Targeted liquid chromatography-tandem mass spectrometry profiling of arginine and histidine derivatives in chronic migraine: Discriminatory performance and changes after onabotulinumtoxinA therapy.

This study explored the role of specific amino acids in chronic migraine patients. Researchers evaluated plasma levels of arginine, histidine, and their derivatives. They aimed to identify potential biomarkers for chronic migraine and treatment monitoring. Data were collected from 30 chronic migraine patients receiving onabotulinumtoxinA and 30 healthy controls. Patients showed higher arginine and 3-methylhistidine levels but lower histidine levels. After treatment, patients reported significant reductions in pain intensity and attack frequency. Histidine levels increased while 3-methylhistidine levels decreased post-treatment. The study found that histidine and 3-methylhistidine could serve as candidate biomarkers for chronic migraine. The combined biomarker model showed high discrimination ability. Overall, chronic migraine associates with a unique metabolic signature. This research highlights the potential of using these metabolites for disease stratification and monitoring treatment responses. Further validation in larger cohorts is necessary to confirm these findings. Clinical relevance: This research suggests that arginine and histidine metabolites may help monitor chronic migraine treatment responses.