Cerebellar Metabolism Altered In Familial Hemiplegic Migraine

NEW YORK (Reuters Health) - Using proton magnetic resonance spectroscopy, researchers in Germany have demonstrated metabolic changes in the cerebellum of patients with familial hemiplegic migraine (FHM).

By monitoring these changes, clinicians may be able to gauge disease progression, the investigators suggest in their report, published in the February 22nd issue of Neurology.

Dr. M. Dichgans, at Ludwig Maximilians University in Munich and colleagues assessed fifteen affected individuals with pathogenic mutations in the CACNA1A gene and 17 healthy volunteers with no history of migraine.

In scans of the superior cerebellar vermis, the investigators found that subjects with FHM had significantly decreased gray matter and white matter and increased cerebrospinal fluid.

There was also decreased N-acetyl-aspartate and glutamate, which they suggest indicates neuronal impairment and impaired glutamatergic neurotransmission. Alterations in gray and white matter, as well as those in N-acetyl-aspartate, were correlated with gait ataxia.

They also observed elevated myo-inositol levels, which likely signify proliferation of glial cells in the cerebellum.

Scans of the parietal cortex and occipital cortex showed that the metabolic abnormalities were limited to the superior cerebellar vermis.

"Localized measures of atrophy and N-acetyl-aspartate might be useful surrogate markers for future interventional trials in patients with FHM and cerebellar involvement," Dr. Dichgans' group concludes.

Magnetic resonance spectroscopy "may represent a useful tool for further exploring the pathophysiology of this complex disorder," Dr. Michael Benetar, at Emory University in Atlanta, and Dr. Corey M. Ford, at the University of New Mexico Health Sciences Center in Albuquerque, comment in an accompanying editorial.

Source: Neurology 2005;64:592-593,608-613. [ Google search on this article ]

MeSH Headings: Chemistry : Chemistry, Analytical : Investigative Techniques : Physical Sciences : Spectrum Analysis : Analytical, Diagnostic and Therapeutic Techniques and Equipment : Physical Sciences

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