Conference Coverage
Sphingolipid metabolism is altered in women with episodic migraine, according to a study published online ahead of print September 9 in Neurology. According to the study authors, serum sphingolipid panels may have the potential to differentiate episodic migraine presence and absence. “While more research is needed to confirm these initial findings, the possibility of discovering a new biomarker for migraine is exciting,” said lead author B. Lee Peterlin, DO, Director of Johns Hopkins Headache Research and Associate Professor of Neurology at Johns Hopkins University School of Medicine in Baltimore.
Case–Control Study
In this study, 88 female participants, 52 with episodic migraine and 36 without, were evaluated on the basis of demographic and health-related criteria, including marital status, BMI, and neuronal functioning. The patients also submitted blood samples, which were tested for lipid concentrations among other things.
The findings suggest that migraineurs had a decreased de novo synthesis of ceramides, which, paired with an independent downstream increase in the conversion of ceramide metabolic products, resulted in a major deficit. Women with migraines had an average concentration of ceramide levels of 6,000 ng/mL, a 43% decrease when compared with controls, who had an average of 10,500 ng/mL of ceramide in their blood.
There was also a marked difference in sphingolipid concentrations in those with migraines, with some species increasing while others were decreased. Dr. Peterlin and colleagues used the difference in blood lipid levels to create a list of 10 sphingolipids thought to classify episodic migraine. In a later test, this constructed biomarker evaluative list was 100% effective in identifying women with and without episodic migraine for a small group of eight migraineurs and six controls.
“This study is an important contribution to our understanding of the pathophysiology of migraine and may have vast practical, clinical, and therapeutic implications if it is supported by further studies,” said Karl Ekbom, PhD, a neurologist at the Karolinska Institutet in Stockholm, in an accompanying commentary.
The study suggests that the presence of migraines is a neurologic disorder of sphingolipid dsymetabolism. With the positive identification of these biomarkers comes the potential of targeted drug therapies directed against the specific sphingolipid pathways involved.
—Adaeze Stephanie Onyechi