Plasma level of calcitonin gene-related peptide in the diagnosis of episodic migraine with comorbid conditions

Authors

DOI:

https://doi.org/10.14739/2310-1210.2022.6.261741

Keywords:

episodic migraine, cervicalgia, calcitonin-gene-related peptide, biomarkers, diagnostics

Abstract

Comorbid and co-occurring diseases are risk factors for the progression of episodic migraine to chronic migraine. Biomarkers for migraine could help with diagnosis and treatment selection and monitoring.

Aim. To examine the role of the plasma level of calcitonin-gene-related peptide (CGRP) in the diagnosis of episodic migraine in combination with comorbid conditions in the form of cervicalgia and psychoemotional disorders.

Materials and methods. The study included 112 patients (84 women, 28 men; mean age 18-58 years), episodic migraine with typical aura – 17, without aura – 60. Patients were divided into 3 groups: I – episodic migraine with cervicalgia (n = 42), II – episodic migraine only (n = 35), III – cervicalgia only (n = 35).

The Visual Analogue Scale, Migraine Disability Assessment (MIDAS) score, Headache Impact Test (HIT-6), Neck Disability Index, State-Trait Anxiety Inventory, Beck’s Depression Inventory and the number of days with headache were assessed. The control group consisted of 30 healthy persons to compare the level of CGRP. The serum level of CGRP was determine by enzyme-linked immunosorbent assay using the sandwich ELISA principle.

Results. Plasma level of CGRP was higher in groups I and II compared with group III (P = 0.012543), where it did not differ from the control (51.48 ± 5.08 pg/ml). The highest level of CGRP was observed in group I (242.98 ± 5.08 pg/ml) in comparison with group II (145.82 ± 15.38 pg/ml, P = 0.000341). Co-occurring neck-pain in patients with episodic migraine was associated with mood and anxiety disorders.

Migraine severity, according to the MIDAS score, was most significantly influenced by plasma level of CGRP, severity of subjective and objective symptoms of headache by the HIT-6, level of State-anxiety and Trait-anxiety, number of days with headache during the last 3 months.

Conclusions. The serum level of CGRP is a reliable diagnostic and differential diagnostic laboratory biomarker for episodic migraine. Additional painful syndrome such as cervicalgia influences CGRP level and daily activity, mood and anxiety disorders in episodic migraine patients.

Author Biographies

O. Ye. Dubenko, Kharkiv Medical Academy of Postgraduate Education, Ukraine

MD, PhD, DSc, Professor of the Department of Neurosurgery, Neurology and Reflexotherapy

A. O. Chernenko, Kharkiv Medical Academy of Postgraduate Education, Ukraine

Assistant of the Department of Clinical Informatics and Information Technologies in Health Management

References

Steiner, T. J., Stovner, L. J., Jensen, R., Uluduz, D., Katsarava, Z., & Lifting The Burden: the Global Campaign against Headache (2020). Migraine remains second among the world's causes of disability, and first among young women: findings from GBD2019. The journal of headache and pain, 21(1), 137. https://doi.org/10.1186/s10194-020-01208-0

Dodick, D. W. (2018). Migraine. Lancet, 391(10127), 1315-1330. https://doi.org/10.1016/S0140-6736(18)30478-1

Ashina, M. (2020). Migraine. The New England journal of medicine, 383(19), 1866-1876. https://doi.org/10.1056/NEJMra1915327

Buse, D. C., Reed, M. L., Fanning, K. M., Bostic, R., Dodick, D. W., Schwedt, T. J., Munjal, S., Singh, P., & Lipton, R. B. (2020). Comorbid and co-occurring conditions in migraine and associated risk of increasing headache pain intensity and headache frequency: results of the migraine in America symptoms and treatment (MAST) study. The journal of headache and pain, 21(1), 23. https://doi.org/10.1186/s10194-020-1084-y

Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd ed. (2018). Cephalalgia, 38(1), 1-211. https://doi.org/10.1177/0333102417738202

Vernon, H., & Mior, S. (1991). The Neck Disability Index: a study of reliability and validity. Journal of manipulative and physiological therapeutics, 14(7), 409-415.

Delgado, D. A., Lambert, B. S., Boutris, N., McCulloch, P. C., Robbins, A. B., Moreno, M. R., & Harris, J. D. (2018). Validation of Digital Visual Analog Scale Pain Scoring With a Traditional Paper-based Visual Analog Scale in Adults. Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, 2(3), e088. https://doi.org/10.5435/JAAOSGlobal-D-17-00088

Loder, E., & Burch, R. (2012). Measuring pain intensity in headache trials: which scale to use?. Cephalalgia, 32(3), 179-182. https://doi.org/10.1177/0333102411434812

Stewart, W. F., Lipton, R. B., Kolodner, K. B., Sawyer, J., Lee, C., & Liberman, J. N. (2000). Validity of the Migraine Disability Assessment (MIDAS) score in comparison to a diary-based measure in a population sample of migraine sufferers. Pain, 88(1), 41-52. https://doi.org/10.1016/S0304-3959(00)00305-5

Yang, M., Rendas-Baum, R., Varon, S. F., & Kosinski, M. (2011). Validation of the Headache Impact Test (HIT-6™) across episodic and chronic migraine. Cephalalgia, 31(3), 357-367. https://doi.org/10.1177/0333102410379890

Cosco, T. D., Prina, M. A., Stubbs, B., & Wu, Y. (2017). Reliability and Validity of the Center for Epidemiologic Studies Depression Scale in a Population-Based Cohort of Middle-Aged U.S. Adults. Journal of Nursing Measurement, 25(3), 476-485. https://doi:org/10.1891/1061-3749.25.3.476

Heeren, A., Bernstein, E. E., & McNally, R. J. (2018). Deconstructing trait anxiety: a network perspective. Anxiety, stress, and coping, 31(3), 262-276. https://doi.org/10.1080/10615806.2018.1439263

Ferroni, P., Barbanti, P., Spila, A., Fratangeli, F., Aurilia, C., Fofi, L., Egeo, G., & Guadagni, F. (2019). Circulating Biomarkers in Migraine: New Opportunities for Precision Medicine. Current medicinal chemistry, 26(34), 6191-6206. https://doi.org/10.2174/0929867325666180622122938

Yan, B. M., Gibson Depoy, E. M., Ahmad, A., & Nahas, S. J. (2021). Biomarkers in Migraine. Neurology India, 69(Supplement), S17-S24. https://doi.org/10.4103/0028-3886.315988

Do, T. P., Guo, S., & Ashina, M. (2019). Therapeutic novelties in migraine: new drugs, new hope?. The journal of headache and pain, 20(1), 37. https://doi.org/10.1186/s10194-019-0974-3

Charles, A., & Pozo-Rosich, P. (2019). Targeting calcitonin gene-related peptide: a new era in migraine therapy. Lancet, 394(10210), 1765-1774. https://doi.org/10.1016/S0140-6736(19)32504-8

Downloads

Published

2022-12-20

How to Cite

1.
Dubenko OY, Chernenko AO. Plasma level of calcitonin gene-related peptide in the diagnosis of episodic migraine with comorbid conditions. Zaporozhye Medical Journal [Internet]. 2022Dec.20 [cited 2024Dec.28];24(6):658-64. Available from: http://zmj.zsmu.edu.ua/article/view/261741

Issue

Vol. 24 No. 6 (2022)

Section

Original research

License

Authors who publish with this journal agree to the following terms:

    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.  Лицензия Creative Commons
    2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
    3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)