OPIOID CONTROL OF THE HYPOTHALAMUS-PITUITARY-ADRENAL AXIS CYCLICALLY FAILS IN MENSTRUAL MIGRAINE

被引:35
作者
FACCHINETTI, F
MARTIGNONI, E
FIORONI, L
SANCES, G
GENAZZANI, AR
机构
[1] University Centre for Adaptive Disorders and Headache (UCADH), Loridine Fioroni
[2] Department of Obstetrics and Gynecology, University of Modena
[3] Neurological Institute, University of Pavia, Ltaly
关键词
Hypothalamus-pituitary-adrenal axis; menstrual cycle; menstrual migraine; opioids;
D O I
10.1046/j.1468-2982.1990.1001051.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
To assess the biological correlates of the precipitation of migraine attacks in the perimenstrual period, plasma b-endorphin (b-EP) and cortisol responses to naloxone (8 mg iv) and corticotropin releasing hormone (100 μg iv) were evaluated in both the follicular phase and the premenstrual period in 7 patients suffering from menstrual migraine and in 7 healthy, asymptomatic control volunteers. In the controls, naloxone evoked a significant release of both b-EP (F = 5.86, p < 0.002) and cortisol (F = 4.43, p < 0.008), independently of the menstrual cycle phase (F = 0.31 and 1.04, for b-EP and cortisol, respectively). Menstrual migraine patients, on the other hand, showed a significant hormone response only in the follicular phase, not in the premenstrual period. Corticotropin releasing hormone significantly increased b-EP and cortisol in both the controls and the menstrual migraine patients, independently of the menstrual cycle phase. In both the naloxone and corticotropin releasing hormone testings, the basal b-EP levels measured in the premenstrual period were lower than those observed in the follicular phase (p < 0.02). These data demonstrate a cyclical, premenstrual dysfunction of the hypothalamic control exerted by opioids on the hypothalamus-pituitary-adrenal axis. Impairment of this fundamental adaptive mechanism (involved in stress responses and in pain control) could establish a causal relationship between menstrual-related migraine attacks and premenstrual opioid hyposensitivity. © 1990, International Headache Society. All rights reserved.
引用
收藏
页码:51 / 56
页数:6
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