Abstract
Clinical observations indicate a central nervous system, probably hypothalamic, involvement in cluster headache pathogenesis. In order to investigate the supposed hypothalamic involvement in cluster headache, we followed the hypothalamic-pituitary-adrenal axis and autonomic responses to the insulin tolerance test and the ovine corticotrophin-releasing hormone test in episodic cluster headache patients, both during remission and during the cluster period. The study revealed increased basal cortisol levels in all cluster patients. A blunted cortisol response to ovine corticotrophin-releasing hormone, in spite of a normal ACTH surge, was subsequently found in both illness phases. These findings suggest hypothalamic-pituitary-adrenal axis hyperactivity in both cluster phases. Furthermore, reduced ACTH and cortisol responses after insulin challenge were also observed in both remission and cluster period patients; a reduced norepinephrine surge was seen only in the cluster period. Taken together, these results suggest a hypothalamic involvement in the altered neuroendocrinological and autonomic responses found in our patients.
| Original language | English |
|---|---|
| Pages (from-to) | 269-274 |
| Number of pages | 6 |
| Journal | Cephalalgia |
| Volume | 11 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 1991 |
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Keywords
- autonomic responses
- cluster period
- hypoglycaemic stimulus
- hypothalamic-pituitary-adrenal axis
- hypothalamus
- remission phase
ASJC Scopus subject areas
- Clinical Neurology
Cite this
The insulin tolerance test and the ovine corticotrophin-releasing hormone test in episodic cluster headache. / Leone, M.; Zappacosta, B. M.; Valentini, S.; Colangelo, A. M.; Bussone, G.
In: Cephalalgia, Vol. 11, No. 6, 1991, p. 269-274.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The insulin tolerance test and the ovine corticotrophin-releasing hormone test in episodic cluster headache
AU - Leone, M.
AU - Zappacosta, B. M.
AU - Valentini, S.
AU - Colangelo, A. M.
AU - Bussone, G.
PY - 1991
Y1 - 1991
N2 - Clinical observations indicate a central nervous system, probably hypothalamic, involvement in cluster headache pathogenesis. In order to investigate the supposed hypothalamic involvement in cluster headache, we followed the hypothalamic-pituitary-adrenal axis and autonomic responses to the insulin tolerance test and the ovine corticotrophin-releasing hormone test in episodic cluster headache patients, both during remission and during the cluster period. The study revealed increased basal cortisol levels in all cluster patients. A blunted cortisol response to ovine corticotrophin-releasing hormone, in spite of a normal ACTH surge, was subsequently found in both illness phases. These findings suggest hypothalamic-pituitary-adrenal axis hyperactivity in both cluster phases. Furthermore, reduced ACTH and cortisol responses after insulin challenge were also observed in both remission and cluster period patients; a reduced norepinephrine surge was seen only in the cluster period. Taken together, these results suggest a hypothalamic involvement in the altered neuroendocrinological and autonomic responses found in our patients.
AB - Clinical observations indicate a central nervous system, probably hypothalamic, involvement in cluster headache pathogenesis. In order to investigate the supposed hypothalamic involvement in cluster headache, we followed the hypothalamic-pituitary-adrenal axis and autonomic responses to the insulin tolerance test and the ovine corticotrophin-releasing hormone test in episodic cluster headache patients, both during remission and during the cluster period. The study revealed increased basal cortisol levels in all cluster patients. A blunted cortisol response to ovine corticotrophin-releasing hormone, in spite of a normal ACTH surge, was subsequently found in both illness phases. These findings suggest hypothalamic-pituitary-adrenal axis hyperactivity in both cluster phases. Furthermore, reduced ACTH and cortisol responses after insulin challenge were also observed in both remission and cluster period patients; a reduced norepinephrine surge was seen only in the cluster period. Taken together, these results suggest a hypothalamic involvement in the altered neuroendocrinological and autonomic responses found in our patients.
KW - autonomic responses
KW - cluster period
KW - hypoglycaemic stimulus
KW - hypothalamic-pituitary-adrenal axis
KW - hypothalamus
KW - remission phase
UR - http://www.scopus.com/inward/record.url?scp=0026314936&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0026314936&partnerID=8YFLogxK
U2 - 10.1046/j.1468-2982.1991.1106269.x
DO - 10.1046/j.1468-2982.1991.1106269.x
M3 - Article
C2 - 1665104
AN - SCOPUS:0026314936
VL - 11
SP - 269
EP - 274
JO - Cephalalgia
JF - Cephalalgia
SN - 0333-1024
IS - 6
ER -