A saliva analysis allows you to determine what type of migraine each person suffers, what opens the door to being able to apply a more personalized treatment in the future and more effective, according to a study by the Vall d’Hebron Hospital from Barcelona.
Migraine it is a very prevalent diseasewhich affects more often women for which there are no biomarkers that can be used for the diagnosis of the disease or for the prediction of the efficacy of the treatment.
During a migraine attackseveral substances are released that are related to pain and one of them is calcitonin gene-related peptide (CGRP), a type of molecule that is a therapeutic target by drugs that block it, but it is not effective in all cases.
The Vall d’Hebron Headache and Neurological Pain Group Institute of Research (VHIR) have measured the levels of this protein in saliva during migraine and have observed that there are two types of attacks: those in which the CGRP increases and those in which it does not increase.
The results of the work, published in the journal ‘Cephalalgia‘, contribute to describe migraine at the molecular level and understand the differences between individuals, which can help to establish a classification between types of migraine and thus approach personalized medicine.
49 attacks studied
The study involved 22 women with sporadic migraine and 22 without headache, aged between 18 and 65, and all of them were followed up for 30 days.
On the first day, a blood sample was taken, and for the rest of the month, the participants had to take saliva samples every morning and also every time they had a migraine attack.
Saliva samples have been shown to be effective in monitoring the evolution of CGRP levels and have the advantage of being a less invasive test than a blood test.
In total, 49 seizures could be studied, which were used to compare CGRP levels between control women and women with sporadic migraine.
differences between people
The results showed that, despite large differences between people, on average, levels of the protein were almost double in people with migraines.
In addition to the differences between people, the study focused on analyzing the change in CGRP levels in the same person during a migraine attack and it was found that the levels increase during the attack and decrease again once it has passed.
Another finding is that changes in CGRP levels during migraine were not clearly seen in all attacks: the researchers identified this as happening in 79.6% of episodes, but not in 20.4% depended on CGRP.
Considering seizures in the same patient, 13 of the 22 participants had only CGRP-dependent seizures, 3 had only non-dependent seizures, and 6 had both types.
Photophobia
In addition, depending on whether the attacks were dependent on CGRP or not, certain associated symptoms used to appear: more photophobia and phonophobia in dependents and more symptoms of dizziness where they were not.
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“This study allows us to begin to describe migraine at the molecular level and understand the differences between individuals, which can help establish a classification based on molecular biology and brings us closer to a future of precision medicine”, highlighted Dr. Alicia Alpuente. , specialist of Neurology Service of the Vall d’Hebron University Hospital and VHIR researcher.
The researcher stressed that if the pathophysiology of migraine is understood, in the future it could “offer a personalized treatment according to the characteristics of each patient”.