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Open Access Research article

Phospholipase C activity increases in cerebrospinal fluid from migraineurs in proportion to the number of comorbid conditions: a case–control study

Alfred N Fonteh1*, Janice M Pogoda2, Rainbow Chung14, Robert P Cowan3 and Michael G Harrington1*

Author Affiliations

1 Molecular Neurology Program, Huntington Medical Research Institutes, 99 N El Molino Ave, Pasadena, CA 91101, USA

2 Statology, 158 W Cooke Rd, Columbus, OH 43214, USA

3 Department of Neurology, Stanford University School of Medicine, Stanford, CA 94305, USA

4 University of California, Irvine School of Medicine, Irvine, CA 92697, USA

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The Journal of Headache and Pain 2013, 14:60  doi:10.1186/1129-2377-14-60

Published: 4 July 2013

Abstract

Background

Migraineurs are more often afflicted by comorbid conditions than those without primary headache disorders, though the linking pathophysiological mechanism(s) is not known. We previously reported that phosphatidylcholine-specific phospholipase C (PC-PLC) activity in cerebrospinal fluid (CSF) increased during migraine compared to the same individual’s well state. Here, we examined whether PC-PLC activity from a larger group of well-state migraineurs is related to the number of their migraine comorbidities.

Methods

In a case–control study, migraineurs were diagnosed using International Headache Society criteria, and controls had no primary headache disorder or family history of migraine. Medication use, migraine frequency, and physician-diagnosed comorbidities were recorded for all participants. Lumbar CSF was collected between the hours of 1 and 5 pm, examined immediately for cells and total protein, and stored at −80°C. PC-PLC activity in thawed CSF was measured using a fluorometric enzyme assay. Multivariable logistic regression was used to evaluate age, gender, medication use, migraine frequency, personality scores, and comorbidities as potential predictors of PC-PLC activity in CSF.

Results

A total of 18 migraineurs-without-aura and 17 controls participated. In a multivariable analysis, only the number of comorbidities was related to PC-PLC activity in CSF, and only in migraineurs [parameter estimate (standard error) = 1.77, p = 0.009].

Conclusion

PC-PLC activity in CSF increases with increasing number of comorbidities in migraine-without-aura. These data support involvement of a common lipid signaling pathway in migraine and in the comorbid conditions.

Keywords:
CSF; PLC; Depression; Irritable bowel syndrome; Painful bladder