Chronic Migraineurs Form Carboxyhemefibrinogen and Iron-Bound Fibrinogen

Title:Chronic Migraineurs Form Carboxyhemefibrinogen and Iron-Bound Fibrinogen

Volume: 14 Issue: 8

Author(s): Vance Girard Nielsen, Wendi Kulin, John Samuel LaWall, Felesia Nancy MacFarland, Andrew Chen, Heidi Adelleen Hadley, Adam James DaDeppo, Evangelina Barbara Steinbrenner and Ryan William Matika

Affiliation:

Keywords: Migraine, fibrinogen, carbon monoxide, iron, thrombelastography, vascular disease.

Abstract: Chronic migraine (CM) is a disabling painful condition that is associated with dementia and thrombotic disease. It has been proposed that carbon monoxide (CO) and iron may play a role in CM, and CO and iron are products of the heme oxygenase system which is widespread within the brain. Further, CO and iron enhance plasmatic coagulation in part via a fibrinogen-dependent mechanism. Thus, our goal was to determine whether patients with CM had experienced carboxyhemefibrinogen formation, iron bound fibrinogen formation and plasmatic hypercoagulability. Nonsmokers with CM were recruited after informed, written consent. Blood was collected, anticoagulated with sodium citrate, and then centrifuged with plasma stored at -80ºC. Carboxyhemefibrinogen formation, iron bound fibrinogen formation and coagulation kinetics were determined via thrombelastographic methods. Patient results were compared with laboratory values generated from normal control plasmas. Incidence (95% confidence intervals) of the various parameters was determined using the Clopper-Pearson method. Twenty-six CM patients (24 female) were recruited; they were 46±12 years old. With regard to fibrinogen modification, 88.5% (69.8%-97.6%) of CM patients had formation of carboxyhemefibrinogen, iron bound fibrinogen, or both. With regard to coagulation, 42.3% (23.4%-63.1%) of patients had abnormally decreased time to clot initiation, 80.8% (60.6%-93.4%) had abnormally large velocity of clot formation, and 46.2% (26.6%-66.7%) had abnormally strong clot strength. Patients with CM have a large incidence of carboxyhemefibrinogen and iron bound fibrinogen formation and hypercoagulability. Confirmatory and potential therapeutic clinical trials targeting CO and iron modified hypercoagulation as a source of pain and vascular disease in CM patients are indicated.

Cite this article as:

Nielsen Girard Vance, Kulin Wendi, LaWall Samuel John, MacFarland Nancy Felesia, Chen Andrew, Hadley Adelleen Heidi, DaDeppo James Adam, Steinbrenner Barbara Evangelina and Matika William Ryan, Chronic Migraineurs Form Carboxyhemefibrinogen and Iron-Bound Fibrinogen, CNS & Neurological Disorders - Drug Targets 2015; 14 (8) . https://dx.doi.org/10.2174/1871527314666150821110836