Background: There is evidence suggesting that an imbalance between the levels of the excitatory neurotransmitter, glutamate, and inhibitory neurotransmitter, gamma aminobutyric acid (GABA), leads to migraine attacks; however, the pathophysiology and specific diagnostic markers remain unknown. Methods: Twenty-one migraine patients (18 female, 3 male, mean age=40.63 14.23years) and 11 healthy controls (9 female, 2 male, mean age=39.78 15.31 years) were included in this study. We used 1H-MRS at 3

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... esla with voxels-of-interest located in the bilateral thalamus and subgenual anterior cingulate cortex (SG ACC) to quantify the GABA and GLX (glutamate-glutamine complex) concentrations measured via the Mescher-Garwood point-resolved spectroscopy (MEGA-PRESS) sequence in migraineurs and healthy controls. Result: Statistical analyses revealed significantly decreased GLX/NAA (N-acetylaspartate) in the right thalamus of migraine patients compared to healthy controls. However, we found no group differences in GABA levels in the SG ACC and bilateral thalamus.Conclusion: The right thalamus may be involved in the pain modulation process of migraineurs through changes in the GLX levels. Decreased GLX levels within the right thalamus might be associated with the disruption of "excitation-inhibition" homeostasis in migraine.Trial registration: ClinicalTrials.gov, NCT02580968. Registered 30 October 2015, https://clinicaltrials.gov/ct2/show/study/NCT02580968