Circadian rhythms of plasma cortisol in migraine.

Ziegler, Dewey K.; Hassanein, Ruth S.; Kodanaz, Altan; Meek, Joseph C.

doi:10.1136/jnnp.42.8.741

Cited by 27 publications

(22 citation statements)

References 22 publications

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“…Cortisol is often elevated in migraine sufferers [53] and the data here by showing that fasting serum cortisol is elevated in male and female migraineurs supports this claim. However, the AUC cortisol data suggests that following a sucrose challenge the release of cortisol in migraineurs may be influenced by gender differences with the adrenal response post-sucrose challenge noted to be significantly higher in male migraineurs.…”

Section: Migrainesupporting

confidence: 83%

Effect of sucrose consumption on serum insulin, serum cortisol and insulin sensitivity in migraine: Evidence of sex differences

Kokavec

2015

Physiology & Behavior

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Section: Migrainesupporting

confidence: 83%

Effect of sucrose consumption on serum insulin, serum cortisol and insulin sensitivity in migraine: Evidence of sex differences

Kokavec

2015

Physiology & Behavior

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“…25 26 In a study of 30 patients complaining of somatic pain with different circadian rhythmicity, higher mean plasma levels of cortisol were found at the time of the highest pain intensity than in healthy pain-free controls.27 On the other hand, in a study of 25 migraine patients an inconsistent association between plasma cortisol levels and pain has been reported. 28 Our patients are quite used to different tests and the test situation as such is not believed to be a major cause of stress. Several patients were examined twice.…”

Section: Cluster Attacksmentioning

confidence: 99%

Circadian secretion of cortisol and melatonin in cluster headache during active cluster periods and remission.

Waldenlind¹,

Gustafsson²,

Ekbom³

et al. 1987

Journal of Neurology, Neurosurgery & Psychiatry

168

132

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SUMMARY The cyclic nature of cluster headache warranted a study of the 24-hour rhythms of serum cortisol and melatonin. They were both altered during cluster periods as compared with periods of remission and healthy controls. The 24-hour mean and maximal cortisol levels were higher and the timing of the cortisol minimum was delayed as compared to the same patients in remission. Although there was no relation between the cortisol and melatonin levels and headaches, the rise of cortisol following many attacks might in part represent an adaptive response to pain. The nocturnal melatonin maximum was lower during cluster periods than in remission. This finding, and the dysautonomic signs during attacks, may reflect a change of the vegetative tone in a hyposympathetic direction.The cyclic nature of cluster headache and dysautonomic signs during attacks may suggest a dysfunction in the central nervous system related to rhythm-regulating centres. Recently, increasing interest has been focused on changes in hormonal biological rhythms in cluster headache patients.'-9 The pineal hormone melatonin is influenced by bright light'0 and is believed to reflect the circadian organisation of biological rhythms in several species including man. " Serum cortisol also exhibits a circadian rhythm. A functional relation between the pineal gland and the hypothalamic-pituitary-adrenal axis has been suggested.'2 13 We recently reported that the nocturnal levels of serum melatonin were lower in cluster headache during the active headache period than during the remission state.7 Decreased nocturnal serum melatonin levels in patients in an active cluster period as compared to normal healthy controls have also been reported.8 In the present paper the 24-hour rhythms of serum cortisol and melatonin were studied in cluster headache patients during active cluster periods and remissions. Furthermore, the nocturnal urinary excretion of melatonin was examined in cluster headache and healthy control subjects. Patients and methodsStudy ofserum cortisol and melatonin Patients Thirty-one cluster headache patients were admitted to the hospital for the study during the years 1981 to 1984. They were diagnosed as suffering from episodic cluster headache (n = 27) according to Ekbom'4 or as chronic cluster headache (n = 4) according to Ekbom and Olivarius."The age distribution and some anamnestic data are summarised in table 1.Serum cortisol was examined in all 31 patients. Eleven males and five females of the episodic cases were examined both during and between periods ofcluster headache. Serum melatonin was studied in 20 episodic and four chronic cluster patients. From nine of the 20 patients with episodic cluster headache data were obtained both during a cluster period and during a remission. Some data from eight out of these nine patients have been reported previously.7When examined during the remission period all patients were free of medication. During the active cluster period prophylactic therapy (methysergide, pizotifen, ergotamine tartrate) was st...

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“…In retrospective questionnaire studies, up to 62% of migraine patients reported that psychosocial stress was an important trigger factor for their attacks (Van den Berg et al, 1987;Robbins, 1994;Zivadinov et al, 2003), but patients have a tendency to overestimate stress on retrospective measures (Wittrock and Foraker, 2001). In crosssectional studies, migraine patients were found to have elevated plasma levels of cortisol, an indicator for stress, both outside a migraine attack compared to healthy volunteers (Ziegler et al, 1979) and during attacks compared to the inter-ictal phase (van Hilten et al, 1991). Stress-provocation studies, involving mental and physical stressors, have suggested sympathetic and parasympathetic changes in migraine patients outside attacks compared to healthy volunteers (Takeshima et al, 1987;Hassinger et al, 1999;Shechter et al, 2002;Avnon et al, 2004).…”

Section: Introductionmentioning

confidence: 99%