arginine levels were associated with pain intensity positively (p = 0.020 and p = 0.021, respectively). There was no correlation between the serum ADMA, SDMA and L-arginine

concentrations and disease duration, attack duration and pain frequency.

Discussion Our study showed higher serum concentrations of ADMA levels in migraine patients compared to the control group but there was no significant difference in patients with and without aura.

The same study also compared the levels of ADMA and NO in migraine patients

during the attack and headache-free period and reported no difference.

There was no significant difference for serum concentrations of ADMA levels in migraine patients with and without aura similar to two previous studies [311, 312]. We found high serum L-arginine levels in migraine patients compared to control group but there was no difference in subanalysis of patients with and without aura. Our study showed high ADMA, SDMA and L-arginine concentrations in migraine patients compared to the control group, but the role of NO in migraine is still unclear.

Acknowledgement A machine generated summary based on the work of Reyhani, Aylin; Celik, Yahya; Karadag, Hakan; Gunduz, Ozgur; Asil, Talip; Sut, Necdet. 2017  in Neurological Sciences.

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