Serum Calcitonin Gene-Related Peptide Levels in Interictal period in Migraineurs versus Controls

Abstract

Background: Migraine is a frequent neurological condition with a complex pathogenesis and neuro-physicians continue to face difficulties in diagnosing and treating migraines due to their clinical breadth and heterogeneity.

Objective: To determine the levels of serum calcitonin gene related peptide (CGRP) outside the attack (interictal) in migraineurs versus healthy controls.

Methods: This cross-sectional, analytical study was conducted in Centre of Research in Molecular Medicine, The University of Lahore, Pakistan from November 2023 to June 2024. A total of eighty cases were added in research. Forty were patients of common migraine (as per ICHD-3 criteria) and forty were healthy controls. Serum CGRP levels were estimated by enzyme linked immune-sorbent assay (ELISA) outside the attack in migraineurs and healthy controls. Shapiro-wilk test, Mann Whitney U and Chi square tests were used for statistical analysis. The ROC (receiver operating characteristic) curve and AUC (area under curve) were acquired to assess capacity of discrimination of CGRP levels for common migraine. The p-value <0.05 was considered statistically significant.

Results: Migraineurs had a median serum CGRP level of 99.6 (64.4–163.4) ng/L while for the healthy controls it was 14.8 (10.9–24.3) ng/L (p <0.001). ROC curve analysis had found cutoff serum CGRP level of 36.8 ng/L with positive predictive value (PPV) as 86.7%, negative predictive value (NPV) as 97.1%, sensitivity as 97.5%, specificity as 85% and accuracy as 91.3% for the diagnosis of common migraine.

Conclusion: Elevated serum CGRP levels outside the migraine attack can be used as a potential biomarker for the diagnosis .................