Serum Resolvin D1 and Maresin 1 Levels During Migraine Attacks and the Interictal Period: A Paired Analysis in Emergency Department Patients

<b>Background/Objectives</b>: Neurogenic inflammation plays a key role in migraine pathophysiology. This study aimed to evaluate serum Resolvin D1 (RvD1) and Maresin 1 (MaR1) levels during acute migraine attacks and in the interictal period in the same patients, using a paired design. <b>Methods</b>: This prospective case-control study included 55 migraine patients and 53 healthy controls. Serum samples were obtained from each patient at two time points: during an acute attack and during the subsequent interictal period. RvD1 and MaR1 concentrations were measured using ELISA. <b>Results</b>: Serum RvD1 and MaR1 levels were significantly lower during migraine attacks compared with both the interictal period (<i>p</i> = 0.006 and <i>p</i> = 0.001, respectively) and healthy controls (<i>p</i> < 0.001). Receiver operating characteristic (ROC) analyses showed moderate discriminatory ability for RvD1 (AUC 0.719) and MaR1 (AUC 0.730). <b>Conclusions</b>: Reduced RvD1 and MaR1 levels are associated with the acute migraine state. These findings indicate an association rather than a causal mechanism and suggest that SPM measurements may have potential as supportive adjunct biomarkers, although further validation is required.