We examined the CBF and CMRO2 changes that accompany menstrual migraine, and evaluated the response to sumatriptan to determine the role of serotonin in migraine pathophysiology. Migraine is accompanied by a decline in global CBF and CMRO2 that appears to be serotonin-mediated. There is also a decline in stimulus-dependent CBF to a visual stimulus, that appears to also involve serotonin, but acts differently from the global responses. A decline in visual stimulus-dependent CMRO2 is not serotonin mediated, and appears to follow the normal variation in stimulus-dependent CMRO2 response that changes with normal menstrual cycle.
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