Currently, a diagnosis of migraine is based solely on medical history. Wouldn’t it be easier if a simple blood test could weed out the migraine sufferers from those whose headaches signal some other health problem? A new Johns Hopkins University study suggests a lipid found in the blood may reveal the presence of episodic migraine (less than 15 headaches per month).

"Taken together, our findings suggest it is possible that migraine is a neurologic disorder," wrote Dr. B. Lee Peterlin, Johns Hopkins University School of Medicine, and his co-authors. They added that further research "may advance our understanding of migraine pathophysiology and open possibilities of the identification of novel migraine biomarkers and targeted drug therapies...."

Inherited Disorder

Migraine is without a doubt the mafia boss of all headaches, the evil crime lord with an icy heart-stopping stare. Characterized by sensitivity to light and sound, nausea, and even vomiting, migraines often include an intense throbbing or pulsing sensation along one side of the head itself. Scientists do not understand the cause of these extreme headaches, though they theorize migraines may be a form of inherited brain disorder. In support of this idea, past studies have indicated that sufferers have a greater risk of stroke and disorders related to the metabolism of lipids (or fats), including obesity.

Based on this research, a team of Johns Hopkins scientists wondered whether one group of lipids, known as ceramides, might somehow be linked to migraine headaches. After all, ceramides help regulate inflammation in the brain. With the help of 52 women who suffered episodic migraine and 36 women without headaches, the team designed an experiment. After the women completed their neurologic examinations, the researchers measured each woman's body mass index. Next, the women gave blood samples, which the researchers tested for ceramides. Analyzing this data, the researchers made a couple of significant discoveries.

First, the participants with migraines had decreased total levels of ceramides compared to the women without headaches. Precisely, the migraine sufferers had approximately 6,000 nanograms per milliliter compared to about 10,500 nanograms per milliliter. Analyzing the blood further, the researchers found each standard deviation increase in total ceramide levels equaled a 92-percent lower risk of migraine.

Secondly, another type of lipid found in the blood, sphingomyelin, also showed a relationship to the painful headaches, but in this case an increased level of sphingomyelin was associated with greater risk of migraine.

After a blind test of the blood from 14 of the study participants, the researchers correctly identified those who had migraine and those who did not based purely on lipid totals.

“This study is an important contribution to our understanding of the pathophysiology of migraine and may have vast practical clinical and therapeutic implications if it is supported by further studies,” Dr. Karl Ekbom, a professor in the department of neurology at Karolinska University Hospital, wrote in an editorial accompanying the new study.

Source: Peterlin L, Mielke MM, Dickens AM, et al. Interictal, circulating sphingolipids in women with episodic migraine: A case-control study. Neurology. 2015.