CSF GLUTAMATE LEVELS ARE DECRESED IN

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CSF GLUTAMATE LEVELS ARE DECRESED IN CHRONIC
MIGRAINE PATIENTS USING TRIPTANS Peres MFP,
Vieira DSS, Zukerman E, Soares CAS, Alonso EO,
Faulhaber MHW Hospital Israelita Albert Einstein,
Instituto de Ensino e Pesquisa.
B053
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Introduction Chronic migraine (CM) is a common
and debilitating condition. There has been a
great impact in migraine acute treatment with the
new 5HT1b - 5HT1d agonists. There is a putative
role of glutamate in migraine pathophysiology.
Little is known about the role of glutamate
neurotransmission in acute medication overuse and
chronic migraine. Objective The objective of
this study was to analyze cerebrospinal fluid
glutamate levels in chronic migraine patients
with use analgesics, nonsteroidal
anti-inflammatory drugs (NSAIDs), ergotamines,
with or no overuse, and triptans. Patients and
Methods We studied 20 patients (eight using
analgesics, NSAIDs and ergotamines, with overuse,
five without overuse and seven using triptans).
The patients were diagnosed with chronic migraine
according to the International Headache Society
diagnostic criteria (2003). They underwent a
lumbar puncture in order to rule out idiopathic
intracranial hypertension. Cerebrospinal fluid
(CSF) glutamate levels were measured by
high-performance liquid chromatography.
Results CSF glutamate levels
were lower in chronic migraine patients using
triptans compared to patients using others
medications with or no overuse (0,19 ? 0,06 vs
0,34 ? 0,23 micromols/l) plt0,02. Discussion
Our study shows decreased glutamate levels in the
CSF of chronic migraine patients using triptans
(equally divided into riza, suma zolmi and
naratriptan) compared to patients using
analgesics, NSAIDs and ergotamine. The hypothesis
of increase in the glutamategic system activity
in chronic migraine patients is supported by this
study. Triptans may be involved in the modulation
of glutamate, decreasing their levels in migraine.
Triptans Analgesics No overuse