The role of tyrosine metabolism in the pathogenesis of chronic migraine

Cephalalgia ◽  
2013 ◽  
Vol 33 (11) ◽  
pp. 932-937 ◽  
Author(s):  
Giovanni D’Andrea ◽  
Domenico D’Amico ◽  
Gennaro Bussone ◽  
Andrea Bolner ◽  
Marco Aguggia ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Plasma Levels ◽  
High Plasma ◽  
Tension Type Headache ◽  
Predisposing Factor ◽  
Tyrosine Metabolism ◽  
Potent Agonist ◽  
Type Headache

Objective: The pathogenesis of chronic migraine (CM) remains largely unknown. We hypothesized that anomalies of tyrosine metabolism, found in migraine without aura (MwwA) patients, play an important role in the transformation of MwwA into CM, since the increase in the number of MwwA attacks is the most predisposing factor for the occurrence of CM. Methods: To test our hypothesis we measured the plasma levels of dopamine (DA), noradrenaline (NE) and trace amines, including tyramine (TYR) and octopamine (OCT), in a group of 73 patients with CM, 13 patients with chronic tension-type headache (CTTH) and 37 controls followed in the Headache Centers of the Neurology Departments of Asti, Milan and Vicenza hospitals in Italy. Results: The plasma levels of DA and NE were several-fold higher in CM patients compared with control subjects ( p > 0.001). The plasma levels of TYR were also extremely elevated ( p > 0.001); furthermore, these levels progressively increased with the duration of the CM. Conclusions: Our data support the hypothesis that altered tyrosine metabolism plays an important role in the pathogenesis of CM. The high plasma levels of TYR, a potent agonist of the trace amine associated receptors type 1 (TAAR1), may ultimately down-regulate this receptor because of loss of inhibitory presynaptic regulation, therein resulting in uncontrolled neurotransmitter release. This may produce functional metabolic consequences in the synaptic clefts of the pain matrix implicated in CM.

scholarly journals Vitamin D, Chronic Migraine, and Extracranial Pain: Is There a Link? Data From an Observational Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Valentina Rebecchi ◽  
Daniela Gallo ◽  
Lucia Princiotta Cariddi ◽  
Eliana Piantanida ◽  
Payam Tabaee Damavandi ◽  
...  
Keyword(s):  
Vitamin D ◽  
Chronic Migraine ◽  
Medication Overuse ◽  
Primary Headache ◽  
Episodic Migraine ◽  
Tension Type Headache ◽  
Exact Test ◽  
Pain Chronification ◽  
Type Headache

Several studies focused on the role of vitamin D (vitD) in pain chronification. This study focused on vitD level and pain chronification and extension in headache disorders. Eighty patients with primary headache underwent neurological examination, laboratory exams, including serum calcifediol 25(OH)D, and headache features assessment along with three questionnaires investigating depression, anxiety, and allodynia. The 86.8% of the population had migraine (48% episodic and 52% chronic). The 44.1% of patients had extracranial pain, and 47.6% suffered from allodynia. A vitD deficit, namely a serum 25(OH)D level <20 ng/ml, was detectable in 46.1% of the patients, and it occurred more frequently (p = 0.009) in patients suffering from chronic migraine (CM)–medication overuse migraine (MOH) (62.9%) than in episodic migraine (EM, 25.7%) or tension-type headache (TTH, 11.4%). The occurrence of extracranial pain and allodynia was higher in the CM-MOH than in the EM and in the TTH groups but was not related to the co-occurrence of vitD deficiency (Fisher's exact test p = 0.11 and p = 0.32, respectively). Our findings show that 25(OH)D deficit is also related to chronic headache, probably because of vitD anti-inflammatory and tolerogenic properties, reinforcing the idea of a neuroinflammatory mechanism underpinning migraine chronification.

scholarly journals Vitamin D, Chronic Migraine and Extracranial Pain: Is there a Link? Data from an Observational Study.

2020 ◽  
Author(s):  
Valentina Rebecchi ◽  
Daniela Gallo ◽  
Lucia Princiotta Cariddi ◽  
Eliana Piantanida ◽  
Payam Tabaee Damavandi ◽  
...  
Keyword(s):  
Vitamin D ◽  
Chronic Migraine ◽  
Medication Overuse ◽  
Antinociceptive Effect ◽  
Primary Headache ◽  
Episodic Migraine ◽  
Tension Type Headache ◽  
Exact Test ◽  
Type Headache

