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Department of Neurology, University Hospital, Leiden (Drs. Ferrari and Bruyn)
Departments of Clinical Biochemistry, TNO-CIVO Toxicology and Nutrition Institute, Zeist (Dr. Odink)
Psychiatric Hospital Endegeest, Oegstgeest, The Netherlands (Drs. Van Kempen and Pennings)
Department of Preclinical Research, Sandoz AG, Basle, Switzerland (Dr. Tapparelli)
To investigate systemic serotonin (5-HT) metabolism in migraine, we determined platelet and platelet-free plasma concentrations of 5-HT, its precursors tryptophan and 5-hydroxytryptophan, and its main metabolite 5-hydroxy-indoleacetic acid (5-HIAA), as well as the activities of the platelet enzymes monoamine oxidase and phenolsulfotransferase in classic and common migraineurs. Between attacks, migraineurs had lower plasma 5-HT and higher 5-HIAA levels than did healthy controls and patients with tension headache. During migraine attacks, plasma 5-HT levels were substantially higher than during attack-free periods, while 5-HIAA concentrations and platelet enzyme activities were lower. Platelet 5-HT was reduced only during common, but not classic, migraine attacks. We hypothesize that systemic 5-HT metabolism is enhanced in migraineurs during headache-free periods and transiently decreases during attacks, presumably due to a fall in enzymatic degradation. Furthermore, platelet behavior differs during migraine attacks with and without aura, and release of platelet 5-HT cannot (exclusively) be held accountable for the rise of plasma 5-HT during migraine attacks.
Address correspondence and reprint requests to Dr. Ferrari, University Hospital Leiden, Department of Neurology, PO Box 9600, 2300 RC Leiden, The Netherlands.
Supported in part by the Dutch Migraine Society.
Received August 29, 1988. Accepted for publication in final form April 10, 1989.
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