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Abstract：
Migraine has been hypothesized to be a syndrome of chronic low serotonin (5-HT) levels, but investigations of brain 5-HT levels have given equivocal results. Here, we used positron emission tomography (PET) imaging of the 5-HT4 receptor as a proxy for brain 5-HT levels. Given that the 5-HT4 receptor is inversely related to brain 5-HT levels, we hypothesized that between attacks migraine patients would have higher 5-HT4 receptor binding compared to controls. Eighteen migraine patients without aura (migraine free >48 h), and 16 age- and sex-matched controls underwent PET scans after injection of [11C]SB207145, a specific 5-HT4 receptor radioligand. An investigator blinded to group calculated a neocortical mean [11C]SB207145 binding potential (BPND). Three migraine patients reported a migraine attack within 48 h after the scan and were excluded from the primary analysis. Comparing 15 migraine patients and 16 controls, we found that migraine patients have significantly lower neocortical 5-HT4 receptor binding than controls (0.60 ± 0.09 vs. 0.67 ± 0.05, p = .024), corrected for 5-HTTLPR genotype, sex and age. We found no association between 5-HT4 receptor binding and attack frequency, years with migraine or time since last migraine attack. Our finding of lower 5-HT4 receptor binding in migraine patients is suggestive of higher brain 5-HT levels. This is in contrast with the current belief that migraine is associated with low brain 5-HT levels. High brain 5-HT levels may represent a trait of the migraine brain or it could be a consequence of migraine attacks.
摘要：
偏头痛被认为是慢性低5-羟色胺（5-HT）水平的综合征，但是对大脑5-HT水平的研究给出了模棱两可的结果。这里,我们使用5-HT4受体的正电子发射断层扫描(PET)成像作为大脑5-HT水平的代表.鉴于5-HT4受体与大脑5-HT水平成反比，我们假设偏头痛患者在发作之间的5-HT4受体结合比对照组高.18例无先兆偏头痛患者（无偏头痛>48h），16个年龄和性别匹配的对照在注射[11C]SB207145(一种特异性5-HT4受体放射性配体)后进行PET扫描。研究人员盲组计算了新皮层平均[11C]SB207145结合电位（BPND）。三名偏头痛患者在扫描后48小时内报告偏头痛发作，并从主要分析中排除。比较15名偏头痛患者和16名对照，我们发现偏头痛患者的新皮质5-HT4受体结合明显低于对照组(0.60±0.09vs.0.67±0.05，p=.024），校正5-HTTLPR基因型，性别和年龄。我们发现5-HT4受体结合和攻击频率之间没有关联，偏头痛或自上次偏头痛发作以来的时间。我们发现偏头痛患者中5-HT4受体结合较低，提示大脑5-HT水平较高。这与目前认为偏头痛与低大脑5-HT水平相关的观点相反。高脑5-HT水平可能代表偏头痛脑的特征或可能是偏头痛发作的结果。
