Neuroendocrine Data in Chronic Post‐traumatic Headache

Abstract

Twenty chronic post-traumatic headache subjects (16 men and 4 women) were considered, together with age and sex matched normal controls. Pituitary function was challenged by means of luteinising hormone releasing hormone (100 microg, i.v.), thyrotropin (TSH) releasing hormone (200 microg, i.v.) and regular insulin (.1 U/kg, i.v.). The responses of gonadotropins, TSH, somatotropin (STH) and prolactin (PRL) were studied in the group as a whole and in clinical subgroups. No differences were found in the baseline levels of the hormones. No significant changes were observed in the responses of gonadotropins and STH. A decreased response was found for TSH and, in the female series, an enhanced response of PRL was observed. Patients complaining for a decreased libido showed a larger PRL response. The smaller response of TSH exhibits a straight inverse relationship to the clinical severity. The periodicity of PRL secretion studied in male patients with a harmonic analysis according to the Fourier's theorem showed the preservation of the physiological sleep-entrained night surge. The per cent incidence of the harmonics with a period shorter than 24 hours decreases according to the clinical severity, at variance to the finding in normal controls. The only persisting harmonic is the one with a 24 hour period. In the absence of major post-traumatic endocrine syndromes, post-traumatic headache subjects show changes of the neuroendocrine regulation of pituitary secretion. The findings are consistent with the hypothesis of an hyperactivity of serotoninergic neurotransmission.

Changes in the 24-Hour Prolactin Pattern in Cluster Headache

“…In the field of headache, we were able to show that the regulation of PRL secretion is altered in common migraine (7) and in catamenial headache (8). We also showed that changes in the regulation of pituitary hormones are present in chronic post-traumatic headache (9,10). Kudrow (11,12) demonstrated that the secretion of luteinizing hormone (LH) and of testosterone is altered in CH.…”

Low headache prevalence amongst women with high TSH values

“…Accordingly, age‐adjusted TSH values were lower in headache sufferers, especially amongst migraineurs, than in those without headache complaints. This result differs from those of previous studies, which have been hospital‐based, and consisted of small series of patients with headache classified as cluster headache, migraine, or post‐traumatic headache (Savoldi et al. , 1982; Murialdo et al.…”

The Effect of Dopamine Receptor Agonists on Prolactin Secretion in Childhood Migraine

“…25 Recently, PRL has been used to study dopaminergic function in migraine. 26 Administration of dopamine-antagonist drugs such as sulpiride or domperidone in adult migraineurs (particularly women) causes a prolonged increase of plasma PRL compared to normal controls. On the contrary, administration of dopamine agonists does not cause the expected extent of decrease in plasma PRL in adult migraineurs.…”