Background and objectives.—The fundamental reason that the migraine phenotype is experienced by sufferers and not by the more fortunate populace is not known. We believe a common biochemical pathway is involved, and are attempting to reveal this by using an objective and broad survey of molecular composition, rather than the conventional hypothesis-driven approaches that are narrowly focused and subjective.
Methods.—This article discusses the application of CSF bioanalysis in a clinical sample and summarizes preliminary findings, which are described more fully in papers currently in press.
Results.—In migraineurs during a migraine attack, compared with a migraine-free period, changes have been documented in the concentrations of specific proteins, lipids, small molecules, and elements in the CSF. The degree to which these changes are specific to migraine remains to be determined.
Conclusions.—As the CSF profiles for proteins, lipids, small molecules, and elements become better delineated in both healthy individuals and in disease states such as migraine, measurement of changes in CSF composition will provide the potential for improving diagnosis, correlating molecular events with symptoms, developing new therapeutic strategies, and enhancing the ability to monitor the results of therapy.