Proteomic vascular anomalies detected during migraine surgery

Background: Many patients with temporal or occipital migraines experience localized and throbbing pain, suggesting potential involvement of extracranial vessels. This study aimed to assess the presence or absence of vascular anomalies through proteomic analysis of biopsies. Methods: Intraoperatively, thirty-three biopsies were collected, including 19 from the superficial temporal artery and 14 from the occipital artery, and immediately processed for proteomic analysis. Based on differences noted in the preliminary results, patients were divided into two Groups: A (age ≤ 40 years) and B (age ≥ 41 years). Results: A total of 5339 proteins were identified. Comparison of temporal arteries between patients from Group A and patients from Group B revealed 394 significantly dysregulated proteins, with 204 upregulated in younger patients and 190 upregulated in older patients. Similarly, comparison of occipital arteries between younger and older patients revealed 325 significantly dysregulated proteins, with 91 upregulated in younger patients and 234 upregulated in older patients. Conclusions: The data collected, indicative of organic lesions, support the rationale for surgical therapy. Our results suggest differences between patients (showing an anti-inflammatory substrate or displaying a pro-inflammatory substrate), which need to be better investigated. Level of Evidence: Level III, Diagnostic Study