RT Journal Article
SR Electronic
T1 Mitochondrial DNA haplogroups influence the therapeutic response to riboflavin in migraineurs
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 1588
OP 1594
DO 10.1212/WNL.0b013e3181a41269
VO 72
IS 18
A1 Di Lorenzo, C.
A1 Pierelli, F.
A1 Coppola, G.
A1 Grieco, G. S.
A1 Rengo, C.
A1 Ciccolella, M.
A1 Magis, D.
A1 Bolla, M.
A1 Casali, C.
A1 Santorelli, F. M.
A1 Schoenen, J.
YR 2009
UL http://n.neurology.org/content/72/18/1588.abstract
AB Objectives: In migraine, an interictal reduction of mitochondrial energy metabolism and a preventive effect of high-dose riboflavin were reported. To explore the relation between the two, we tested if the therapeutic response to riboflavin is associated with specific mitochondrial DNA (mtDNA) haplogroups. We focused our attention on haplogroup H, which is known to differ from others in terms of energy metabolism. Methods: Sixty-four migraineurs completed a 4-month open trial with riboflavin (400 mg QD) and were genotyped blindly for mtDNA haplogroups. Results: Forty patients responded to riboflavin treatment and 24 were nonresponders. The mtDNA haplogroup H was found in 29 subjects (20 migraine without aura, 9 migraine with aura). Riboflavin responders were more numerous in the non-H group (67.5%). Conversely, nonresponders were mostly H (66.7%). The difference between the two groups was significant (χ2 = 7.07; p = 0.01). The presence of aura had no influence on riboflavin's effectiveness (χ2 = 0.113; p = 0.74) and was not associated with a particular haplogroup (χ2 = 0.55; p = 0.46). Conclusions: In this pharmacogenetic study, riboflavin appears to be more effective in patients with migraine with non-H mitochondrial DNA haplotypes. The underlying mechanisms are unknown, but could be related to the association of haplogroup H with increased activity in complex I, which is a major target for riboflavin. Our results may have ethnic implications, since haplogroup H is chiefly found in the European population. CI=confidence intervals; MA=migraine with aura; MO=migraine without aura; mtDNA=mitochondrial DNA; OR=odds ratio; OXPHOS=oxidative phosphorylation.