High Brain Serotonin Levels in Migraine Between Attacks: A 5-HT Receptor Binding PET Study

Overview

Journal Neuroimage Clin

Publisher Elsevier

Specialties Neurology
Radiology

Date 2018 Feb 2

PMID 29387527

Citations 19

Authors

Marie Deen

Hanne D Hansen

Anders Hougaard

Martin Norgaard

Hans Eiberg

Szabolcs Lehel

Messoud Ashina

Gitte M Knudsen

Affiliations

Soon will be listed here.

Abstract

Migraine has been hypothesized to be a syndrome of chronic low serotonin (5-HT) levels, but investigations of brain 5-HT levels have given equivocal results. Here, we used positron emission tomography (PET) imaging of the 5-HT receptor as a proxy for brain 5-HT levels. Given that the 5-HT receptor is inversely related to brain 5-HT levels, we hypothesized that between attacks migraine patients would have higher 5-HT receptor binding compared to controls. Eighteen migraine patients without aura (migraine free >48 h), and 16 age- and sex-matched controls underwent PET scans after injection of [C]SB207145, a specific 5-HT receptor radioligand. An investigator blinded to group calculated a neocortical mean [C]SB207145 binding potential (BP). Three migraine patients reported a migraine attack within 48 h after the scan and were excluded from the primary analysis. Comparing 15 migraine patients and 16 controls, we found that migraine patients have significantly lower neocortical 5-HT receptor binding than controls (0.60 ± 0.09 vs. 0.67 ± 0.05, p = .024), corrected for 5-HTTLPR genotype, sex and age. We found no association between 5-HT receptor binding and attack frequency, years with migraine or time since last migraine attack. Our finding of lower 5-HT receptor binding in migraine patients is suggestive of higher brain 5-HT levels. This is in contrast with the current belief that migraine is associated with low brain 5-HT levels. High brain 5-HT levels may represent a trait of the migraine brain or it could be a consequence of migraine attacks.

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