{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T14:14:06Z","timestamp":1783692846276,"version":"3.55.0"},"reference-count":38,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Fujian Province Natural Science Foundation","award":["2023D006"],"award-info":[{"award-number":["2023D006"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cephalalgia"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Glutathione (GSH) and glutamate (Glu) have been individually implicated in migraine pathophysiology, but their ratio as a marker of oxidative\u2013excitatory balance in the thalamus\u2014a key pain-processing hub\u2014remains unexplored. This study investigated thalamic GSH\/Glu ratios across primary headache subtypes and evaluated their diagnostic utility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study included 131 participants: 36 healthy controls (HC), 17 migraine with aura (MwA), 46 migraine without aura (MwoA), and 32 tension-type headache (TTH). Single-voxel proton magnetic resonance spectroscopy was performed at 3T using a MEGA-PRESS sequence targeting bilateral thalami. Metabolite concentrations were quantified with LCModel and corrected for partial volume effects using an established tissue correction framework. Group differences were analyzed using ANOVA with Tukey HSD correction; diagnostic performance was assessed using ROC analysis with bootstrap resampling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The GSH\/Glu ratio differed significantly across groups (F\u2009=\u20099.41, p\u2009&lt;\u20090.001, \u03b7\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.183), confirmed by bootstrap validation. MwA (0.250\u2009\u00b1\u20090.038, p\u2009&lt;\u20090.001, Cohen's d\u2009=\u20091.47) and MwoA (0.280\u2009\u00b1\u20090.052, p\u2009=\u20090.006, d\u2009=\u20090.79) showed significantly lower ratios than HC (0.320\u2009\u00b1\u20090.055), whereas TTH (0.318\u2009\u00b1\u20090.068) did not differ from HC. This reduction was driven by decreased GSH levels, with Glu concentrations unchanged across groups. Exploratory ROC analysis yielded apparent AUCs of 0.874 for GSH and 0.758 for the GSH\/Glu ratio; these estimates require independent validation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Migraine is characterized by reduced thalamic GSH levels and decreased GSH\/Glu ratios, reflecting diminished antioxidant buffering capacity against normal excitatory neurotransmission. This metabolic alteration distinguishes migraine from TTH, supporting distinct pathophysiological mechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03331024261462792","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T09:27:45Z","timestamp":1783502865000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Differential thalamic GSH\/Glu ratios Among primary headache subtypes and clinical implications: A cross-sectional magnetic resonance spectroscopy study"],"prefix":"10.1177","volume":"46","author":[{"given":"Yinhua","family":"Jin","sequence":"first","affiliation":[{"name":"The Fifth Hospital of Xiamen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Wang","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Xiamen Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongying","family":"Huang","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Xiamen Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongrouwen","family":"Ren","sequence":"additional","affiliation":[{"name":"Xiang\u2019an Hospital of Xiamen University, School of Medicine, Xiamen University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9652-9651","authenticated-orcid":false,"given":"Gen","family":"Yan","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Xiamen Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30322-3"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32160-7"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-021-00257-2"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.wco.0000227043.00824.a9"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/head.12725"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-016-0606-0"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13760-015-0427-y"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-0082(99)00060-X"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12011-008-8193-9"},{"key":"e_1_3_3_11_2","first-page":"713","article-title":"Role of oxidative stress in migraine with and without aura","volume":"57","author":"Gupta R","year":"2009","unstructured":"Gupta R, Pathak R, Bhatia MS, et al. Role of oxidative stress in migraine with and without aura. Neurol India 2009; 57: 713\u2013717.","journal-title":"Neurol India"},{"key":"e_1_3_3_12_2","first-page":"877","article-title":"Oxidative and antioxidative balance in patients of migraine","volume":"14","author":"Alp R","year":"2010","unstructured":"Alp R, Selek S, Alp SI, et al. Oxidative and antioxidative balance in patients of migraine. 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Glutamate induces mitochondrial dysfunction in cultured rat forebrain neurons. 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