Migraine and cluster headache show impaired neurosteroids patterns

Angela Koverech, Claudia Cicione, Luana Lionetto, Marta Maestri, Francesco Passariello, Elisabetta Sabbatini, Matilde Capi, Cristiano Maria De Marco, Martina Guglielmetti, Andrea Negro, Luisa Di Menna, Maurizio Simmaco, Ferdinando Nicoletti, Paolo Martelletti

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Perturbation of neuronal excitability contributes to migraine. Neurosteroids modulate the activity of γ-aminobutyric acid A and N-methyl-d-aspartate receptors, and might be involved in the pathogenesis of migraine. Here, we measured plasma levels of four neurosteroids, i.e., allopregnanolone, epiallopregnanolone, dehydroepiandrosterone and deydroepiandrosterone sulfate, in patients affected by episodic migraine, chronic migraine, or cluster headache.

METHODS: Nineteen female patients affected by episodic migraine, 51 female patients affected by chronic migraine, and 18 male patients affected by cluster headache were recruited to the study. Sex- and age-matched healthy control subjects (31 females and 16 males) were also recruited. Patients were clinically characterized by using validated questionnaires. Plasma neurosteroid levels were measured by liquid chromatography-tandem mass spectrometry.

RESULTS: We found disease-specific changes in neurosteroid levels in our study groups. For example, allopregnanolone levels were significantly increased in episodic migraine and chronic migraine patients than in control subjects, whereas they were reduced in patients affected by cluster headache. Dehydroepiandrosterone and dehydroepiandrosterone sulfate levels were reduced in patients affected by chronic migraine, but did not change in patients affected by cluster headache.

CONCLUSION: We have shown for the first time that large and disease-specific changes in circulating neurosteroid levels are associated with chronic headache disorders, raising the interesting possibility that fluctuations of neurosteroids at their site of action might shape the natural course of migraine and cluster headache. Whether the observed changes in neurosteroids are genetically determined or rather result from exposure to environmental or intrinsic stressors is unknown. This might also be matter for further investigation because stress is a known triggering factor for headache attacks in both migraineurs and cluster headache patients.

Original languageEnglish
Pages (from-to)61
JournalThe journal of headache and pain
Volume20
Issue number1
DOIs
Publication statusPublished - May 27 2019

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Cluster Headache
Migraine Disorders
Neurotransmitter Agents
Headache Disorders
Pregnanolone
Dehydroepiandrosterone Sulfate
Aminobutyrates
Dehydroepiandrosterone
Environmental Exposure
Tandem Mass Spectrometry
Liquid Chromatography
Headache
Healthy Volunteers

Cite this

Koverech, A., Cicione, C., Lionetto, L., Maestri, M., Passariello, F., Sabbatini, E., ... Martelletti, P. (2019). Migraine and cluster headache show impaired neurosteroids patterns. The journal of headache and pain, 20(1), 61. https://doi.org/10.1186/s10194-019-1005-0

Migraine and cluster headache show impaired neurosteroids patterns. / Koverech, Angela; Cicione, Claudia; Lionetto, Luana; Maestri, Marta; Passariello, Francesco; Sabbatini, Elisabetta; Capi, Matilde; De Marco, Cristiano Maria; Guglielmetti, Martina; Negro, Andrea; Di Menna, Luisa; Simmaco, Maurizio; Nicoletti, Ferdinando; Martelletti, Paolo.

In: The journal of headache and pain, Vol. 20, No. 1, 27.05.2019, p. 61.

Research output: Contribution to journalArticle

Koverech, A, Cicione, C, Lionetto, L, Maestri, M, Passariello, F, Sabbatini, E, Capi, M, De Marco, CM, Guglielmetti, M, Negro, A, Di Menna, L, Simmaco, M, Nicoletti, F & Martelletti, P 2019, 'Migraine and cluster headache show impaired neurosteroids patterns', The journal of headache and pain, vol. 20, no. 1, pp. 61. https://doi.org/10.1186/s10194-019-1005-0
Koverech A, Cicione C, Lionetto L, Maestri M, Passariello F, Sabbatini E et al. Migraine and cluster headache show impaired neurosteroids patterns. The journal of headache and pain. 2019 May 27;20(1):61. https://doi.org/10.1186/s10194-019-1005-0
Koverech, Angela ; Cicione, Claudia ; Lionetto, Luana ; Maestri, Marta ; Passariello, Francesco ; Sabbatini, Elisabetta ; Capi, Matilde ; De Marco, Cristiano Maria ; Guglielmetti, Martina ; Negro, Andrea ; Di Menna, Luisa ; Simmaco, Maurizio ; Nicoletti, Ferdinando ; Martelletti, Paolo. / Migraine and cluster headache show impaired neurosteroids patterns. In: The journal of headache and pain. 2019 ; Vol. 20, No. 1. pp. 61.
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T1 - Migraine and cluster headache show impaired neurosteroids patterns

