Twenty-Four-Hour Melatonin and Cortisol Plasma Levels in Relation to Timing of Cluster Headache

Abstract

The cyclic recurrence of cluster periods and the regular timing of headache occurrence in cluster headache (CH) induced us to study the circadian secretion of melatonin and cortisol in 12 patients with episodic CH, during a cluster period, and compare them with 7 age- and sex-matched healthy controls. Blood was sampled every 2 h for 24 h. All subjects were confined to a dark room from 22.00 to 08.00. Plasma melatonin levels were significantly reduced in CH patients (repeated measures ANOVA p < 0.03; mesor p < 0.02), and the cortisol mesor was significantly increased (p < 0.03). Amplitudes and acrophases did not differ between the groups. Individual cosinor analysis showed that 4/12 (33.3%) CH patients had no significant melatonin rhythm, and that 5/11 (45.5%) had no cortisol rhythm. Group analysis of cosinor revealed significantly rhythmicity of melatonin and cortisol secretion in both groups. In controls, the timing of melatonin and cortisol acrophase significantly correlated with each other, indicating that the biorhythm controllers for the secretion of these hormones were synchronized. Such correlation was not found in the CH patients; mesor, amplitude and acrophase of melatonin and cortisol did not correlate with duration of illness, duration of headache in course, or time since last headache attack.

Exacerbated mechanical allodynia in rats with depression-like behavior

“…Of note is that those rats with an incorrect cannula placement did not show improvement in either immobility score or mechanical allodynia, suggesting a selective effect of melatonin within ACC. This behavioral data is also consistent with a low plasma melatonin level in WKY rats and in patients suffering from abdominal pain, idiopathic pain, neuropathic pain, or cluster headache (Waldenlind et al, 1987;Almay et al, 1987;Roberts-Thompson et al, 1988;von Knorring, Ekselius, 1994;Leone et al, 1995). It should be noted that the role of a specific MT receptor subtype was not examined in this study, because luzindole (MT2 > MT1) is not a highly selective antagonist for an MT receptor subtype.…”

Chronic cluster headache: a review

“…Serum melatonin levels are reduced in CH patients during a cluster period [31,32]. In a double blind, placebo-controlled trial in 18 ECH and 2 PCCH patients, melatonin appeared only effective in the prophylaxis of ECH [33].…”

A Cluster Headache Responsive to Ramelteon, a Selective Melatonin MT₁/MT₂ Receptor Agonist

“…A fall in the nocturnal plasma melatonin level occurs in patients with cluster headaches, suggesting that melatonin may play a role in the promotion of attacks (8,12). Neuroimaging studies have confirmed clinical and neuroendocrinological data indicating hypothalamic involvement in a cluster headache (11).…”