Urinary 6-sulphatoxymelatonin levels are depressed in chronic migraine and several comorbidities.
OBJECTIVE
To assess urinary 6-sulphatoxymelatonin levels in a large consecutive series of patients with migraine and several comorbidities (chronic fatigue, fibromyalgia, insomnia, anxiety, and depression) as compared with controls.


BACKGROUND
Urine analysis is widely used as a measure of melatonin secretion, as it is correlated with the nocturnal profile of plasma melatonin secretion. Melatonin has critical functions in human physiology and substantial evidence points to its importance in the regulation of circadian rhythms, sleep, and headache disorders.


METHODS
Urine samples were collected into a single plastic container over a 12-hour period from 8:00 pm to 8:00 am of the next day, and 6-sulphatoxymelatonin was measured by quantitative ELISA. All of the patients were given a detailed questionnaire about headaches and additionally answered the following questionnaires: Chalder fatigue questionnaire, Epworth somnolence questionnaire, State-Trait Anxiety Inventory, and the Beck Depression Inventory.


RESULTS
A total of 220 subjects were evaluated - 73 (33%) had episodic migraine, 73 (33%) had chronic migraine, and 74 (34%) were enrolled as control subjects. There was a strong correlation between the concentration of 6-sulphatoxymelatonin detected and chronic migraine. Regarding the comorbidities, this study objectively demonstrates an inverse relationship between 6-sulphatoxymelatonin levels and depression, anxiety, and fatigue.


CONCLUSIONS
To our knowledge, this is the first study to evaluate the relationship between the urinary concentration of melatonin and migraine comorbidities. These results support hypothalamic involvement in migraine pathophysiology.
Masruha
Marcelo R
MR
Department of Neurology and Neurosurgery - Federal University of São Paulo, São Paulo - Brazil.
Lin
Jaime
J
de Souza Vieira
Domingos S
DS
Minett
Thais S C
TS
Cipolla-Neto
José
J
Zukerman
Eliova
E
Vilanova
Luiz C P
LC
Peres
Mario F P
MF
D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology / Q000503:physiopathology / Q000652:urine; D015415:Biomarkers / Q000032:analysis / Q000652:urine; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology / Q000503:physiopathology / Q000652:urine; D015536:Down-Regulation / Q000502:physiology; D004797:Enzyme-Linked Immunosorbent Assay; D015673:Fatigue Syndrome, Chronic / Q000453:epidemiology / Q000503:physiopathology / Q000652:urine; D005260:Female; D005356:Fibromyalgia / Q000453:epidemiology / Q000503:physiopathology / Q000652:urine; D006801:Humans; D008297:Male; D008550:Melatonin / Q000031:analogs & derivatives* / Q000032:analysis / Q000378:metabolism* / Q000652:urine; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology* / Q000503:physiopathology / Q000652:urine*; D019964:Mood Disorders / Q000453:epidemiology* / Q000503:physiopathology / Q000652:urine*; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D015995:Prevalence; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000503:physiopathology / Q000652:urine; D011795:Surveys and Questionnaires; D055815:Young Adult
D015415:Biomarkers; C054513:6-sulfatoxymelatonin; D008550:Melatonin