A possible role of amyloidogenic blood clotting in the evolving haemodynamics of female migraine-with-aura : results from a pilot study

dc.contributor.authorDe Villiers, Sulette
dc.contributor.authorBester, Janette
dc.contributor.authorKell, Douglas B.
dc.contributor.authorPretorius, Etheresia
dc.date.accessioned2020-03-25T07:12:08Z
dc.date.available2020-03-25T07:12:08Z
dc.date.issued2019-11-26
dc.description.abstractINTRODUCTION : Migraine is a debilitating primary headache disorder with a poorly understood aetiology. An extensive body of literature supports the theory of migraine as a systemic vascular inflammatory disorder characterised by endothelial dysfunction. It is also well-known that chronic inflammation results in an excessive burden of oxidative stress and therefore cellular dysfunction. In this study the effects of excessive oxidative stress through the phases of female migraine-with-aura (FMA) were evaluated by examining the health of the systems of haemostasis. METHODS : Blood was obtained from 11 FMA patients at baseline and during the headache phase of migraine, as well as from 8 healthy age-matched female controls. Samples were analysed using thromboelastography (TEG) to evaluate viscoelastic profiles, light microscopy for erythrocyte morphology, Scanning Electron Microscopy (SEM) for erythrocyte and fibrin clot structure, confocal microscopy for β-amyloid detection in fibrin clots. RESULTS : Viscoelastic profiles from platelet poor plasma showed decreased clot reaction times in FMA at baseline (95% CI [5.56, 8.41]) vs. control (95% CI [7.22, 11.68]); as well as decreased time to maximum thrombus generation for the same comparison (95% CI [6.78, 10.20] vs. [8.90, 12.96]). Morphological analysis of erythrocytes indicated widespread macrocytosis, poikilocytosis and eryptosis in the migraineurs. Analysis of fibrin networks indicated that this hypercoagulability may be a result of aberrant fibrin polymerisation kinetics caused by the adoption of a β-amyloid conformation of fibrin(ogen). CONCLUSION : The results reaffirm the hypercoagulable state in migraine, and would suggest that this state is most likely a result of a systemic inflammatory state which induces oxidative damage to both erythrocytes and fibrin(ogen) in female episodic migraine-with-aura. Furthermore, if the amylodogenic changes to fibrin(ogen) were observed in a larger cohort, this would support theories of micro-embolisation in migraine-with-aura.en_ZA
dc.description.departmentPhysiologyen_ZA
dc.description.librarianam2020en_ZA
dc.description.sponsorshipThe Biotechnology and Biological Sciences Research Council (grant BB/L025752/1), the National Research Foundation (NRF) of South Africa (91548: Competitive Program) and the Medical Research Council of South Africa (SAMRC) (Self- Initiated Research Program).en_ZA
dc.description.urihttp://www.frontiersin.org/Neurologyen_ZA
dc.identifier.citationde Villiers S, Bester J, Kell DB and Pretorius E (2019) A Possible Role of Amyloidogenic Blood Clotting in the Evolving Haemodynamics of Female Migraine-With-Aura: Results From a Pilot Study. Frontiers in Neurology 10:1262. DOI: 10.3389/fneur.2019.01262.en_ZA
dc.identifier.issn1664-2295 (online)
dc.identifier.other10.3389/fneur.2019.01262
dc.identifier.urihttp://hdl.handle.net/2263/73826
dc.language.isoenen_ZA
dc.publisherFrontiers Mediaen_ZA
dc.rights© 2019 de Villiers, Bester, Kell and Pretorius. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).en_ZA
dc.subjectCoagulationen_ZA
dc.subjectFibrin(ogen)en_ZA
dc.subjectβ-Amyloiden_ZA
dc.subjectThromboelastographyen_ZA
dc.subjectEryptosisen_ZA
dc.subjectFemale migraine-with-aura (FMA)en_ZA
dc.titleA possible role of amyloidogenic blood clotting in the evolving haemodynamics of female migraine-with-aura : results from a pilot studyen_ZA
dc.typeArticleen_ZA

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