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PLATELETS IN MIGRAINE: FINDINGS ON ENZYME MONOAMINE OXIDASE (MAO),
Another interesting finding is that the activity of one form of the enzyme monoamine oxidase (MAO), the function of which is to destroy amines such as serotonin in platelets, is lower during an attack of migraine than at other times. It might be thought that this lowering of MAO activity would lay the body open to amines which would then exert their noxious influence, but this is not so. However, we do not know precisely when this lowering occurs; whether it is a primary change or secondary to the headache; nor do we know what the other MAOs are doing.
This yo-yo behaviour of the platelet MAO in migraine seems to be at odds with findings that people with a consistently low level of platelet MAO are at greater risk of mental illness; a measurement that is constant, highly reproducible, and probably a genetic trait.
In our own studies, we found three individuals who not only had a low level of MAO during a migraine attack but also between attacks. There were no obvious psychiatric problems in any of them but, interestingly, they showed a response to tyramine similar to that found in depression. Although infusions of adrenalin and noradrenalin, as well as hard exercise, seem to increase the activity of MAO, no clear overall picture has emerged as yet.
The responses to all these tests in migraine patients differ from the normal but this does not mean that migraine sufferers are inherently different from other people. It is more likely that there is a gradation from normals to headache sufferers to migraine sufferers. It is because of this lack of sharp distinction that research on migraine is so difficult.
There are certain more clear-cut differences between the migraine sufferer and others. First, migraine can be inherited; second, there is an increased incidence of epilepsy in migraine sufferers, and, third, the EEG may be more often abnormal. The last two differences could be explained by repeated migraine attacks or by drugs used in treatment, and a good deal of research has been done to clarify this particular problem.
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