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From the Departments of Pediatrics (Drs. D.C. Chugani and Niimura, M.-L. Lee, and Dr. H.T. Chugani), Radiology (Drs. D.C. Chugani, Muzik, and H.T. Chugani), and Neurology (Drs. Chaturvedi, Fakhouri, and H.T. Chugani), Children’s Hospital of Michigan, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI.
Address correspondence and reprint requests to Dr. Diane C. Chugani, PET Center, Children’s Hospital of Michigan, 3901 Beaubien Blvd., Detroit, MI 48201.
OBJECTIVE: To measure brain serotonin synthesis with PET using the tracer 
-[11C]methyl-L-tryptophan in migraine patients.
BACKGROUND: Although the cause of migraine remains poorly understood, there is considerable evidence to support a role of the neurotransmitter serotonin in the pathophysiology of migraine.
METHODS: We studied 11 women (aged 33 ± 7.7 years) with a diagnosis of migraine according to International Headache Society criteria and 8 healthy women (aged 29 ± 9.2 years). Five patients were studied before and after chronic treatment with propranolol or nadolol.
RESULTS: Serotonin synthesis capacity (K-complex) values in migraine patients were higher than those measured in controls throughout the brain (p = 0.016); mean K-complex for whole brain was 0.0077 + 0.0020 mL/g/min in patients with migraine and 0.0054 ± 0.0003 mL/g/min in controls. The regional pattern did not differ between the two groups. However, the K-complex for whole brain in the subgroup of migraine patients with aura (n = 3) did not differ from that of the control group (p = 0.32). In the five patients studied twice (before and after treatment), we found a trend of increased whole-brain K-complex after drug treatment (p = 0.06).
CONCLUSIONS: Our findings indicating increased brain serotonin synthesis capacity in migraine patients are consistent with previous reports of systemic alteration of serotonin metabolism in patients without aura. Our results also suggest that the mechanism of action of beta-adrenergic antagonists for migraine prophylaxis may involve regulation of serotonin synthesis.
Key words: Migraine—Serotonin—Positron emission tomography—-[11C]methyl-L-tryptophan—Neuroimaging.
This article has been cited by other articles:
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  Y. Sakai, C. Dobson, M. Diksic, M. Aube, and E. Hamel Sumatriptan normalizes the migraine attack-related increase in brain serotonin synthesis Neurology, February 5, 2008; 70(6): 431 - 439. [Abstract] [Full Text] [PDF]
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 C. Gianluca and S. Jean Reply: Migraine, cortical excitability, and evoked potentials: a clinico-pharmacological perspective Brain, September 1, 2005; 128(9): E37 - E37. [Full Text] [PDF]
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P. D. Drummond Effect of tryptophan depletion on symptoms of motion sickness in migraineurs Neurology, August 23, 2005; 65(4): 620 - 622. [Abstract] [Full Text] [PDF]
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 Z. Pfund, D. C. Chugani, O. Muzik, C. Juhasz, M. E. Behen, J. Lee, P. Chakraborty, T. Mangner, and H. T. Chugani {alpha}[ 11C]Methyl-L-Tryptophan Positron Emission Tomography in Patients With Alternating Hemiplegia of Childhood J Child Neurol, April 1, 2002; 17(4): 253 - 260. [Abstract] [PDF]
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R. Hering-Hanit, A. Cohen, and Z. Horev Successful Withdrawal From Analgesic Abuse in a Group of Youngsters With Chronic Daily Headache J Child Neurol, June 1, 2001; 16(6): 448 - 449. [Abstract] [PDF]
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