The relationship of plasma FFA, plasma PGE1 and platelet serotonin changes were investigated in migrainous patients and in patients subjected to stressful procedures.

Plasma FFA levels rose and platelet serotonin content fell during the migrainous episode in the majority of patients. These changes were statistically significant. Plasma FFA levels and platelet serotonin changed reciprocally in 60% of cases. No statistically significant change in plasma FFA levels were observed in patients subjected to stressful procedures or during cluster headache.

Plasma levels of PGE1 showed no significant change during migraine. No difference in PGE1 between venous and arterial plasma was found in normal subjects and in patients with various neurologic diseases. Plasma levels of natural PGE1 do not accurately reflect the rate of PGE1 synthesis in the body and this may account for these negative results.

The migraine attack is accompanied by a rise in plasma FFA. However, this rise is not necessarily the cause for serotonin release which occurs during migraine. Both the amine and PGE1 could release FFA from body stores. Identification of the individual FFA released would be necessary to resolve the problem. The role of PGE1 in migraine, might be assessed by estimation of its more stable 15-keto-dihydro metabolite which reflects more accurately its rate of synthesis. This could demonstrate whether PGE 1 plays a part in the biochemical process of headache.