H Ketanserin Binding in Tension-type Headache

Objective.—The present study was undertaken to investigate the alterations in platelet 5-HT 2 receptor binding in patients with tension-type headache. Background.—Serotonin (5-HT) has an important but complex role in pain modulation. The involvement of serotonin in tension-type headache has been investigated by studying serotonin in peripheral blood, but results have been inconclusive. There are, however, only a few investigations in which the status of platelet serotonin transporters has been studied by 3 H imipramine and 3 H paroxetine. The present study was undertaken to investigate alterations in platelet 5-HT 2A receptors using 3 H ketanserin as a ligand. Methods.—Platelet 3 H ketanserin binding was studied in 14 patients with tension-type headache and in 15 healthy controls. The binding characteristics, equilibrium dissociation constant and maximal number of binding sites were determined by Scatchard analysis. Results.—There was no change in the equilibrium dissociation constant in the patients with headache as compared to the control group, but subgroup analysis revealed that patients with tension-type headache with a headache index of less than 360 had a significantly lower equilibrium dissociation constant as compared to those with a headache index of more than 360; there was a significant correlation between the equilibrium dissociation constant and the headache index. A significant decrease was observed in the maximal number of binding sites in tensiontype headache. No correlation was observed between the maximal number of binding sites and age, duration of illness, or headache intensity. Conclusions.—The findings of the present study show that there is a decrease in the number of binding sites of 5-HT 2A receptors in some patients with tension-type headache, suggesting postsynaptic serotonergic dysfunction and the involvement of serotonin in that group.