Lipid Panels May Be Useful in Diagnosing Migraines

Migraines may be associated with irregularities in the metabolism of certain lipids and serum sphingolipid panels could play a role in the diagnosis of migraines, according to a study published in the Oct. 6 issue of Neurology.

Sphingolipids (e.g., sphingomyelins, ceramides) are a group of bioactive lipids that are critical components of cell membranes. Recent research suggests that even subtle changes of sphingolipid balance may be tied to neurologic disorders and obesity and that sphingolipids may participate in neuronal functions and signaling pathways associated with pain.

In the current study, researchers obtained fasting serum samples from 52 pain-free women, 88 women with episodic migraine, and 36 controls. Forty sphingolipid species were quantified using high-performance liquid chromatography coupled with tandem mass spectrometry.

The researchers found that total ceramide and dihydroceramide (ceramide's precursor) were significantly decreased in women with episodic migraine, compared with controls. Using multivariate logistic regression, each standard deviation increase in total ceramide and total dihydroceramide levels was associated with more than 92 percent reduced odds of migraine. However, every standard deviation increase in sphingomyelin, was associated with a 2.5 times greater risk of migraine.

"Our findings suggest it is possible that migraine is a neurologic disorder of 'minor' sphingolipid dysmetabolism," write the authors led by B. Lee Peterlin, D.O., from Johns Hopkins University in Baltimore, Md. "Further research, validating the ceramide and sphingomyelin associations with migraine, as well as research examining mechanisms for these associations, may advance our understanding of migraine pathophysiology and open possibilities of the identification of novel migraine biomarkers and targeted drug therapies directed against sphingolipid pathways."

Takeaway: With further validation, serum sphingolipid panels may be useful in diagnosing episodic migraines in women.