Abstract Details

Title Chronic Migraineurs Often Present with Severe Gastric Stasis and Inflammation in the Enteric Autonomic Nervous System

Topic Headache

Presentation(s) P01 - (-)

Poster/Presentation
Number 069

Objective

Background Migraine is a complex, recurrent and often disabling disorder that affects about 15-10% of the general population. The complexity of Chronic Migraine (CM), including headache causing intense throbbing or pulsing in one area of the head and is commonly accompanied by nausea, vomiting, and extreme sensitivity to light and sound; however, its characterization remains inadequate. Moreover, the prevalence of gastric dysfunction patients with migraine has yet to be reported.

Design/Methods Setting, and Patients: 29 consecutive gastric motility clinic patients (26 female, 3 male; mean age 40yrs; all with chronic migraine were enrolled. Baseline gastric emptying times (GET),electromyogram (EMG), intra operative full thickness gastric biopsy findings and baseline gastric stasis symptom scores were also recorded via Likert scale and chart reviews.

Results Duration of migraine; avg 17 years; 4th hour GET was delayed averaging at 16.22 ±10.35 (normal GET 4th hour is at <10%); Gastric dysmotility symptom of nausea was 3.5±0.66 and vomiting was 2.88±1.66 on a scale of 0-5(max). Inflammatory cells were present in the myenetric plexus:CD4 5.9±4.3;CD8 4.4±4.4 and CD68 6.05 ±4.1.These cells were not present in healthy controls. Other systemic inflammatory comorbidities:Hypothyroidism: 6/29, Fibromyalgia 3/29,Depression 9/29,endometriosis 2/29. Electromyogram recordings:Sensory abnormalities upper limbs 6/18, Sensory abnormalities lower limbs 8/18. Motor abnormalities upper limb 6/18,Motor abnormalities lower limb 7/18.

Conclusions Inflammatory enteric nervous system changes are seen in the myenteric plexus of the full thickness gastric tissue along with gastric emptying delays in patients with chronic migraine. Sensory and motor abnormalities were also observed indicative of systemic autonomic nervous system involvement in the form of progressive and permanent damage in this condition.Fuller characterizations of gastrointestinal and peripheral manifestations of migraine may lead to new diagnostic and therapeutic approaches.

Authors/Disclosures
Archana Kedar, MBBS (University of Missippi Medical Center) PRESENTER	No disclosure on file
V V. Vedanarayanan, MD, FRCPC (University of Texas at Austin, Dell Medical School)	Dr. Vedanarayanan has nothing to disclose.
	No disclosure on file
Parminder Vig, PhD (Univrsity of Mississippi Medical Center)	No disclosure on file
Shashidhar Kori, MD	Dr. Kori has received personal compensation for serving as an employee of Novilla Pharma. Dr. Kori has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Satsuma Pharma. Dr. Kori has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Tonix Pharma. Dr. Kori has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Exalys Pharma. Dr. Kori has received personal compensation in the range of $0-$499 for serving as a Consultant for NewBio Pharma. Dr. Kori has received personal compensation in the range of $0-$499 for serving as a Consultant for Afsci Pharma. Dr. Kori has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Trigemina Inc. Dr. Kori has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Novilla Pharma. Dr. Kori has received stock or an ownership interest from Novilla Pharma. Dr. Kori has received stock or an ownership interest from NewBio Pharma. Dr. Kori has received stock or an ownership interest from Tonix Pharma. Dr. Kori has received intellectual property interests from a discovery or technology relating to health care. Dr. Kori has received intellectual property interests from a discovery or technology relating to health care. Dr. Kori has received personal compensation in the range of $0-$499 for serving as a Reviewer of grant applications with Department of Defense.
Noah Berkowitz	No disclosure on file
	No disclosure on file

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