Abstract Background: Several studies focused on the possible role of vitamin D (vitD) in pain chronicization.. The aim of this study was to assess the potential implications of VitD deficit on headache characteristics and extracranial pain extension.Methods: Eighty consecutive patients with primary headache underwent neurological examination, laboratory exams including serum calcifediol 25(OH)D and headache features assessment along with three questionnaires investigating depression, anxiety and allodynia. Results: The 82.6% of the population had migraine (48% episodic and 52% chronic form). The 45% of patients had extracranial pain and 47% suffered from allodynia. In the 45% of patients had a VitD deficit since the serum 25(OH)D levels fell below the cut-off level of 20 ng/ml. The occurrence of VitD deficit was significantly higher (p=0.009) in patients suffering from chronic migraine (CM)- medication overuse migraine (MOH) (64.7%) than in episodic migraine (EM) or tension type headache (TTH). The occurrence of subjects with extracranial pain and allodynia was higher, as expected, in the CM-MOH than in the EM and in the TTH groups but was not related to the co-occurrence of vit-D deficiency (Fischer’s exact test p=0.11 and p=0.32 respectively).Conclusions: Our findings show that 25(OH)D deficit is related to chronic pain suggesting that vitD probably has anti-inflammatory and tolerogenic properties, rather than a direct antinociceptive effect, and reinforce the idea of a neuroinflammatory mechanisms underpinning migraine chronicization.

scholarly journals Calcitonin Gene-Related Peptide in Tension-Type Headache

2002 ◽  
Vol 2 ◽  
pp. 1527-1531 ◽  
Author(s):  
M. Ashina
Keyword(s):  
Plasma Levels ◽  
Calcitonin Gene Related Peptide ◽  
Tension Type Headache ◽  
Nerve Fibers ◽  
Primary Headaches ◽  
Chronic Tension Type Headache ◽  
Related Peptide ◽  
Calcitonin Gene ◽  
Type Headache

In the last 10 years there has been increasing interest in the role of calcitonin gene-related peptide (CGRP) in primary headaches. Tension-type headache is one of the most common and important types of primary headaches, and ongoing nociception from myofascial tissues may play an important role in the pathophysiology of this disorder. CGRP sensory fibers are preferentially located in the walls of arteries, and nerve fibers containing CGRP accompany small blood vessels in human cranial muscles. It is well established that nociception may lead to release of CGRP from sensory nerve endings and from central terminals of sensory afferents into the spinal cord. It has also been shown that density of CGRP fibers around arteries is increased in persistently inflamed muscle. These findings indicate that ongoing activity in sensory neurons in the cranial muscles may be reflected in changes of plasma levels of neuropeptides in patients with chronic tension-type headache. To explore the possible role of CGRP in tension-type headache, plasma levels of CGRP were measured in patients with chronic tension-type headache. This study showed that plasma levels of CGRP are normal in patients and unrelated to headache state. However, the findings of normal plasma levels of CGRP do not exclude the possibility that abnormalities of this neuropeptide at the neuronal or peripheral (pericranial muscles) levels play a role in the pathophysiology of tension-type headache. Investigation of CGRP in other compartments with new sensitive methods of analysis is necessary to clarify its role in tension-type headache.

Neurovascular Headache and A Midbrain Vascular Malformation: Evidence for A Role of the Brainstem in Chronic Migraine

Cephalalgia ◽  
2002 ◽  
Vol 22 (2) ◽  
pp. 107-111 ◽  
Author(s):  
PJ Goadsby
Keyword(s):  
Chronic Migraine ◽  
Functional Imaging ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Transformed Migraine ◽  
Positron Emission ◽  
Neurovascular Headache ◽  
Daily Headache ◽  
Type Headache

Migraine is a common, disabling form of primary headache that has been linked by functional imaging studies to activation in the rostral brainstem. In specialty clinics migraine is most commonly seen in association with frequent less feature full headache that has been called transformed migraine or more recently termed chronic migraine. A patient is described with frequent migraine, 3 days per week, and less feature full headaches on other days. The patient has a cavernoma in the midbrain that has bled. She was previously headache free and now has contralateral daily headache. The patient supports the functional imaging observations from positron emission tomography (PET) that the rostral brainstem is pivotal in migraine pathophysiology, particularly the contralateral midbrain periaqueductal grey matter. Moreover, the patient's lesion provides biologically plausible support that a single entity causes her clinical presentation: chronic migraine, not two-disorders, migraine and tension-type headache.

Psychophysical testing in chronic migraine and chronic tension type headache: An observational study

Cephalalgia ◽  
2021 ◽  
pp. 033310242110603
Author(s):  
Ignacio Elizagaray-García ◽  
Gabriela F Carvalho ◽  
Tibor M Szikszay ◽  
Waclaw M Adamczyk ◽  
Gonzalo Navarro-Fernández ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Tension Type Headache ◽  
Headache Frequency ◽  
Chronic Tension Type Headache ◽  
Psychophysical Testing ◽  
Pressure Pain Thresholds ◽  
Type Headache ◽  
Neck Disability ◽  
Painful Area

