5 CHAPTER 5 104 Figure 4 Timing migraine onset in GTN responders The onset of migraine is plotted for each glyceryl trinitrate (GTN) responder with respect to time after GTN infusion. The start of the black continuous line represents the timing of onset of migraine attack per individual. The dotted line represents the blood draw timepoints T0, T1 and T2 at 0, ~140 and ~320 minutes, respectively, after the start of the GTN infusion. Table 2 Median PGE2 concentrations over time independent of migraine phase Group [T0] [T1] [T2] GTN responders 0.044 (0.02-0.10) 0.053 (0.03-0.10) 0.049 (0.03-0.08) GTN non-responders 0.052 (0.01-0.09) 0.031 (0.01-0.07) 0.040 (0.02-0.07) Controls 0.044 (0.02-0.08) 0.043 (0.03-0.09) 0.060 (0.03-0.09) Values are the uncorrected medians of absolute concentrations in ng/mL with their interquartile range. [T0] = baseline, [T1] = ~140 minutes after the start of GTN infusion, [T2] = ~320 minutes after GTN infusion. GTN responder, migraine patients who responded to GTN; GTN non-responder, migraine patients who did not respond to GTN. GTN, glyceryl trinitrate. PGE2 in relation to migraine-like attack onset The level of PGE2 per individual varied per time point (Table 2).To determine whether PGE2 levels were linked to the various phases (baseline, preictal and ictal) of a migraine attack, a generalized linear mixed model was used. The transition from an interictal state towards a migraine-like attack had no influence on PGE2 concentration (F (2, 69.70) = 1.235, P = 0.297). Both the transition from “interictal to preictal” (P = 0.527) and “interictal to ictal” (P = 0.141) phase of GTN-induced migraine-like attacks had no influence on PGE2 concentration (Table S1).
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