Neurochemical Changes Following Botulinum Toxin Type A in Chronic Migraine: An LC-MS/MS and HPLC Evaluation of Plasma and Urinary Biomarkers.
Abstract
Botulinum toxin type A (BoNT-A) is an established preventive therapy for chronic migraine (CM), yet the accompanying neurochemical changes remain incompletely characterized. To evaluate the effects of BoNT-A on plasma substance P (SP), γ-aminobutyric acid (GABA), glutamate, glutamine, and 5-hydroxytryptamine (5-HT), and on urinary 5-HT, and to explore relationships with clinical outcomes. In this prospective study, plasma neurotransmitters were analyzed in CM patients (n = 31) at baseline and one month after BoNT-A (155 U; PREEMPT protocol) and in healthy controls (n = 30). Plasma SP was measured using enzyme-linked immunosorbent assay (ELISA); plasma GABA, glutamate, and glutamine were quantified via liquid chromatography-tandem mass spectrometry (LC-MS/MS) with isotopically labeled internal standards; plasma and urinary 5-HT were determined by high-performance liquid chromatography (HPLC). Clinical outcomes included monthly headache frequency, Visual Analog Scale (VAS), and Migraine Disability Assessment (MIDAS). Statistical analyses applied appropriate parametric or non-parametric tests with < 0.05 considered significant. One month post-BoNT-A, headache frequency, MIDAS, and VAS were significantly reduced (all < 0.001). SP levels were significantly higher after BoNT-A than at baseline and versus controls. Plasma 5-HT increased post-BoNT-A, while urinary 5-HT decreased. Plasma GABA was elevated in patients versus controls without statistical significance. Glutamine was significantly higher before treatment, whereas the Glu/Gln ratio increased after BoNT-A. Correlations revealed that higher GABA was associated with lower VAS and attack frequency post-treatment. BoNT-A provided short-term clinical improvement with distinct neurochemical changes, including increased plasma SP and 5-HT, decreased urinary 5-HT, reduced glutamine, and a higher Glu/Gln ratio. These biomarkers, particularly Glu/Gln, may serve as indicators of cortical excitability and therapeutic response in CM.
추출된 의학 개체 (NER)
| 유형 | 영어 표현 | 한국어 / 풀이 | UMLS CUI | 출처 | 등장 |
|---|---|---|---|---|---|
| 시술 | botulinum toxin
|
보툴리눔독소 주사 | dict | 2 | |
| 해부 | Plasma
|
scispacy | 1 | ||
| 해부 | urinary 5-HT
|
scispacy | 1 | ||
| 해부 | plasma neurotransmitters
|
scispacy | 1 | ||
| 해부 | Plasma SP
|
scispacy | 1 | ||
| 해부 | plasma GABA
|
scispacy | 1 | ||
| 해부 | urinary 5-HT were
|
scispacy | 1 | ||
| 해부 | Plasma 5-HT
|
scispacy | 1 | ||
| 해부 | cortical
|
scispacy | 1 | ||
| 약물 | GABA
|
C0016904
gamma-aminobutyric acid
|
scispacy | 1 | |
| 약물 | glutamate
|
C0017789
Glutamates
|
scispacy | 1 | |
| 약물 | glutamine
|
C0017797
glutamine
|
scispacy | 1 | |
| 약물 | 5-hydroxytryptamine
|
C0036751
serotonin
|
scispacy | 1 | |
| 약물 | 5-HT
|
C0036751
serotonin
|
scispacy | 1 | |
| 약물 | BoNT-A.
|
scispacy | 1 | ||
| 약물 | Glu/Gln
|
scispacy | 1 | ||
| 약물 | Urinary
|
scispacy | 1 | ||
| 약물 | BoNT-A
→ Botulinum toxin type A
|
scispacy | 1 | ||
| 약물 | γ-aminobutyric acid
|
scispacy | 1 | ||
| 질환 | Migraine
|
C0149931
Migraine Disorders
|
scispacy | 1 | |
| 질환 | headache
|
C0018681
Headache
|
scispacy | 1 | |
| 기타 | Botulinum Toxin Type A
|
scispacy | 1 | ||
| 기타 | BoNT-A
→ Botulinum toxin type A
|
scispacy | 1 | ||
| 기타 | glutamine
|
scispacy | 1 | ||
| 기타 | patients
|
scispacy | 1 | ||
| 기타 | post-BoNT-A
|
scispacy | 1 | ||
| 기타 | Glu/Gln
|
scispacy | 1 | ||
| 기타 | 5-HT
|
scispacy | 1 |
📑 인용 관계
이 논문이 참조한 문헌 40
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외부 PMID 30건 (DB 미수집)
- PMID 10665805 ↗
- PMID 10715374 ↗
- PMID 10890306 ↗
- PMID 12887389 ↗
- PMID 1356988 ↗
- PMID 15330825 ↗
- PMID 17241445 ↗
- PMID 18184328 ↗
- PMID 18461049 ↗
- PMID 20223589 ↗
- PMID 22238656 ↗
- PMID 23499661 ↗
- PMID 2422252 ↗
- PMID 24420081 ↗
- PMID 24915026 ↗
- PMID 25090640 ↗
- PMID 25445477 ↗
- PMID 27418178 ↗
- PMID 27649042 ↗
- PMID 28633367 ↗
- PMID 29033605 ↗
- PMID 29368949 ↗
- PMID 29387527 ↗
- PMID 30019230 ↗
- PMID 30211382 ↗
- PMID 30284083 ↗
- PMID 32619710 ↗
- PMID 33008515 ↗
- PMID 33069326 ↗
- PMID 33211930 ↗
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