High CSF sodium levels may be linked to migraines

Individuals who suffer from migraine headaches may have higher sodium concentrations in their cerebrospinal fluid (CSF) compared with those who do not have migraines, according to a recent study—the first to use sodium magnetic resonance imaging (MRI) to study migraines. Results were presented at the 2017 annual meeting of the Radiological Society of North America (RSNA).

Migraines affect roughly 18% of women and 6% of men. They can be debilitating, as well as difficult to diagnose as their characteristics, types, and timing vary greatly. As a result, many patients with migraine remain undiagnosed and untreated, while many others are misdiagnosed and treated for migraines when they have a different type of headache.

“It would be helpful to have a diagnostic tool supporting or even diagnosing migraine and differentiating migraine from all other types of headaches,” said study author Melissa Meyer, MD, radiology resident, Institute of Clinical Radiology and Nuclear Medicine, University Hospital Mannheim and Heidelberg University, Heidelberg, Germany.

In their study, Dr. Meyer and fellow researchers used a magnetic resonance technique known as cerebral sodium MRI. Typically, MRI uses protons to generate images, but sodium can be used as well. Its use is important because sodium has a critical role in regulating brain chemistry.

The researchers included 12 women (mean age: 34 years) who had undergone clinical evaluation for migraine, and 12 healthy women of similar ages as controls. Cerebral sodium MRI was done in all patients, and when researchers compared the sodium concentrations, they found no significant differences between groups in sodium concentrations in gray or white matter, the brain stem, and the cerebellum.

Cerebral spinal fluid sodium concentrations differed significantly between groups, however. In patients with migraines, CSF sodium concentrations were significantly higher than in controls.

“These findings might facilitate the challenging diagnosis of a migraine,” Dr. Meyer said.

Future studies of this imaging technique are planned.

“As this was an exploratory study, we plan to examine more patients, preferably during or shortly after a migraine attack, for further validation,” Dr. Meyer concluded.