Investigating the Role of Oxidant-Antioxidant Balance in the Etiology of Migraine

Abstract

Aim: Migraine, a prevalent neurovascular disorder, is marked by repetitive headache episodes. Its complex etiology encompasses biochemical, genetic, and environmental influences, but its exact pathophysiology remains elusive. Recent studies have hinted at a link between migraine and oxidative stress. Hence, this study sought to delve into the correlation between migraine, oxidative stress markers, and lipid profiles. Material and Method: This case-control study involved 60 adult migraine patients from Dicle University's Neurology Department in Diyarbakır, Türkiye, observed between 2009 and 2010. The control group was age- and gender-matched healthy individuals. Parameters like malondialdehyde (MDA), paraoxonase-1 (PON-1), total antioxidant capacity (TAC), and lipid constituents such as total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were measured in both groups. Results: Migraine sufferers, particularly those with aura, had significantly elevated MDA levels compared to controls (p<0.05). Conversely, TAC and PON-1 levels were notably lower in the migraine population, suggesting an imbalance in their oxidant/antioxidant systems (p<0.05). Lipid analysis showed heightened TC, LDL-C, and TG in migraine patients, while HDL-C was diminished, with marked differences in subgroups (p<0.05). Conclusion: The surge in MDA and the decline in TAC and PON-1 levels insinuate that oxidative stress plays a pivotal role in migraine's pathophysiology. The lipid profile alterations in migraineurs highlight potential cardiovascular concerns. Comprehensive cohort studies are essential to confirm these findings and understand the intricate ties between migraine, oxidative stress, and metabolic indicators. This research underscores oxidative balance's potential significance in migraine pathogenesis, emphasizing the need to consider oxidative stress in migraine management and prevention strategies.

Keywords

• Migraine disorders
• oxidative stress
• malondialdehyde
• aryldialkylphosphatase
• lipids
• cardiovascular diseases

Kaynakça

1. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia Int J Headache. 2018;38:1-211.
2. Burch R, Rizzoli P, Loder E. The prevalence and impact of migraine and severe headache in the United States: Updated age, sex, and socioeconomic specific estimates from government health surveys. Headache J Head Face Pain. 2021;61:60-8.
3. Qubty W, Patniyot I. Migraine Pathophysiology. Pediatr Neurol. 2020;107:1-6.
4. Geyik S, Altunısık E, Neyal AM, Taysi S. Oxidative stress and DNA damage in patients with migraine. J Headache Pain. 2016;17:10.
5. Dong X, Guan X, Chen K, et al. Abnormal mitochondrial dynamics and impaired mitochondrial biogenesis in trigeminal ganglion neurons in a rat model of migraine. Neurosci Lett. 2017;636:127-33.
6. Varadhan S, Venkatachalam R, Perumal SM, Ayyamkulamkara SS. Evaluation of oxidative stress parameters and antioxidant status in coronary artery disease patients. Arch Razi Inst. 2022;77:853-9.
7. Tsikas D, Mikuteit M. N-Acetyl-L-cysteine in human rheumatoid arthritis and its effects on nitric oxide (NO) and malondialdehyde (MDA): analytical and clinical considerations. Amino Acids. 2022;54:1251-60.
8. Godbole C, Thaker S, Salagre S, et al. A prospective study to assess the role of paraoxonase 1 genotype and phenotype on the lipid-lowering and antioxidant activity of statins. Indian J Pharmacol. 2023;55:179-84.

