Endocrine function is altered in chronic migraine patients with medication-overuse.
OBJECTIVE
To evaluate the effects of analgesic overuse on endocrine function in patients with chronic migraine and medication-overuse headache (CM-MOH).


BACKGROUND
Chronic migraine is frequently associated with an overuse of symptomatic medications. Drugs currently used in acute migraine attacks are associated with several endocrine effects. At present, the endocrine effects of medication overuse in chronic migraine patients are unknown.


METHODS
Eighteen patients with CM-MOH, diagnosed according to the ICHD-II criteria, and 18 healthy controls received an intravenous administration of GHRH, hCRH, and TRH. Plasma concentrations of GH, TSH, ACTH, and cortisol were measured for a 90-minute period after administration of the specific releasing hormones.


RESULTS
Hormonal basal concentrations were similar in both groups. GH response to GHRH was significantly reduced in patients with CM-MOH in comparison with controls. TRH induced a reduction of TSH concentrations only at the end of the test. After hCRH administration, ACTH and cortisol concentrations were significantly higher in cases than in controls. A significant correlation between duration of the disease and altered hormonal response was found.


CONCLUSIONS
Our study shows that both corticotropic and somatotropic functions are significantly impaired in CM-MOH patients and suggests a role for hormones in the development of chronic migraine.
Rainero
Innocenzo
I
Department of Neuroscience, Neurology III--Headache Center, University of Turin, Via Cherasco 15, 10126 Torino, Italy.
Ferrero
Margherita
M
Rubino
Elisa
E
Valfrè
Walter
W
Pellegrino
Michela
M
Arvat
Emanuela
E
Giordano
Roberta
R
Ghigo
Ezio
E
Limone
Paolo
P
Pinessi
Lorenzo
L
D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D019540:Area Under Curve; D002908:Chronic Disease; D003346:Corticotropin-Releasing Hormone / Q000008:administration & dosage* / Q000493:pharmacokinetics; D004702:Endocrine Glands / Q000378:metabolism; D005260:Female; D013006:Growth Hormone / Q000097:blood; D013007:Growth Hormone-Releasing Hormone / Q000008:administration & dosage* / Q000493:pharmacokinetics; D051271:Headache Disorders, Secondary / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D013972:Thyrotropin / Q000097:blood; D013973:Thyrotropin-Releasing Hormone / Q000008:administration & dosage* / Q000493:pharmacokinetics
D013973:Thyrotropin-Releasing Hormone; D000324:Adrenocorticotropic Hormone; D013972:Thyrotropin; D013006:Growth Hormone; D003346:Corticotropin-Releasing Hormone; D013007:Growth Hormone-Releasing Hormone; D006854:Hydrocortisone