Background Clinical presentation is the key to the diagnosis of patients with migraine and tension-type headache, but features may overlap when both become chronic. Psychophysical parameters may distinguish both conditions. We aimed to compare psychophysical aspects of patients with chronic migraine, chronic tension-type headache and headache-free controls, and to determine whether these can predict headache frequency. Methods An examiner blinded to the diagnosis assessed 100 participants (chronic migraine (n = 38), chronic tension-type headache (n = 31) and controls (n = 31)). Assessed variables included painful area, pressure pain thresholds, temporal summation, cervical range of motion, neck posture, headache and neck impact, quality of life, and kinesiophobia. Comparison between groups was performed with one-way ANOVA and multiple linear regression was used to assess the headache frequency predictors. Results We found differences of both headache groups compared to controls ( p < 0.01), but not between headache groups. Neck disability was a significant predictor of headache frequency for chronic tension-type headache (adjusted R2 = 0.14; β = 0.43; p = 0.03) and chronic migraine (adjusted R2 = 0.18; β = 0.51; p < 0.01). Conclusions Chronic tension-type headache and chronic migraine showed similar psychophysical results, but were significantly worse when compared to controls. The psychophysical examination did not discriminate between headache types. The variable best explaining headache frequency for both headache types was neck disability.

Migraine and Glaucoma: an Epidemiologic Survey of French Ophthalmologists

Cephalalgia ◽  
1998 ◽  
Vol 18 (2) ◽  
pp. 74-76 ◽  
Author(s):  
A Pradalier ◽  
P Hamard ◽  
E Sellem ◽  
L Bringer
Keyword(s):  
Potential Role ◽  
International Headache Society ◽  
Tension Type Headache ◽  
Epidemiologic Survey ◽  
Migraine Prevalence ◽  
Low Tension Glaucoma ◽  
Ihs Criteria ◽  
Type Headache ◽  
Low Tension

Glaucoma is a common ocular disorder; a high intraocular pressure is observed in the majority of glaucoma (HIOPG) cases, but some patients have low-tension glaucoma (LTG). In the literature, some works link LTG and migraine, which is speculative of a potential role of a vasospastic factor or diathesis common to migraine and LTG. Using a standardized questionnaire based on International Headache Society (IHS) criteria, we investigated 954 glaucoma patients; 320 (33.5%) described a headache (migraine or tension-type headache) and 240 (25.1%) presented the IHS criteria for migraine. Migraine prevalence was not significantly different between HIOPG and LTG patients (22.8% and 32%, respectively) in this study.

Plasma levels of calcitonin gene-related peptide in chronic tension-type headache

Neurology ◽  
2000 ◽  
Vol 55 (9) ◽  
pp. 1335-1340 ◽  
Author(s):  
M. Ashina ◽  
L. Bendtsen ◽  
R. Jensen ◽  
S. Schifter ◽  
I. Jansen-Olesen ◽  
...  
Keyword(s):  
Plasma Levels ◽  
Calcitonin Gene Related Peptide ◽  
Tension Type Headache ◽  
Chronic Tension Type Headache ◽  
Related Peptide ◽  
Calcitonin Gene ◽  
Type Headache

The impact of parental attitudes toward children with primary headaches

2019 ◽  
Vol 24 (4) ◽  
pp. 767-775
Author(s):  
Devrimsel Harika Ertem ◽  
Ayhan Bingol ◽  
Busra Ugurcan ◽  
Özlem Mercan ◽  
Ismail Simsek ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Parental Attitudes ◽  
Episodic Migraine ◽  
Attitude Scale ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Scale Scores ◽  
Vas Scores ◽  
Attitudes Toward Children ◽  
Type Headache

There is a lack of data on parental attitudes toward children with primary headaches. The aim of this study is to determine whether there is a relationship between primary headaches and parental attitudes in the pre-adolescent pediatric population. In this cross-sectional study, 195 children with primary headache and 43 healthy children aged 9–16 years were included. A questionnaire for sociodemographic variables, visual analog scale (VAS), Social Anxiety Scale and Depression Inventory for Adolescents and Children, and Parental Attitudes Determining Scale (PATS), which is an attitude measure specifically designed to evaluate psychological adjustment, were administered. Of 195 children (female/male ratio: 89/106, mean age: 12.59 ± 1.09 years), episodic migraine ( n = 90), chronic migraine ( n = 25), and tension-type headache ( n = 80) were evaluated. There was no significant difference among headache groups and healthy subjects in terms of depression, anxiety, and fathers’ attitude scale scores. However, there were significant differences in mean mothers’ attitude scale scores and VAS scores ( p = .002, p = .000). Mean oppressive-authoritarian attitude subscale scores of mothers’ was significantly higher in children with chronic migraine ( p = .000). A relationship between depression and VAS scores among all patient groups was detected ( p = .000). Parental age was negatively related to PATS scores of children with episodic migraine and tension-type headache ( p = .037 and p = .036). Parental attitudes may elevate psychiatric symptoms and influence children’s perception of pain intensity and result in chronification of headache. Our findings support that mothers’ attitude toward children with chronic migraine has strong impacts on the child’s pain experience.

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