Platelet Dysfunction in Migraine: Effect of Self-Medication with Aspirin

Summary

Circulating microembolic index (CMI) was determined by drawing one blood sample into EDTA-formalin and the other into DTA alone in patients with migraine and compared with matched normal controls. Platelet aggregates, if any, are fixed in EDTA-formalin but dis- aggregated by EDTA. Ratios of these two counts approximate “unity” in normals and are proportionately less than unity, depending on the number of platelet aggregates. 26 untreated migraineurs and 19 migraineurs with history of self-medication with aspirin taken within 72 hours of the test, were studied in headache-free intervals. Results were compared with those from 20 healthy, age and sex matched volunteers, without migraine, who were medication- free for at least one week. Mean CMI in untreated migraineurs (0.77±0.03 SEM) was significantly lower than the mean in normal controls (0.94±0.02, p. <0.002). Migraineurs with selfadministration of aspirin had mean CMI of 0.88±0.02, differing significantly from untreated migraineurs (p <0.01) but not from normal controls (0.1<p<0.2). Results suggest excessive platelet aggregation in migraineurs which tends to be corrected by treatment with platelet inhibitors such as aspirin.

• References

• 1 Ad Hoc Committee on Classification of Headache: Classification of headache. 1962; Journal of the American Medical Association. 179: 717.
• 2 Antony M, Hinterberger H, Lance J. W. 1967; Plasma serotonin in migraine and stress. Archives of Neurology 16: 544.
• 3 Deshmukh V. D, Harper A. M. 1973; The effect of serotonin on cerebral and extracerebral blood flow with possible implications in migraine. Acta Neurlogica Scandinavica 49: 649.
• 4 Dukes H. T, Vieth R. G. 1964; Cerebral arteriography during migraine prodrome and headache. Neurology 14: 636.
• 5 Hardisty R. M, Stacey R. S. 1955; 5-Hydroxytryptamine in normal human platelets. Journal of Physiology 130: 711.
• 6 Hilton B. P, Cumings J. N. 1971; An assessment of platelet aggregation induced by 5-hydroxy-tryptamine. Journal of Clinical Pathology 24: 250.
• 7 Kalendovsky Z, Austin J. H. 1975; “Complicated migraine” -Its association with increased platelet aggregability and abnormal plasma coagulation factors. Headache 15: 18.
• 8 Kapp J, Mahaley M. S, Odom G. L. 1968; Cerebral arterial spasm. Part 2: Experimental evaluation of mechanical and humoral factors in pathogenesis. Journal of Neurosurgery 29: 339.
• 9 Mathew N. T, Hrastnik F, Meyer J. S. 1976; Regional cerebral blood flow in the diagnosis of vascular headache. Headache 15: 252.
• 10 O’Brien M. D. 1971; Cerebral blood flow changes in the migraine headache. Headache 10: 139.
• 11 Rosenblum W. I. 1975; Constriction of pial arterioles produced by prostaglandin F₂alpha. Stroke 6: 293.
• 12 Sicuteri F, Buffoni F, Anselmi B, del Bianco P. L. 1972; An enzyme (MAO) defect on the platelets in migraine. Research Clinical Studies in Headache 3: 245.
• 13 Skinhøj E. 1971. Value of regional cerebral blood flow studies in migraine research. In: Proceedings of the International Headache Symposium. Basel: 201.
• 14 Smith J. B, Ingerman C, Kocsis J. J, Silver M. J. 1973; Formation of prostaglandins during the aggregation of human blood platelets. Journal of Clinical Investigation 52: 965.
• 15 Smith J. B, Willis A. L. 1971; Aspirin selectively inhibits prostaglandin production in human platelets. Nature New Biology 231: 235.
• 16 Vardi Y, Ralsey I. M, Streiffer M, Schwartz H, Lindner H. R, Zorr U. 1976 Migraine attacks. Alleviation by an inhibition of prostaglandin synthesis and action. Neurology (March). in press.
• 17 Wu K. K, Hoak J. C. 1974; A new method for the quantitative detection of platelet aggregates in patients with arterial insufficiency. Lancet 2: 924.
• 18 Weiss H. J, Aledort L. M, Kochwa S. 1968; The effect of salicylates on the hemostatic properties of platelets in man. Journal of Clinical Investigation 47: 2169.