Preventive treatment modifies endothelial function and oxidative stress status in patients with migraine: an observational study

Background: To evaluate whether preventive treatment can modify endothelial function and the oxidative stress profile of patients with migraines. Methods 88 treatment-naïve patients with migraines and 56 healthy sex/age matched controls underwent ultrasonography exams and blood tests at baseline, and again in the migraine patients after 3 months’ treatment with metoprolol or topiramate. Biomarkers for endothelial function and oxidative stress were analyzed. Results At baseline, patients with migraines had higher C-reactive protein (CRP; 2.55 vs. 1.64 mg/dL; p  = 0.025) and lower high-density lipoprotein (HDL) cholesterol (61.7 vs. 66.8 mg/dL; p  = 0.048), nitrate (19.4 vs. 27.3 µM; p  = 0.037), and isoprostane levels (181 vs. 238 µM; p  = 0.036) than matched controls. After treatment biomarker levels improved in patients with migraine, including CRP (2.55 mg/dL at baseline vs. 1.75 mg/dL at 3 months; p =  0.045); HDL cholesterol levels were the exception (significantly decreased). Treatment responders (> 50% reduction from baseline in migraine frequency) had higher nitrate (24.2 vs. 13.8 µM; p  = 0.022) and nitrite levels (10.4 vs. 3.4 µM; p  = 0.002) than non-responders after treatment. Conclusion Patients with migraines exhibit endothelial and oxidative dysfunction, which can be modified with prophylactic therapy.