Preliminary exploration of metabolomics mechanisms in patients with patent foramen ovale and migraine.

This study aimed to investigate the metabolic mechanisms underlying the combination of patent foramen ovale (PFO) and migraine by assessing metabolite expression before and after interventional occlusion surgery. The study included 11 PFO patients from the Heart Center of Xinjiang Medical University Affiliated Hospital of Traditional Chinese Medicine, who underwent transcatheter PFO intervention and occlusion surgery between January 2018 and February 2023, and 11 healthy controls. Blood samples were collected pre-surgery, 3 days post-surgery, and 30 days post-surgery for metabolomics analysis. The goal was to identify differentially expressed metabolites between groups. Statistical analyses were performed to evaluate these metabolites alongside migraine disability, assessed using the Migraine Disability Assessment (MIDAS) score. Preliminary analysis of metabolic pathways was also conducted. Results showed significant differences in serum metabolites, including dopamine, L-proline, L-tyrosine, D-proline, acetylcarnitine, and dulcitol, between PFO migraine patients and healthy controls based on Liquid Chromatography-Mass Spectrometry (LC-MS) non-targeted metabolomics analysis. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis of these metabolites revealed enrichment in protein digestion, absorption, and metabolic signaling pathways, highlighting the role of metabolism in the disease process. Elevated levels of dopamine and other metabolites were found in migraine patients, with differential metabolites primarily associated with the arginine metabolic pathway, suggesting its importance in the condition's progression. Additionally, patients with PFO and migraine showed significant improvements in headache frequency, duration, and severity post-treatment (p < 0.05), though accompanying symptoms did not show statistically significant changes (p > 0.05). Overall, interventional closure surgery for PFO significantly alleviates headache symptoms in patients.