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The Journal of Headache and Pain
Published in: The Journal of Headache and Pain 1/2018

Open Access 01-12-2018 | Research article

Feasibility of serum CGRP measurement as a biomarker of chronic migraine: a critical reappraisal

Authors: Mi Ji Lee, Sook-Yeon Lee, Soohyun Cho, Eun-Suk Kang, Chin-Sang Chung

Published in: The Journal of Headache and Pain | Issue 1/2018

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Abstract

Background

Calcitonin gene-related peptide (CGRP) has been reported as elevated in chronic migraine. We aimed to validate the role of interictal serum CGRP concentration in peripheral blood samples as a biomarker of chronic migraine.

Methods

We prospectively recruited patients with episodic and chronic migraine and normal controls (NCs) in the Samsung Medical Center between August 2015 and May 2016. Blood samples were collected interictally from antecubital veins per prespecified protocol. Serum CGRP measurement was performed in the central laboratory by a single experienced technician blinded to clinical information. Migraine subtype, headache days in the previous month, and the presence and characteristics of headache at ±2 days of measurement were evaluated at every visit.

Results

A total of 156 migraineurs (106 episodic and 50 chronic) and 27 NCs were recruited in this study. Compared to NCs (75.7 ± 20.07 pg/mL) and patients with episodic migraine (67.0 ± 20.70 pg/mL), patients with chronic migraine did not show an interictal elevation of serum CGRP levels (64.9 ± 15.32 pg/mL). Serum CGRP concentration was not associated with headache status (ictal vs. interictal), migraine subtype (migraine with vs. without aura), use of preventive or acute medications, and comorbid medication overuse. Higher serum CGRP concentration did not predict treatment response in patients with chronic migraine.

Conclusions

Serum CGRP concentration may not be a feasible biomarker for chronic migraine. Further validation is necessary before CGRP can be used in the clinical practice.
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Literature
1.
Headache Classification Committee of the International Headache Society (IHS) (2018) The international classification of headache disorders, 3rd edition. Cephalalgia 38:1–211CrossRef
2.
Cernuda-Morollon E, Larrosa D, Ramon C, Vega J, Martinez-Camblor P, Pascual J (2013) Interictal increase of CGRP levels in peripheral blood as a biomarker for chronic migraine. Neurology 81:1191–1196CrossRefPubMed
3.
Sarchielli P, Pini LA, Zanchin G, Alberti A, Maggioni F, Rossi C et al (2006) Clinical-biochemical correlates of migraine attacks in rizatriptan responders and non-responders. Cephalalgia 26:257–265CrossRefPubMed
4.
Barbanti P, Aurilia C, Dall'Armi V, Egeo G, Fofi L, Bonassi S (2016) The phenotype of migraine with unilateral cranial autonomic symptoms documents increased peripheral and central trigeminal sensitization. A case series of 757 patients. Cephalalgia 36:1334–1340CrossRefPubMed
5.
Puntmann VO (2009) How-to guide on biomarkers: biomarker definitions, validation and applications with examples from cardiovascular disease. Postgrad Med J 85:538–545CrossRefPubMed
6.
Durham P, Papapetropoulos S (2013) Biomarkers associated with migraine and their potential role in migraine management. Headache 53:1262–1277CrossRefPubMed
7.
Nagata E, Hattori H, Kato M, Ogasawara S, Suzuki S, Shibata M et al (2009) Identification of biomarkers associated with migraine with aura. Neurosci Res 64:104–110CrossRefPubMed
8.
Goadsby PJ, Edvinsson L, Ekman R (1990) Vasoactive peptide release in the extracerebral circulation of humans during migraine headache. Ann Neurol 28:183–187CrossRefPubMed
9.
10.
Edvinsson L (2017) The Trigeminovascular pathway: role of CGRP and CGRP receptors in migraine. Headache 57(Suppl 2):47–55CrossRefPubMed
11.
Tajti J, Uddman R, Moller S, Sundler F, Edvinsson L (1999) Messenger molecules and receptor mRNA in the human trigeminal ganglion. J Auton Nerv Syst 76:176–183CrossRefPubMed
12.
Silberstein SD, Dodick DW, Bigal ME, Yeung PP, Goadsby PJ, Blankenbiller T et al (2017) Fremanezumab for the preventive treatment of chronic migraine. N Engl J Med 377:2113–2122CrossRefPubMed
13.
Tepper S, Ashina M, Reuter U, Brandes JL, Dolezil D, Silberstein S et al (2017) Safety and efficacy of erenumab for preventive treatment of chronic migraine: a randomised, double-blind, placebo-controlled phase 2 trial. Lancet Neurol 16:425–434CrossRefPubMed
14.
Ho TW, Connor KM, Zhang Y, Pearlman E, Koppenhaver J, Fan X et al (2014) Randomized controlled trial of the CGRP receptor antagonist telcagepant for migraine prevention. Neurology 83:958–966CrossRefPubMed
15.
Dominguez C, Vieites-Prado A, Perez-Mato M, Sobrino T, Rodriguez-Osorio X, Lopez A et al (2018) CGRP and PTX3 as predictors of efficacy of Onabotulinumtoxin type a in chronic migraine: an observational study. Headache 58:78–87CrossRefPubMed
16.
Cernuda-Morollon E, Martinez-Camblor P, Ramon C, Larrosa D, Serrano-Pertierra E, Pascual J (2014) CGRP and VIP levels as predictors of efficacy of Onabotulinumtoxin type a in chronic migraine. Headache 54:987–995CrossRefPubMed
17.
Tvedskov JF, Lipka K, Ashina M, Iversen HK, Schifter S, Olesen J (2005) No increase of calcitonin gene-related peptide in jugular blood during migraine. Ann Neurol 58:561–568CrossRefPubMed
18.
Woldeamanuel YW, Cowan RP (2017) Migraine affects 1 in 10 people worldwide featuring recent rise: a systematic review and meta-analysis of community-based studies involving 6 million participants. J Neurol Sci 372:307–315CrossRefPubMed
19.
Wang SJ, Fuh JL, Young YH, Lu SR, Shia BC (2000) Prevalence of migraine in Taipei, Taiwan: a population-based survey. Cephalalgia 20:566–572CrossRefPubMed
20.
Takeshima T, Ishizaki K, Fukuhara Y, Ijiri T, Kusumi M, Wakutani Y et al (2004) Population-based door-to-door survey of migraine in Japan: the Daisen study. Headache 44:8–19CrossRefPubMed
Metadata
Title
Feasibility of serum CGRP measurement as a biomarker of chronic migraine: a critical reappraisal
Authors
Mi Ji Lee
Sook-Yeon Lee
Soohyun Cho
Eun-Suk Kang
Chin-Sang Chung
Publication date
01-12-2018
Publisher
Springer Milan
Published in
The Journal of Headache and Pain / Issue 1/2018
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI
https://doi.org/10.1186/s10194-018-0883-x

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