There are many reports concerning platelet dysfunction and abnormalities of platelet 5-hydroxytryptamine (5-HT) in migrainous patients. In recent years, platelets are considered good models of monoamine neurons. Levels of neurotransmitters in platelets are suggested to reflect those in the nervous system. We reported alteration of platelet neurotransmitters and other biogenic substances in migraine and tension-type headache. In patients with tension-type headache, the concentrations of platelet 5-HT and norepinephrine were significantly lower than in the controls. However, the activity of platelet superoxide dismutase was normal in the patients with tension-type headache, while the activity of platelet superoxide dismutase in the patients with migraine was lower than the controls. A recent study has shown that migraine is associated with a generalized disorder of mitochondrial oxidative phosphorylation and this may constitute a threshold for the triggering of migraine attacks. Some patients with migraine had a mutation in mitochondrial gene. None of the patients with tension-type headache had the mutation. the point mutation in the mitochondrial gene of these patients may play an important role in the pathogenesis of their migraine attacks.