The insulin tolerance test and the ovine corticotrophin-releasing hormone test in episodic cluster headache

M. Leone, B. M. Zappacosta, S. Valentini, A. M. Colangelo, G. Bussone

Research output: Contribution to journalArticle

17 Citations (Scopus)

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 languageEnglish
Pages (from-to)269-274
Number of pages6
JournalCephalalgia
Volume11
Issue number6
DOIs
Publication statusPublished - 1991

Fingerprint

Cluster Headache
Corticotropin-Releasing Hormone
Sheep
Insulin
Hydrocortisone
Adrenocorticotropic Hormone
Norepinephrine
Central Nervous System

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 journalArticle

Leone, M. ; Zappacosta, B. M. ; Valentini, S. ; Colangelo, A. M. ; Bussone, G. / The insulin tolerance test and the ovine corticotrophin-releasing hormone test in episodic cluster headache. In: Cephalalgia. 1991 ; Vol. 11, No. 6. pp. 269-274.
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