Peptides whose levels change during the attack period in episodic migraine: NETRIN-1 and amylin.

OBJECTIVES: The role of neuroinflammation in the pathophysiology of migraine is becoming increasingly important. The aim of this study was to evaluate serum netrin-1 and amylin levels in patients with episodic migraine. METHODS: The study included 60 patients diagnosed with episodic migraine and 30 healthy controls. Patients were evaluated during an ictal (n = 25) or interictal (n = 35) period. They were further categorized based on the presence of aura (migraine with aura, n = 25; migraine without aura, n = 35). RESULTS: Serum netrin-1 levels were markedly lower in the migraine group compared to the control group (492.7 ± 638.0 pg/mL vs. 744.8 ± 754.7 pg./mL, p = 0.038). Although amylin levels were also lower in migraine patients (324.9 ± 451.7 ng/mL vs. 453.7 ± 490.2 ng/mL), this difference did not reach statistical significance (p = 0.141). No significant differences in netrin-1 and amylin levels were observed between patients with and without aura, nor between ictal and interictal periods. In the ROC analysis, netrin-1 levels demonstrated significant diagnostic performance in distinguishing migraine patients from controls (AUC = 0.635; 95% CI: 0.512-0.758; p = 0.031). The ROC analysis for amylin was not significant (AUC = 0.596, p = 0.133), and the combined model yielded an AUC of 0.636 (p = 0.036). CONCLUSION: Serum netrin-1 levels were markedly lower in patients with episodic migraine compared with healthy controls, while amylin levels also showed a decreasing trend. Further large-scale studies are needed to elucidate the clinical significance and pathophysiological roles of these biomarkers in migraine.