AU - Koverech, Angela

AU - Cicione, Claudia

AU - Lionetto, Luana

AU - Maestri, Marta

AU - Passariello, Francesco

AU - Sabbatini, Elisabetta

AU - Capi, Matilde

AU - De Marco, Cristiano Maria

AU - Guglielmetti, Martina

AU - Negro, Andrea

AU - Di Menna, Luisa

AU - Simmaco, Maurizio

AU - Nicoletti, Ferdinando

AU - Martelletti, Paolo

PY - 2019/5/27

Y1 - 2019/5/27

N2 - BACKGROUND: Perturbation of neuronal excitability contributes to migraine. Neurosteroids modulate the activity of γ-aminobutyric acid A and N-methyl-d-aspartate receptors, and might be involved in the pathogenesis of migraine. Here, we measured plasma levels of four neurosteroids, i.e., allopregnanolone, epiallopregnanolone, dehydroepiandrosterone and deydroepiandrosterone sulfate, in patients affected by episodic migraine, chronic migraine, or cluster headache.METHODS: Nineteen female patients affected by episodic migraine, 51 female patients affected by chronic migraine, and 18 male patients affected by cluster headache were recruited to the study. Sex- and age-matched healthy control subjects (31 females and 16 males) were also recruited. Patients were clinically characterized by using validated questionnaires. Plasma neurosteroid levels were measured by liquid chromatography-tandem mass spectrometry.RESULTS: We found disease-specific changes in neurosteroid levels in our study groups. For example, allopregnanolone levels were significantly increased in episodic migraine and chronic migraine patients than in control subjects, whereas they were reduced in patients affected by cluster headache. Dehydroepiandrosterone and dehydroepiandrosterone sulfate levels were reduced in patients affected by chronic migraine, but did not change in patients affected by cluster headache.CONCLUSION: We have shown for the first time that large and disease-specific changes in circulating neurosteroid levels are associated with chronic headache disorders, raising the interesting possibility that fluctuations of neurosteroids at their site of action might shape the natural course of migraine and cluster headache. Whether the observed changes in neurosteroids are genetically determined or rather result from exposure to environmental or intrinsic stressors is unknown. This might also be matter for further investigation because stress is a known triggering factor for headache attacks in both migraineurs and cluster headache patients.

AB - BACKGROUND: Perturbation of neuronal excitability contributes to migraine. Neurosteroids modulate the activity of γ-aminobutyric acid A and N-methyl-d-aspartate receptors, and might be involved in the pathogenesis of migraine. Here, we measured plasma levels of four neurosteroids, i.e., allopregnanolone, epiallopregnanolone, dehydroepiandrosterone and deydroepiandrosterone sulfate, in patients affected by episodic migraine, chronic migraine, or cluster headache.METHODS: Nineteen female patients affected by episodic migraine, 51 female patients affected by chronic migraine, and 18 male patients affected by cluster headache were recruited to the study. Sex- and age-matched healthy control subjects (31 females and 16 males) were also recruited. Patients were clinically characterized by using validated questionnaires. Plasma neurosteroid levels were measured by liquid chromatography-tandem mass spectrometry.RESULTS: We found disease-specific changes in neurosteroid levels in our study groups. For example, allopregnanolone levels were significantly increased in episodic migraine and chronic migraine patients than in control subjects, whereas they were reduced in patients affected by cluster headache. Dehydroepiandrosterone and dehydroepiandrosterone sulfate levels were reduced in patients affected by chronic migraine, but did not change in patients affected by cluster headache.CONCLUSION: We have shown for the first time that large and disease-specific changes in circulating neurosteroid levels are associated with chronic headache disorders, raising the interesting possibility that fluctuations of neurosteroids at their site of action might shape the natural course of migraine and cluster headache. Whether the observed changes in neurosteroids are genetically determined or rather result from exposure to environmental or intrinsic stressors is unknown. This might also be matter for further investigation because stress is a known triggering factor for headache attacks in both migraineurs and cluster headache patients.

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DO - 10.1186/s10194-019-1005-0

M3 - Article

VL - 20

SP - 61

JO - Journal of Headache and Pain

JF - Journal of Headache and Pain

SN - 1129-2369

IS - 1

ER -