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The Headaches and Polymorphisms of the Methylenetetrahydrofolate Reductase

The headaches are a heterogeneous clinical manifestations characterized not only by pain but also by a severe multifactorial disabilities. Numerous studies showed the association between the enzyme MTHFR mutations, the T allele and genotype TT and migraine, particularly migraine with aura.

Aim of the study: On the basis of the literature data we propose to evaluate the prevalence of the MTHFR mutation in the population of patients admitted to a headache center of the childhood.

Materials and methods: we examined 226 children, aged 5-17 years, admitted to " Headache Center" of Children Neuropsychiatry of Hospital San Salvatore L'Aquila, from 2013 to the year 2015. The diagnosis of headache is made according to ICHD III criteria. The identification of the MTHFR C677T polymorphism of the enzyme was carried out by the Real-time PCR qualitative. The statistical analysis by SAS System.

Results: Diagnosis of migraine without aura in 96 patients, migraine with aura in 39, in 18 chronic migraine, frequent episodic tension-type headache in 40, chronic tension type headache in 20 and in 13 other headaches. 61 patients are without mutation, 85 with heterozygous mutation, and 28 homozygous. Therefore, the mutation is present in 147 patients with a percentage of 65%. The heterozygous mutation is present in 50.56% of females and 47.06% males; the homozygous in 10.19% and 12.94% in females than males. In migraineurs the mutation is present in 66.67% compared with patients with tension-type headache (33.33%), homozygous is the 70.37% versus 29.63% (p<0.001). Homocysteine levels are elevated only on the 8.69% of mutated patients, of which 5/12 patients have a mutation in homozygosity.

Conclusion: we confirme the statistical association between MTHFR mutation both in the heterozygous and homozygous forms and migraines. The migraines with aura, unlike the literature, does not seem to have an important role.


Elisabetta Tozzi

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