Mitochondrial DNA haplogroups influence the therapeutic response to riboflavin in migraineurs
Steven R.Brenner, Dept. Neurology at St. Lous VA Med Center and Dept. Neurology and Psychiatry at St. Louis University, 1438 S. Grand Blvd., St. Louis, MO 63104SBren20979@aol.com
None
Submitted July 22, 2009
I read the article by Di Lorenzo et al. who described the effect of riboflavin on migraine in patients with mitochrondrial genetic abnormalities. [1] Treatments with riboflavin [1] coenzyme Q10 [2] and thioctic acid [3]—metabolic enhancers acting through mitochondria—may be beneficial in migraine prophylaxis.
Migraine is increasingly perceived as a chronic, progressive, debilitating brain disease rather than an episodic pain disorder. [4] The positive response to riboflavin in patients with a distinctive DNA haplogroup may indicate correction of an underlying metabolic abnormality that could potentially lead to a chronic disabling state.
In addition to pain relief and recurrence reduction, migraine treatment should include preventing the progression to chronic migraine, which is poorly responsive to therapy. Developing an understanding of the basic pathophysiology of the disease such as determination of mitochrondrial metabolism contributing to migraine may lead to this type of preventative measure. Those having this metabolic abnormality may need life-long treatment to prevent migraine progression.
References
1. DiLorenzo C, Pierelli F, Coppola G, Grieco G, Rengo C. Mitochondrial DNA haplogroups influence the therapeutic response to riboflavin in migraineurs. Neurology 2009;72:1588-1594.
2. Sandor PS, DiClemente L, Coppola G, et al. Efficiency of Coenzyme Q10 in migraine prophylaxis: A randomized controlled trial. Neurology 2005;64:713-715.
3. Magis D, Ambrosini A, Sandor P, Jacquy J, Laloux P, Schoenen J. A randomized double blind placebo controlled trial of thioctic acid in migraine prophylaxis. Headache 2007;47:52-77.
4. Cady RK. The future of migraine, beyond just another pill. Mayo Clinic Proceedings. 2009;84:397-399.
I read the article by Di Lorenzo et al. who described the effect of riboflavin on migraine in patients with mitochrondrial genetic abnormalities. [1] Treatments with riboflavin [1] coenzyme Q10 [2] and thioctic acid [3]—metabolic enhancers acting through mitochondria—may be beneficial in migraine prophylaxis.
Migraine is increasingly perceived as a chronic, progressive, debilitating brain disease rather than an episodic pain disorder. [4] The positive response to riboflavin in patients with a distinctive DNA haplogroup may indicate correction of an underlying metabolic abnormality that could potentially lead to a chronic disabling state.
In addition to pain relief and recurrence reduction, migraine treatment should include preventing the progression to chronic migraine, which is poorly responsive to therapy. Developing an understanding of the basic pathophysiology of the disease such as determination of mitochrondrial metabolism contributing to migraine may lead to this type of preventative measure. Those having this metabolic abnormality may need life-long treatment to prevent migraine progression.
References
1. DiLorenzo C, Pierelli F, Coppola G, Grieco G, Rengo C. Mitochondrial DNA haplogroups influence the therapeutic response to riboflavin in migraineurs. Neurology 2009;72:1588-1594.
2. Sandor PS, DiClemente L, Coppola G, et al. Efficiency of Coenzyme Q10 in migraine prophylaxis: A randomized controlled trial. Neurology 2005;64:713-715.
3. Magis D, Ambrosini A, Sandor P, Jacquy J, Laloux P, Schoenen J. A randomized double blind placebo controlled trial of thioctic acid in migraine prophylaxis. Headache 2007;47:52-77.
4. Cady RK. The future of migraine, beyond just another pill. Mayo Clinic Proceedings. 2009;84:397-399.
Disclosure: The author reports no disclosures.