Sunay AYALP, ŞEVKİ ŞAHİN, Fehime Benli AKSUNGAR, SİBEL KARŞIDAĞ

Aurasız migrende trombosit serotonin düzeylerinin değerlendirilmesi

Amaç: Migren ile serotonin düzeyleri arasındaki ilişki net değildir. Daha önceki çalışmalarda migrenlilerde plazma serotonin düzeyleri araştırılmıştır. Ancak, güncel literatürde santral sinir sistemindeki düzeyi yansıtması açısından trombositlerdeki serotonin düzeyinin daha güvenilir sonuçlar vereceği belirtilmektedir. Gereç ve Yöntem: Çalışma Uluslararası Başağrısı Derneğinin ölçütlerine göre tanı almış 30 aurasız migrenli kadın hasta ile yaş ve cinsiyet olarak uyumlu 20 sağlıklı kontrolle gerçekleştirildi. Tüm hasta ve kontrollere Hamilton depresyon ölçeği (HAM-D) uygulandı ve 10 puanın üzerinde alanlar çalışmaya alınmadı. Olgulardan sabah açlık venöz kan örnekleri alındı. Trombositten zengin ve fakir plazma hazırlanarak yüksek performanslı sıvı kromatografisi cihazında değerlendirildi ve trombosit serotonin konsantrasyonu hesaplandı. Bulgular: Çalışmamızda migrenlilerin trombosit serotonin konsantrasyonunu kontrol gurubuna göre istatistiksel olarak anlamlı düzeyde düşük olduğu saptandı. Hasta grubunda ailede migren görülme oranı kontrol grubundan belirgin oranda yüksek bulundu. Migrenlilerin HAM-D puanları kontrol grubundan belirgin düzeyde yüksek bulundu. Atak sayısı ve süresi ile düşük serotonin düzeyleri arasında zayıf bir korelasyon görülse de istatiksel olarak anlamlı bir ilişki saptanmadı. Sonuç: Sonuçlarımız migren patojenezinde düşük serotonin düzeylerine ve migrende kalıtımın rolüne işaret etmektedir. Çalışmaya alınan tüm olgular klinik depresyon puanının altında seçilmiş olmalarına rağmen, migrenlilerde kontrollere göre HAM-D puanları daha yüksek bulunmuştur. Bu durum migrenlilerde düşük serotonin düzeyi ile ilişkili subklinik depresyonun varlığına işaret edebilir. Hem ağrılı hem de ağrısız dönemleri içeren ve serotonin dışında da belirteçleri kapsayan geniş ölçekli çalışmalara ihtiyaç vardır.

Evaluation of platelet serotonin levels in migraine without aura

Objectives: The relation between migraine and serotonin levels is not clear. Plasma serotonin levels in migraineurs were investigated in previous studies. However, in the current literature, it is stated that measurement of serotonin level in platelets is more reliable. Methods: Thirty female migraine without aura patients who were diagnosed according to the criteria of the International Headache Society and 20 healthy controls were enrolled in the study. The Hamilton depression scale (HAM-D) was applied to all subjects and those scoring 10 and above were not considered. Fasting venous blood samples were taken from subjects in the morning. Platelet rich and poor plasma were prepared. The samples were measured with high performance liquid chromatography and platelet serotonin concentration was calculated. Results: Our results suggest that migraineurs have significantly low platelet serotonin concentration compared to controls. The ratio of family history of migraine in the patient group was clearly higher than in controls. HAM-D scores were significantly higher in migraineurs than in the control group. Although there was a weak correlation between low serotonin levels and attack duration and number, there was no statistical significance. Conclusion: Our results suggest the role of heredity and low serotonin levels in the migraine pathogenesis. Even though all subjects enrolled in the study had scores under the depression level, HAM-D scores were higher in migraineurs than controls. This may indicate the presence of subclinical depression associated with low serotonin levels in migraineurs. Extensive studies including both serotonin and other markers during pain and pain-free periods are needed.

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