The Association Between Clinical Characteristics of Migraine and Brain GABA Levels: An Exploratory Study

Maria-Eliza R Aguila; Trudy Rebbeck; Andrew M Leaver; Jim Lagopoulos; Patrick C Brennan; Markus Hübscher; Kathryn M Refshauge

doi:10.1016/j.jpain.2016.06.008

The Association Between Clinical Characteristics of Migraine and Brain GABA Levels: An Exploratory Study

J Pain. 2016 Oct;17(10):1058-1067. doi: 10.1016/j.jpain.2016.06.008. Epub 2016 Jun 29.

Authors

Maria-Eliza R Aguila¹, Trudy Rebbeck², Andrew M Leaver², Jim Lagopoulos³, Patrick C Brennan², Markus Hübscher⁴, Kathryn M Refshauge²

Affiliations

¹ The University of Sydney Faculty of Health Sciences, Lidcombe, New South Wales, Australia; University of the Philippines College of Allied Medical Professions, Manila, Philippines. Electronic address: magu5636@uni.sydney.edu.au.
² The University of Sydney Faculty of Health Sciences, Lidcombe, New South Wales, Australia.
³ Brain and Mind Centre, Sydney Medical School, Camperdown, New South Wales, Australia; Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland, Australia.
⁴ The University of Sydney Faculty of Health Sciences, Lidcombe, New South Wales, Australia; Neuroscience Research Australia and The University of New South Wales, Randwick, New South Wales, Australia.

PMID: 27369186
DOI: 10.1016/j.jpain.2016.06.008

Abstract

Migraine is prevalent and disabling yet is poorly understood. One way to better understand migraine is to examine its clinical characteristics and potential biomarkers such as gamma-aminobutyric acid (GABA). The primary objective of this study was to explore whether relevant disease characteristics of migraine are associated with brain GABA levels. Twenty adults fulfilling the established diagnostic criteria for migraine and 20 age- and gender-matched controls completed this cross-sectional study. Pain, central sensitization, negative emotional state, and perceived disability were measured using Short-form McGill Pain Questionnaire-2, Central Sensitization Inventory, Depression Anxiety Stress Scales-21, and Headache Impact Test-6, respectively. Secondary analysis of brain GABA levels of the same cohort measured using proton magnetic resonance spectroscopy was conducted. The migraine group had significantly higher scores than the control group on pain, central sensitization, and disability. Correlation analyses showed fair positive association between GABA levels and pain and central sensitization scores. No association was found between GABA levels and emotional state and disability. These findings are preliminary evidence supporting the use of questionnaires and GABA levels in characterizing migraine better and broadening the diagnostic process. These findings also strengthen the rationale for the role of GABA in migraine pathophysiology and corroborate the potential of GABA as a migraine biomarker.

Perspective: Higher pain and central sensitization scores were associated with increased brain GABA levels in individuals with migraine. These findings offer preliminary evidence for the usefulness of measuring pain and central sensitization in migraine and provide some support for the possible role of GABA in migraine pathophysiology and its potential as a diagnostic marker.

Keywords: Gamma-aminobutyric acid; central sensitization; disability; headache; migraine disorders; questionnaires.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Area Under Curve
Brain / diagnostic imaging
Brain / metabolism*
Case-Control Studies
Cross-Sectional Studies
Disability Evaluation
Emotions
Female
Humans
Male
Middle Aged
Migraine Disorders / diagnostic imaging
Migraine Disorders / metabolism*
Pain / diagnostic imaging
Pain / metabolism
Proton Magnetic Resonance Spectroscopy
Psychiatric Status Rating Scales
ROC Curve
Regression Analysis
Self Report
gamma-Aminobutyric Acid / metabolism*

Substances

gamma-Aminobutyric Acid