Migraines Linked to High Sodium Levels in CSF

A new sodium Magnetic Resonance Imaging (sMRI) study reveals that migraine sufferers have significantly higher sodium concentrations in their cerebrospinal fluid (CSF).

Researchers at University Medical Center Mannheim (Germany) and the University of Heidelberg (Germany) conducted a study involving 12 women (mean age 34), who had been clinically evaluated for migraine, and 12 healthy women of similar ages who served as a control group. The women suffering from migraines filled out a questionnaire regarding the length, intensity, and frequency of their migraine attacks and the accompanying auras. Both groups then underwent cerebral sMRI, and sodium concentrations were compared.

The results showed no statistical differences between the two groups for sodium concentrations in the gray and white matter, brain stem, and cerebellum. However, significant differences emerged when the researchers looked at sodium concentrations in the CSF--the fluid that surrounds the brain and spinal cord, which were significantly higher in the migraine patients than in the healthy control group. The study was presented at the annual meeting of the Radiological Society of North America (RSNA), held during November 2017 in Chicago (IL, USA).

“It would be helpful to have a diagnostic tool supporting or even diagnosing migraine and differentiating migraine from all other types of headaches,” concluded lead author radiology resident Melissa Meyer, MD, and colleagues. “These findings might facilitate the challenging diagnosis of a migraine. As this was an exploratory study, we plan to examine more patients, preferably during or shortly after a migraine attack, for further validation.”

Although most MRI is done to image 1H nuclei, other nuclei, such as 23Na, can be visualized as well. As sodium ions (Na+) play key roles in biological processes, homeostasis, and metabolism, imaging 23Na nuclei can provide direct insights into the metabolic activity and cellular integrity of tissues. However, 23Na MRI is complicated by the low concentrations of sodium nuclei in biological tissues, compared to concentration of H2O molecules, and the lower gyromagnetic ratio of the 23Na nucleus. As a result, a stronger magnetic field is needed for higher resolution. 23Na MRI can detect Na+ levels in tissues rising sharply, and can even visualize a sodium-rich meal in a patient’s stomach.

Related Links:
University Medical Center Mannheim
University of Heidelberg