{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T10:44:14Z","timestamp":1771670654053,"version":"3.50.1"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T00:00:00Z","timestamp":1635206400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T00:00:00Z","timestamp":1635206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Neurol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>A recent study showed that 60\u2013s paranasal air suction results in an immediate pain relief in acute migraine. This is the study to assess the Nitric Oxide (NO) and Carbon Monoxide (CO) concentration in nasal-paranasal sinus air of migraine patients and to compare it with healthy controls.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methodology<\/jats:title>\n                <jats:p>The NO and CO levels of air sucked out from nasal-paranasal sinuses of 20 migraine adolescent and young adults among school students, aged 16 \u201319\u2009years, and 22 healthy similar aged school students as controls were measured as key responses using a portable NO and a portable CO analyzer.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Patients had comparatively high values compared to the controls for paranasal NO (both left and right sides), paranasal CO (both left and right sides), Fraction Exhaled NO (FeNO) and Fraction Exhaled CO (FeCO). Patients had median paranasal NO contents of 132.5\u2009ppb and 154\u2009ppb on left and right sides respectively compared to 36\u2009ppb and 34.5\u2009ppb corresponding values in controls (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009\u00a00.0001). Similar pattern was observed with paranasal CO (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009\u00a00.0001). FeNO and FeCO content were also higher in patients (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009\u00a00.0001). Receiver characteristic operating curves of all gas measurements showed that they all could classify patients and controls effectively and NO was the most effective followed by paranasal CO. After air suction, the mean pain scores of general headache and tenderness dropped by a very large margin in migraine patients (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009\u00a00.0001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Suctioned out high nasal-paranasal sinus NO and CO levels can be used to distinguish migraine patients from healthy subjects. In fact, suctioned out paranasal NO measurements of both sides with a cutoff point of 50\u2009ppb provided a perfect classification of patients and controls. Increased sinus NO and CO during acute episode of migraine is an observation we had and we agree that further studies are needed to conclude that NO and CO can be a causative molecule for migraine headache.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trail registration<\/jats:title>\n                <jats:p>Clinical Trial Government Identification Number \u2013 1548\/2016.<\/jats:p>\n                <jats:p>Ethical Clearance Granted Institute \u2013 Medical Research Institute, Colombo, Sri Lanka (No 38\/2016).<\/jats:p>\n                <jats:p>Sri Lanka Clinical Trial Registration number: SLCTR\/ 2017\/018 (29\/06\/2017).<\/jats:p>\n                <jats:p>Approval Granting Organization to use the device in the clinical trial\u2013 National Medicines Regulatory Authority Sri Lanka (16\/06\/2018), The device won award at Geneva international inventers exhibition in 2016 and President award in 2018 in Sri Lanka. It is a patented device in Sri Lanka and patent number was SLKP\/1\/18295.<\/jats:p>\n                <jats:p>All methods were carried out in accordance with CONSORT 2010 guidelines.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12883-021-02434-y","type":"journal-article","created":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T10:03:05Z","timestamp":1635242585000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Elevated nitric oxide and carbon monoxide concentration in nasal-paranasal sinus air as a diagnostic tool of migraine: a case \u2013 control study"],"prefix":"10.1186","volume":"21","author":[{"given":"S. M. R.","family":"Bandara","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Samita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. 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Registration No: 38\/2016. All methods were performed in accordance with the relevant guidelines and regulations of Medical Research Institute ethical committee.All methods were performed in accordance with the guidelines and regulations of Declarations of Helsinki.Clinical Trial Registration number\u2009=\u2009SLCTR\/ 2017\/018.Sri Lanka Clinical Trials Registry.Date of Registration\u2009=\u200929\/06\/2017.Universal Trail Number\u2009=\u2009U1111-1190-2358.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics and consent to participate"}},{"value":"A formal informed consent in writing was obtained from all participants and from legally acceptable representative of the participants who were below age of 18\u2009years. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"407"}}