TY - JOUR
T1 - Involvement of corticotrophin-releasing factor and orexin-A in chronic migraine and medication-overuse headache
T2 - Findings from cerebrospinal fluid
AU - Sarchielli, P.
AU - Rainero, I.
AU - Coppola, F.
AU - Rossi, C.
AU - Mancini, M. L.
AU - Pinessi, L.
AU - Calabresi, P.
PY - 2008/7
Y1 - 2008/7
N2 - The study set out to investigate the role of corticotrophin-releasing factor (CRF) and orexin-A in chronic migraine (CM) and medication-overuse headache (MOH). Twenty-seven patients affected by CM and 30 with MOH were enrolled. Control CSF specimens were obtained from 20 age-matched subjects who underwent lumbar puncture for diagnostic purposes, and in all of them CSF and blood tests excluded central nervous system or systemic diseases. Orexin-A and CRF were determined by radioimmunoassay methods. Significantly higher levels of orexin-A and CRF were found in the CSF of MOH and to a lesser extent in patients with CM compared with control subjects (orexin-A: P <0.001 and P <0.02; CRF: P <0.002 and P <0.0003). A significant positive correlation was also found between CSF orexin-A values and those of CRF (R = 0.71; P <0.0008), monthly drug intake group (R = 0.39; P <0.03) and scores of a self-completion 10-item instrument to measure dependence upon a variety of substances, the Leeds Dependence Questionnaire (LDQ) in the MOH group (R = 0.68; P <0.0003). The significantly higher orexin-A levels found in CM and MOH can be interpreted as a compensatory response to chronic head pain or, alternatively, as an expression of hypothalamic response to stress due to chronic pain. A potential role for orexin-A in driving drug seeking in MOH patients through activation of stress pathways in the brain can also be hypothesized.
AB - The study set out to investigate the role of corticotrophin-releasing factor (CRF) and orexin-A in chronic migraine (CM) and medication-overuse headache (MOH). Twenty-seven patients affected by CM and 30 with MOH were enrolled. Control CSF specimens were obtained from 20 age-matched subjects who underwent lumbar puncture for diagnostic purposes, and in all of them CSF and blood tests excluded central nervous system or systemic diseases. Orexin-A and CRF were determined by radioimmunoassay methods. Significantly higher levels of orexin-A and CRF were found in the CSF of MOH and to a lesser extent in patients with CM compared with control subjects (orexin-A: P <0.001 and P <0.02; CRF: P <0.002 and P <0.0003). A significant positive correlation was also found between CSF orexin-A values and those of CRF (R = 0.71; P <0.0008), monthly drug intake group (R = 0.39; P <0.03) and scores of a self-completion 10-item instrument to measure dependence upon a variety of substances, the Leeds Dependence Questionnaire (LDQ) in the MOH group (R = 0.68; P <0.0003). The significantly higher orexin-A levels found in CM and MOH can be interpreted as a compensatory response to chronic head pain or, alternatively, as an expression of hypothalamic response to stress due to chronic pain. A potential role for orexin-A in driving drug seeking in MOH patients through activation of stress pathways in the brain can also be hypothesized.
KW - Cerebrospinal fluid
KW - Chronic migraine
KW - Corticotrophin-releasing factor
KW - Medication-overuse headache
KW - Orexin-A
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U2 - 10.1111/j.1468-2982.2008.01566.x
DO - 10.1111/j.1468-2982.2008.01566.x
M3 - Article
C2 - 18479471
AN - SCOPUS:41649092804
VL - 28
SP - 714
EP - 722
JO - Cephalalgia
JF - Cephalalgia
SN - 0333-1024
IS - 7
ER -