Establishment of Reference Value of Insulin Tolerance Test, Low-, and High-Dose ACTH Stimulation Test for Assessment of the Hypothalamo-Pituitary-Adrenal Axis in Normal Korean Subjects.

2010 ◽  
pp. P2-690-P2-690
Author(s):  
JH An ◽  
HY Cho ◽  
HJ Choi ◽  
MJ Kim ◽  
KW Kim ◽  
...  
Keyword(s):  
Reference Value ◽  
Tolerance Test ◽  
Insulin Tolerance Test ◽  
Stimulation Test ◽  
High Dose ◽  
Acth Stimulation Test ◽  
Acth Stimulation ◽  
Adrenal Axis ◽  
Insulin Tolerance ◽  
Pituitary Adrenal Axis

The Insulin Tolerance Test and the Ovine Corticotrophin-Releasing Hormone Test in Episodic Cluster Headache

Cephalalgia ◽  
1991 ◽  
Vol 11 (6) ◽  
pp. 269-274 ◽  
Author(s):  
Massimo Leone ◽  
Boris M Zappacosta ◽  
Sergio Valentini ◽  
Anna M Colangelo ◽  
Gennaro Bussone
Keyword(s):  
Cluster Headache ◽  
Tolerance Test ◽  
Insulin Tolerance Test ◽  
Releasing Hormone ◽  
Autonomic Responses ◽  
Adrenal Axis ◽  
Insulin Tolerance ◽  
Basal Cortisol ◽  
Episodic Cluster Headache ◽  
Pituitary Adrenal Axis

Clinical observations indicate a central nervous system, probably hypothalamic, involvement in cluster headache pathogenesis. In order to investigate the supposed hypothalamic involvement in cluster headache, we followed the hypothalamic-pituitary-adrenal axis and autonomic responses to the insulin tolerance test and the ovine corticotrophin-releasing hormone test in episodic cluster headache patients, both during remission and during the cluster period. The study revealed increased basal cortisol levels in all cluster patients. A blunted cortisol response to ovine corticotrophin-releasing hormone, in spite of a normal ACTH surge, was subsequently found in both illness phases. These findings suggest hypo-thalamic-pituitary-adrenal axis hyperactivity in both cluster phases. Furthermore, reduced ACTH and cortisol responses after insulin challenge were also observed in both remission and cluster period patients; a reduced norepinephrine surge was seen only in the cluster period. Taken together, these results suggest a hypothalamic involvement in the altered neuroendocrinological and autonomic responses found in our patients.

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