Author response: Iron deposition in periaqueductal gray matter as a potential biomarker for chronic migraine
ClaraDomínguez, MD, Hospital Clínico Universitario de Santiago de Compostela
RogelioLeira, MD, PhD, Hospital Clínico Universitario de Santiago de Compostela
Submitted May 17, 2019
We are grateful for the comments and insight of Dr. Welch regarding our article.1 We agree that our results linking iron deposition with migraine chronification are of special interest, as the structures that we found affected—red nucleus and periaqueductal gray matter (PAG)—have proved to play an important role in pain regulation. Further research in the relation between iron deposition and allodynia, as well as other clinical features related to chronic migraine, is needed. On the other hand, Dr. Welch adds on our discussion regarding the mechanisms of iron deposition and the apparent paradox of decreased attack frequency and higher levels of iron in older patients. As he suggests, iron deposits in PAG can increase while the frequency of attacks decreases due to changes in environment and triggers. Our findings contribute to the current understanding of mechanisms underlying migraine pathophysiology and chronification.
Disclosure
The authors report no relevant disclosures. Contact journal@neurology.org for full disclosures.
Reference
Domínguez C, López A, Ramos-Cabrer P, et al. Iron deposition in periaqueductal gray matter as a potential biomarker for chronic migraine. Neurology 2019; 92:e1076–e1085.
We are grateful for the comments and insight of Dr. Welch regarding our article.1 We agree that our results linking iron deposition with migraine chronification are of special interest, as the structures that we found affected—red nucleus and periaqueductal gray matter (PAG)—have proved to play an important role in pain regulation. Further research in the relation between iron deposition and allodynia, as well as other clinical features related to chronic migraine, is needed. On the other hand, Dr. Welch adds on our discussion regarding the mechanisms of iron deposition and the apparent paradox of decreased attack frequency and higher levels of iron in older patients. As he suggests, iron deposits in PAG can increase while the frequency of attacks decreases due to changes in environment and triggers. Our findings contribute to the current understanding of mechanisms underlying migraine pathophysiology and chronification.
Disclosure
The authors report no relevant disclosures. Contact journal@neurology.org for full disclosures.
Reference