β‐Endorphin in Plasma and Monocytes in Juvenile Headache

Abstract

Interictal serum levels of serotonin and plasma and mononuclear cell concentrations of beta-endorphin were measured in 20 juvenile patients (13 suffering from migraine without aura and 7 from episodic tension-type headache) before and after 3 months of L-5-hydroxytryptophan treatment (5 mg/kg/day) and compared with a control group of 17 headache-free healthy subjects. While no significant differences in serum serotonin levels emerged between the three groups (migraine 104.6 +/- 26 micrograms/L, tension-type headache 90.7 +/- 26.2 micrograms/L, controls 96 +/- 32.9 micrograms/L), significantly lower plasma and mononuclear cell concentrations of beta-endorphin were found in both patient groups by comparison with the healthy controls (beta-endorphin in plasma: migraine sufferers 16.2 +/- 4.2 pmol/L [P < 0.05], tension-type headache subjects 14.5 +/- 1.7 pmol/L [P < 0.001] vs controls 21.3 +/- 4.6 pmol/L and respectively, beta-endorphin in mononuclear cells: migraine sufferers 110.5 +/- 16.4 pmol/10(6) GB/L [P < 0.001], tension-type headache subjects 142.3 +/- 22.7 pmol/10(6) GB/L [P < 0.001] vs controls 359.3 +/- 31.6 pmol/10(6) GB/L). No differences emerged between the two clinical forms of headache for the plasma and mononuclear cell concentrations of beta-endorphin. After L-5-hydroxytryptophan treatment, serum serotonin and both plasma and mononuclear cell beta-endorphin levels tended to be higher, though not significantly so, than prior to treatment, and the clinical score (frequency x intensity of headache attacks) was significantly lower in both headache groups than at the baseline. This study supports the theory that opiate analgesic system function is abnormally low in juvenile primary headache as in adults, and confirms that administering serotoninergic precursor drugs increases beta-endorphin, even in the peripheral blood, and may favorably affect clinical symptoms.

Study of Pressure Pain and Cellular Concentration of Neurotransmitters Related to Nociception in Episodic Tension‐Type Headache Patients

“…Conversely, our findings are consistent with those of a recent study performed by Battistella et al 46 who demonstrated a significant reduction in the levels of β-endorphins in PBMCs of both migraine and tension-type headache juvenile patients compared with age-matched control subjects, but did not show a significant difference in these levels between the two forms of headache.…”

Migraine biomarkers in cerebrospinal fluid: A systematic review and meta-analysis

“…β-EP concentrations were decreased in CSF (SMD: –1.37, 95% CI: –1.80, –0.94) (30,37–39) and blood (SMD: –0.76, 95% CI: –1.17, –0.36) (38,63,64) from chronic migraine patients. Concentrations were also decreased in CSF (SMD: –1.12, 95% CI: –1.65, –0.58) (37,38,40) and blood (SMD: –0.40, 95% CI: –0.64, –0.16) (38,40,65–73) from interictal patients. Pooled estimates remained similar in sensitivity analysis.…”

Serotonin and Neuropeptides in Blood From Episodic and Chronic Migraine and Cluster Headache Patients in Case‐Control and Case‐Crossover Settings: A Systematic Review and Meta‐Analysis

“…For comparison group f, ictal vs interictal also refers to the active cluster bout vs remission. In addition to the references from Table 3 with clear blood specimen descriptions (n = 30), 15 references were included 21,26,27,37,39,43,48,125‐132 . Abbreviations: chronic cluster headache (CCH); chronic migraine (CM); control (CTRL); episodic cluster headache (ECH); female/female‐dominated (F/FD); migraine (M); both sexes (M/F); male/male‐dominated (M/MD); migraine with aura (MWA); migraine without aura (MWoA).…”