Elevated nitric oxide and carbon monoxide concentration in nasal-paranasal sinus air as a diagnostic tool of migraine: a case - control study - BMC Neurology
Source : https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-021-02434-y
Background A recent study showed that 60-s paranasal air suction results in an immediate pain relief in acute migraine. This is the study to assess the Nitric Oxide (NO) and Carbon Monoxide (CO) concentration in nasal-paranasal sinus air of migraine patients and to compare it with healthy controls.
Conclusions: Suctioned out high nasal-paranasal sinus NO and CO levels can be used to distinguish migraine patients from healthy subjects. In fact, suctioned out paranasal NO measurements of both sides with a cutoff point of 50 ppb provided a perfect classification of patients and controls. Increased sinus NO and CO during acute episode of migraine is an observation we had and we agree that further studies are needed to conclude that NO and CO can be a causative molecule for migraine headache.
• Source: BMC Neurology
• Conclusion/Relevance: “Suctioned out high nasal-paranasal sinus NO [nitric oxide] and CO [carbon monoxide] levels can be used to distinguish migraine patients from healthy subjects. In fact, suctioned out paranasal NO measurements of both sides with a cutoff point of 50 ppb provided a perfect classification of patients and controls. Increased sinus NO [nitric oxide] and CO during acute episode of migraine is an observation we had and we agree that further studies are needed to conclude that NO and CO can be a causative molecule for migraine headache.”
• Using a portable NO and CO analyzer, researchers measured NO and CO levels of air sucked out from nasal-paranasal sinuses of 20 migraine adolescent/young adults and 22 healthy controls.
• During an acute episode, the researchers found that a CO level above 1 ppm occurred in all migraine patients vs a CO level up to 1 ppm.
• “[P]aranasal NO and CO concentrations can be used to distinguish between individuals with and without migraine during an episode and especially NO with a cutoff value of 50 ppb can be used as a diagnostic test for migraine,” wrote the authors. “Moreover, air suction relieves patients from migraine headache as well as supraorbital tenderness. It seems this relief can be achieved with about three consecutive 50 L /min speed suction of 30 s for each nostril. Increased sinus NO and CO during acute episode of migraine is an observation we had and acute migraine can be relieved by evacuation of vasoactive and neuroactive nasal and paranasal sinus NO and CO.”