Deficient energy metabolism is associated with low free magnesium in the brains of patients with migraine and cluster headache

We used phosphorus magnetic resonance spectroscopy to assess in vivo the br ain cytosolic free magnesium concentration and the free energy released by the reaction of adenosine triphosphate (ATP) hydrolysis (DeltaG(ATPhyd)), t he latter being an index of the cell's bioenergetics condition. We studied 78 patients with migraine in attack-free periods (7 with migraine stroke, 1 3 with migraine with prolonged aura, 37 with migraine with typical aura or basilar migraine, and 21 with migraine without aura), and 13 patients with cluster headache. In the occipital lobes of all subgroups of migraine and i n cluster headache patients cytosolic free [Mg2+] as well as the free energ y released by the reaction of ATP hydrolysis were significantly reduced. Am ong migraine patients, the level of free energy released by the reaction of ATP hydrolysis and the cytosolic free [Mg2+] showed a trend in keeping wit h the severity of clinical phenotype, both showing the lowest values in pat ients with migraine stroke and the highest in patients with migraine withou t aura. These results support our current hypothesis that the reduction in free [Mg2+] in tissues with mitochondrial dysfunction is secondary to the b ioenergetics deficit, and are against a primary role of low brain cytosolic free [Mg2+] in causing the bioenergetics deficit in headache. (C) 2001 Els evier Science inc.