Migraine Sufferers Might Have a Reason to Be Salty

Anyone who suffers from migraine headaches can tell you that the feeling is unlike what most people experience as a headache, and that common drug therapies are often ineffective.

Now, researchers from Heidelberg University in Germany might have stumbled onto an underlying factor that could provide insight into the causes of migraine. The investigators found that individuals who get migraine headaches have significantly higher concentrations of sodium in their cerebrospinal fluid (CSF) than those without the condition. Findings from the study were presented at the annual meeting of the Radiological Society of North America (RSNA) through a presentation entitled “Cerebral Sodium (23Na) Magnetic Resonance Imaging in Patients with Migraine vs. Healthy Controls.”

Using a technique called cerebral sodium magnetic resonance imaging (MRI), the research team recruited 12 female patients (mean age 34) who were clinically evaluated and diagnosed as suffering from migraine headaches. This disorder disproportionately affects women, as approximately 18% of the female population is afflicted compared to only 6% of men. Moreover, diagnosis is challenging, as the characteristics of migraines and the types of attacks vary widely among patients.

“It would be helpful to have a diagnostic tool supporting or even diagnosing migraine and differentiating migraine from all other types of headaches,” noted lead study investigator Melissa Meyer, M.D., a radiology resident at the Institute of Clinical Radiology and Nuclear Medicine, University Hospital Mannheim, and Heidelberg University in Heidelberg, Germany.

Migraine, which is characterized by severe head pain, and sometimes nausea and vomiting, is one of the most common headache disorders. Yet, many migraine patients go undiagnosed and untreated. Other patients, in contrast, are treated with medications for migraine even though they suffer from a different type of headache, such as the more common tension variety.

In the current study, the researchers wanted to evaluate if cerebral sodium MRI could be utilized as a possible means to help in the diagnosis and understanding of migraine. While MRI most often relies on protons to generate an image, sodium can be visualized as well. Research has shown that sodium plays an important role in brain chemistry.

Interestingly, the scientists found no statistical differences between the migraine suffers and the control groups for sodium concentrations in the gray and white matter, brainstem, and cerebellum. However, significant differences emerged when the researchers looked at sodium concentrations in the CSF, the fluid that surrounds the brain and spinal cord, providing a cushion for the brain while also helping to ensure chemical stability for proper brain function.

Overall, sodium concentrations were significantly higher in the brain’s CSF in migraine patients than in the healthy control group.

“These findings might facilitate the challenging diagnosis of a migraine,” Dr. Meyer concluded. “As this was an exploratory study, we plan to examine more patients, preferably during or shortly after a migraine attack, for further validation.”