الفهرس 
IntroductionOnly 14 pages are availabe for public view
Abstract
A migraine is a primary headache disorder characterized by recurrent headaches that are moderate to severe. The understanding of migraine pathophysiology is advancing rapidly. Improved characterization and diagnosis of its clinical features have led to the view of migraine as a complex, variable disorder of nervous system function rather than simply a vascular headache. Recent studies have provided important new insights into its genetic causes, anatomical and physiological features, and pharmacological mechanisms. Altered brain excitability has been supposed, which regulate the metabolism of neuronal mitochondrial energy, NTs and ion canals of the CNS.
The aim of this study is to explore the alterations of mitochondrial functions in migraine by assay of serum level of NAA. This was a cross sectional observational prospective hospital based study conducted on 100 subjects from the outpatient clinics of Neurology, and Psychiatry in Ain Shams University Hospitals in. They were divided into two groups;
group A 50 migraine patients, and group B 50 healthy subjects, both were age and sex matched. All subjects undergone a full neurological and psychiatric examination. Full headache evaluation sheet used in headache outpatient clinic in Ain Shams University Hospitals and HIT-6™ Headache Impact was used. Assay of serum level of NAA as mitochondrial function marker was done.
In this study there were no significant difference between the two groups regarding as regards gender, age or age group, marital state, education, residence and special habits between both groups. However there was statistical significant difference as regards family history of migraine more in patient group.
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In this study, serum NAA levels in migraine patients were significantly lower than in healthy controls. Decreased NAA level is generally believed to indicate a neuronal loss. The NAA serum reduction may be nonspecific finding; however, following the reason that it may be a sign of reduced neuronal and glial mitochondria function. In this study migraine with aura patients showed lower NAA levels when compared to migraine without aura subtypes.
In this study, in the migraine group, no significant correlation was found between NAA serum levels, and type of onset of pain, frequent site of pain, time to max severity, severity of attack, duration of migraine attack and daily functions (social life, work, psychological wellbeing, sleep and cognition).
In this study, in the migraine group, no significant correlation was found between NAA serum levels, and age at onset, age group sex, type of aura and duration of the illness.
Findings of this study may presently indicate that NAA in serum may be a sign of neuronal dysfunction predisposing to migraine, probably based on reduced mitochondria function. However, the results of this study should be confirmed by MRS study.
Furthermore, new techniques are crucial for clinicians in order to further elucidate pathophysiological mechanisms underlying this complex and often disabling disease and to provide new therapeutical approaches for migraine patients