9. Mehvari F, Imanparast F, Mohaghegh P, et al. Protective effects of paraoxonase-1, vitamin E and selenium, and oxidative stress index on the susceptibility of low density lipoprotein to oxidation in diabetic patients with/without coronary artery disease. Eur J Med Res. 2023;28:300. Erratum in: Eur J Med Res. 2023;28:459.
10. Nasreen FJ, Balasubramaniam G. Paraoxonase gene polymorphisms: understanding the biochemical and genetic basis of coronary artery disease. J Taibah Univ Med Sci. 2023;18:257-64.
11. Rico D, Cano AB, Álvarez Álvarez S, et al. Study of the total antioxidant capacity (TAC) in native cereal−pulse flours and the influence of the baking process on TAC using a combined bayesian and support vector machine modeling approach. Foods. 2023;12:3208.
12. Togha M, Rahimi P, Farajzadeh A, et al. Proteomics analysis revealed the presence of inflammatory and oxidative stress markers in the plasma of migraine patients during the pain period. Brain Res. 2022;1797:148100.
13. Dini E, Mazzucchi S, De Luca C, et al. Plasma levels of oxidative stress markers, before and after BoNT/A treatment, in chronic migraine. Toxins. 2019;11:608.
14. Bhoi S, Nanda R, Dash S, et al. Status of inflammatory and anti-inflammatory parameters in migraine: a case-control study. Int J Med Rev Case Rep. 2022;6:33-6.
15. İçme F, Erel O, Avci A, et al. The role of oxidative stress markers in the pathophysiology of migraine and after treatment. Neurosurg Q. 2014;24:286-90.
16. Yang Z, Xu P, Geng C, Zhang H. Evaluation of simple antioxidant blood parameters in patients with migraine. Front Neurol. 2022;13:939363.
17. Togha M, Razeghi Jahromi S, Ghorbani Z, et al. An investigation of oxidant/antioxidant balance in patients with migraine: a case-control study. BMC Neurol. 2019;19:323.
18. Eren Y, Dirik EB, Neşelioğlu S, Erel Ö. Serum lipid profiles, relationship between paraoxonase/arylesterase activity and high-density lipoprotein levels in patients with migraine. Turk J Neurol. 2017;23:117-21.
19. Lai J, Dilli E. Migraine aura: updates in pathophysiology and management. Curr Neurol Neurosci Rep. 2020;20:17.
20. Zhao M, Li Y, Bai X, Feng J, Xia X, Li F. Inhibitory effect of guava leaf polyphenols on advanced glycation end products of frozen chicken meatballs (−18°C) and its mechanism analysis. Foods. 2022;11:2509.
21. Adkins S, Gan KN, Mody M, La Du BN. Molecular basis for the polymorphic forms of human serum paraoxonase/arylesterase: glutamine or arginine at position 191, for the respective A or B allozymes. Am J Hum Genet. 1993;52:598-608.
22. Erel O. A novel automated direct measurement method for total antioxidant capacity using a new generation, more stable ABTS radical cation. Clin Biochem. 2004;37:277-85.
23. Bernecker C, Ragginer C, Fauler G, et al. Oxidative stress is associated with migraine and migraine-related metabolic risk in females. Eur J Neurol. 2011;18:1233-9.
24. Yıldırım S, Akar S, Kuyucu M, et al. Paraoxonase 1 gene polymorphisms, paraoxonase/arylesterase activities and oxidized low-density lipoprotein levels in patients with migraine. Cell Biochem Funct. 2011;29:549-54.
25. Çakina S, Yücel S, Polat CÇ, Öztürk Ş. Oxidative stress parameters in patients with migraine without aura. Namık Kemal Tıp Derg. 2020;8:31-5.
26. Tripathi GM, Kalita J, Misra UK. A study of oxidative stress in migraine with special reference to prophylactic therapy. Int J Neurosci. 2018;128:318-24.
27. Kurth T, Gaziano JM, Cook NR, et al. Migraine and Risk of Cardiovascular Disease in Women. JAMA. 2006;296:283. Erratum in: JAMA. 2006 Aug 9;296(6):654. Erratum in: JAMA. 2006;296:1 p following 291.
28. Tana C, Santilli F, Martelletti P, et al. Correlation between migraine severity and cholesterol levels. Pain Pract. 2015;15:662-70.
29. Maghbooli M, Jameshorani M, Afshar S, Kamali K. The prevalence of metabolic syndrome parameters and their association with headache characteristics among migraineurs. Curr J Neurol. 2021;20:190-201.
30. Uygur-Kucukseymen E, Akca G. Serum lipid profile in migraine and its association with clinical characteristics. Neurol Res. 2023;45:57-61.