Migraines Linked to High Cerebrospinal Fluid Sodium Levels

Migraines Linked to High Cerebrospinal Fluid Sodium Levels

By Staff.

If you suffer from migraines, it’s likely you have significantly higher concentrations of sodium in your cerebrospinal fluid compared to people who do not suffer from migraines.

These findings come from a novel study that used a technique called sodium MRI to assess the migraine sufferers.  The findings were presented at the Radiological Society of North America (RSNA) annual conference.

Migraines are a type of headache characterized by severe head pain, and sometimes nausea and vomiting.  They can also include vision changes called auras.  Migraine affects about 18 percent of women and 6 percent of men. But those numbers may be higher, as migraines are difficult to diagnose.

“It would be helpful to have a diagnostic tool supporting or even diagnosing migraine and differentiating migraine from all other types of headaches,” said study author Melissa Meyer, M.D., radiology resident at the Institute of Clinical Radiology and Nuclear Medicine, University Hospital Mannheim and Heidelberg University in Heidelberg, Germany.

The researchers used a magnetic resonance technique called cerebral sodium MRI as a possible means to help in the diagnosis and understanding of migraines.  While MRI most often relies on protons to generate an image, sodium can also be visualized, and it has been shown with previous research that sodium plays an important role in brain chemistry.

The study included 12 women with a mean age of 34 years and who had been clinically evaluated for migraine, and 12 women of similar ages to serve as a control group.  Both groups underwent cerebral sodium MRI and both groups completed a questionnaire on the length, intensity and frequency of their migraine attacks and accompanying auras.  The sodium concentrations for both groups were analyzed and they found no statistical differences between the two groups for sodium concentrations in the gray and white matter, brain stem and cerebellum.

There were, however, significant differences when the researchers looked at sodium concentrations in the cerebrospinal fluid, which is the fluid that surrounds the brain and spinal cord and provides a cushion for the brain.

“These findings might facilitate the challenging diagnosis of a migraine,” Dr. Meyer said.

The researchers hope to learn more about the connection between migraines and sodium in future studies.

“As this was an exploratory study, we plan to examine more patients, preferably during or shortly after a migraine attack, for further validation,” Dr. Meyer said.

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Authored by: Staff

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Bob Schubring

MichaelL raises an interesting point. A co-morbid condition in some migraineurs, particularly people who experience migraines with aura, is panic disorder (Torelli, P. & D’Amico, D. Neurol Sci (2004) 25(Suppl 3): s234. https://doi.org/10.1007/s10072-004-0294-4), which is known to be linked to elevated systemic sodium levels. People who suffer panic disorder often respond to stress by developing a salt craving but experience diminished thirst, leading to blood pressure elevation. After having panic attacks that can be temporarily disabling, thirst is again experienced and the people re-hydrate. Conceivably both disorders involve a dysfunction in how the sodium balance is regulated. It is possible that different tissue types don’t respond identically, to the hormones that regulate the sodium balance. If, for example, the kidneys adjust the blood sodium level down, but the CSF sodium level remains high, water would flow from the blood into the brain cells, as Michael L speculates. Possibly the sensations of migraine aura induce the salt craving, as adding more salt to the blood would reverse the brain swelling but boost the blood pressure further.

This does seem a promising field for further research, and one that can extend life as well as improve quality of life. Migraine is a known risk factor for stroke. High salt intake is a known risk factor for high blood pressure and heart disease. Understanding these mechanisms will improve patient education and treatment compliance, as well as lead to improved treatments.


I am an MD/scientist. I developed clinical depression after trying to taper cortisone dose too fast in the past. I have always thought that there was an association with sodium distribution and the health of the adrenal glands. In cortisol deficiency, the sodium balance could be affected resulting in high intracellular sodium in the brain affecting the brain. Hypernatremia causes a patient to develop hallucinations and brain dysfunction. Migraines could be related to swelling of the tissues relative to the high sodium in the tissue. Since it is swollen the amount of sodium in the tissue would appear to be normal. The body might elevate the CSF sodium to attempt to decrease the swelling in the brain. Whatever it is, it is still a complicated process that will take a long time to figure out. Right now, they have to determine the connection between the CSF sodium and the migraines. The answer could be there. The elevated levels are a good find. It could be the biggest breakthrough in migraine research for a long time.