The Relationship Between Serum Atrial Natriuretic Peptide Levels and Pain in Migraine Patients

Background: Atrial natriuretic peptide (ANP) is a natriuretic, diuretic and vasoactive peptide hormone which synthesized by cardiac atria and released to plasma. Studies investigating the role of ANP in the physiopathology of migraine have risen. The increase of ANP in the cerebral cortex is suggested to be a defense and a neuroprotective mechanism that occurs against the ischemic damage that may arise from vasoconstriction forming during the aura stage of migraine. The aim of this study is to determine the serum ANP levels in patient with migraine during initial, aura and attack periods and compare with healthy controls and investigate the relationship between serum ANP level and migraine pain.Methods: A total of 15 patients (10 female, 5 male; age range: 17-61), who were diagnosed with migraine with aura, and an equal number of age- and gender matched patients with migraine without aura according to the International Classification of Headache Disorders, 2nd edition (ICHD-2), and 15 healthy volunteers with the same demographic characteristics were randomly enrolled in the study. Blood samples were taken from patients with migraine with aura three times; at baseline, during an attack and during aura, whereas from patients with migraine without aura twice; at baseline and during an attack, and, once from healthy subjects. All blood samples were analyzed in the biochemistry laboratory, Yedikule Pulmonary Diseases Hospital using a cardiac reader and, ANP levels were calculated. Statistical analysis was performed using SPSS 15.0 for Windows. Data were analyzed using the student’s t-test, Kruskal-Wallis test, Spearman’s correlation coefficient and the Mann-Whitney U test.Results: Initial serum ANP levels in patients with migraine with aura were statistically significantly lower than in controls. On the other hand, initial ANP levels in patients with migraine without aura were higher than in the control subjects. When the patients were compared, it was seen that the ANP levels in non-aura subjects were statistically significantly higher than in aura subjects. Discussion: It is determined that in patients with migraine with aura, serum ANP level highly increases in the aura/attack stage compared to the initial stage, and this increase is marked in the aura stage. (Arc-hi-ves of Neu-ropsy-chi-atry 2012; 49: 203-207)