Researchers in Szeged Investigate Personalized Treatment for Migraines

Researchers from the HUN-REN–University of Szeged Neuroscience Research Group are investigating personalized options for the treatment of migraines, depending on the individual metabolism of the patient. Migraines are often associated with unbearable

By: hungarytoday.hu

Oct 08 2024
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Researchers in Szeged Investig

Migraines are often associated with unbearable suffering, but this is not the only reason it is considered one of the most significant neurological disorders. It affects between 10 and 16% of the world’s population—more than 1 million people in Hungary alone—and is more common in women than men. Globally, nearly a billion people live with these highly uncomfortable headaches as part of their daily lives.

Professor László Vécsei, head of the research team, stressed that

any result that reduces the suffering of migraine patients also has very serious economic consequences.

Clinically, migraines can be divided into two main categories: migraine with aura and migraine without aura. Migraines with aura are characterized by certain warning signs and other symptoms that accompany the headache, such as visual disturbances. Additionally, several types of migraines can be identified based on their clinical presentation. These include basilar migraine (with the involvement of visual and speech problems), the rare hemiplegic migraine (which may cause weakness or paralysis on one side of the body), chronic migraine (where episodes typically occur for 15 days per month over a three month period), menstrual migraine, retinal migraine, and various other clinical forms.

Managing stress and getting the right amount and quality of sleep can reduce migraine headaches, but genetic predisposition also plays a role. The combined effect of several genes may increase the chances of developing symptoms. However, the environment can also play a role: people may respond to weather changes with migraine attacks, but stressful lifestyles and lack of sleep can also trigger them.

Some research has found that people with migraines are statistically slightly more likely to have a stroke than those without the condition, but there is also some association between migraines and epilepsy.

The research team is currently investigating the relationship between migraine and the kynurenine (a key compound in a pathway that is present in the blood, brain, and peripheral organs) system, an area that has received relatively little attention in previous studies. In their latest publication, they reviewed the roles of the nervous and immune systems from the perspective of alterations in kynurenine metabolism.

Tryptophan is an essential amino acid that cannot be produced by the body and must be obtained from the diet. Kynurenines are the primary products of tryptophan metabolism, as this amino acid is predominantly converted into kynurenine.

Through the kynurenine pathway, tryptophan is transformed into a wide range of biologically active molecules that play a crucial role in the functioning of the immune and nervous systems.

One such metabolite is kynurenic acid, inhibiting neuronal activity, while another molecule, quinolinic acid, activates it. These molecules also play an important role in regulating the immune system. In previous clinical studies, the research group found significant changes in kynurenine metabolism in both migraine and cluster headache patients.

In addition to kynurenine, a peptide known as PACAP (pituitary adenylate cyclase-activating polypeptide) also plays an important role in the pathogenesis of migraine. The studies have shown that blood levels of PACAP are elevated in migraine patients.

Professor László Vécsei noted that this is one reason why personalized medicine is needed, because almost 40% of patients do not respond adequately to migraine drugs based on the recently developed CGRP (Calcitonin gene-related peptide) blockade, a protein that plays a key role in triggering and maintaining migraine and other types of chronic headache.