Chronic migraine linked to hypothalamic hormonal dysfunction

By Megan Rauscher

NEW YORK, (Reuters Health) – When episodic migraine becomes chronic migraine, hormone irregularities may be to blame, according to a report in the December Journal of Neurology, Neurosurgery and Psychiatry.

Dr. Mario F. Peres, of the Sao Paulo Headache Center, Brazil, and colleagues measured melatonin, prolactin, growth hormone, and cortisol secretion in 17 patients with chronic migraine and 9 healthy matched controls. They did this by taking blood samples from the subjects every hour between 7 p.m. and 7 a.m.

An abnormal pattern of hypothalamic hormone secretion emerged in patients with chronic migraine but not in healthy controls. Forty-seven percent of chronic migraine patients had "a significant phase delay in the melatonin peak and half had insomnia," the team reports. Patients with chronic migraine and insomnia had significantly lower melatonin concentrations than control subjects and patients with chronic migraine without insomnia. [

"There is a potential benefit from melatonin supplementation in these patients," Dr. Peres told Reuters Health, although it has yet to be proven.

Chronic migraineurs also had higher cortisol levels and a lower prolactin peak than controls. The "lower prolactin levels reflect a hyperdopaminergic state," the researcher noted, suggesting that "drugs interfering with dopamine neurotransmission may help chronic migraineurs."

"These findings have never been reported in chronic migraine," Dr. Peres told Reuters Health.

J Neurol Neuosurg Psychiatry 2001;71:747-751.

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