Interictal, circulating sphingolipids in women with episodic migraine: A case-control study

Objective: To evaluate interictal, circulating sphingolipids in women migraineurs. Methods: In the fasting state, serum samples were obtained pain-free from 88 women with episodic migraine (EM; n = 52) and from controls (n = 36). Sphingolipids were detected and quantified by high-performance liquid chromatography coupled with tandem mass spectrometry using multiple reaction monitoring. Multivariate logistic regression was used to examine the association between serum sphingolipids and EM odds. A recursive partitioning decision tree based on the serum concentrations of 10 sphingolipids was used to determine the presence or absence of EM in a subset of participants. Results: Total ceramide (EM 6,502.9 ng/mL vs controls 10,518.5 ng/mL; p p p p p = 0.001) and C18:1 (OR 2.93; 95% CI: 1.55, 5.54; p = 0.001) was associated with an increased odds of migraine. Recursive portioning models correctly classified 14 of 14 randomly selected participants as EM or control. Conclusion: These results suggest that sphingolipid metabolism is altered in women with EM and that serum sphingolipid panels may have potential to differentiate EM presence or absence. Classification of evidence: This study provides Class III evidence that serum sphingolipid panels accurately distinguish women with migraine from women without migraine.