OBJECTIVE: To assess ictal adiponectin (ADP) levels before and after acute 
abortive treatment in women episodic migraineurs.
METHODS: Peripheral blood specimens were collected from women episodic 
migraineurs before and after acute abortive treatment with sumatriptan/naproxen 
sodium vs placebo. Univariate and multivariate models were utilized to examine 
the relationship between serum total ADP (T-ADP), ADP oligomers (high molecular 
weight [HMW], middle molecular weight, and low molecular weight [LMW]-ADP), and 
ADP ratio levels and pain severity. Paired t-tests and random intercept 
longitudinal models were utilized to assess the mean changes in T-ADP, ADP 
oligomers, and ratios over time in treatment responders and nonresponders.
RESULTS: Twenty participants (11 responders, 9 nonresponders) have been studied 
to date. In all participants, increases in the HMW : LMW ADP ratio were 
associated with an increase in pain severity. For every 1 point increase in the 
HMW : LMW ratio, pain severity increased by 0.22 (Confidence Interval [CI]: 
0.07, 0.37; P = .004). In contrast, for every 0.25 μg/mL increase in LMW-ADP, 
pain severity decreased by 0.20 (CI: -0.41, -0.002; P = .047). In treatment 
responders, T-ADP levels were reduced at 30 minutes (12.52 ± 3.4; P = .03), 60 
minutes (12.32 ± 3.2; P = .017), and 120 minutes (12.65 ± 3.2; P = .016) after 
treatment as compared with onset (13.48 ± 3.8). Additionally, in responders, the 
HMW : LMW ratio level was greater at pain onset (3.70 ± 1.9 μg/mL) as compared 
with nonresponders (2.29 ± 0.71 μg/mL), P = .050. Responders also showed a 
decrease in the HMW : LMW ratio at 60 minutes (2.37 ± 1.1; P = .002) and 120 
minutes (2.76 ± 1.4; P = .02) after treatment as compared with onset 
(3.70 ± 1.9). These changes in responders remained significant after adjusting 
for covariates, including measured body mass index (m-BMI). Although 
nonresponders showed no significant changes in unadjusted T-ADP or ADP oligomer 
or ratio levels, the HMW : LMW ratio was increased in nonresponders after 
adjustments (P = .025).
CONCLUSION: In this pilot study of women episodic migraineurs, the HMW : LMW ADP 
ratio level was associated with migraine severity and predictive of acute 
treatment response. ADP and the HMW : LMW ratio of ADP represent potential novel 
biomarkers and drug targets for episodic migraine.