Rainero Innocenzo, Ferrero Margherita, Rubino Elisa, Valfrè Walter, Pellegrino Michela, Arvat Emanuela, Giordano Roberta, Ghigo Ezio, Limone Paolo, Pinessi Lorenzo
Department of Neuroscience, Neurology III--Headache Center, University of Turin, Via Cherasco 15, 10126 Torino, Italy.
Headache. 2006 Apr;46(4):597-603. doi: 10.1111/j.1526-4610.2006.00409.x.
To evaluate the effects of analgesic overuse on endocrine function in patients with chronic migraine and medication-overuse headache (CM-MOH).
Chronic migraine is frequently associated with an overuse of symptomatic medications. Drugs currently used in acute migraine attacks are associated with several endocrine effects. At present, the endocrine effects of medication overuse in chronic migraine patients are unknown.
Eighteen patients with CM-MOH, diagnosed according to the ICHD-II criteria, and 18 healthy controls received an intravenous administration of GHRH, hCRH, and TRH. Plasma concentrations of GH, TSH, ACTH, and cortisol were measured for a 90-minute period after administration of the specific releasing hormones.
Hormonal basal concentrations were similar in both groups. GH response to GHRH was significantly reduced in patients with CM-MOH in comparison with controls. TRH induced a reduction of TSH concentrations only at the end of the test. After hCRH administration, ACTH and cortisol concentrations were significantly higher in cases than in controls. A significant correlation between duration of the disease and altered hormonal response was found.
Our study shows that both corticotropic and somatotropic functions are significantly impaired in CM-MOH patients and suggests a role for hormones in the development of chronic migraine.
评估镇痛药物过度使用对慢性偏头痛和药物过度使用性头痛（CM-MOH）患者内分泌功能的影响。
慢性偏头痛常与症状性药物的过度使用有关。目前用于急性偏头痛发作的药物具有多种内分泌效应。目前，慢性偏头痛患者药物过度使用的内分泌效应尚不清楚。
18例根据国际头痛疾病分类第二版（ICHD-II）标准诊断的CM-MOH患者和18名健康对照者接受了生长激素释放激素（GHRH）、促肾上腺皮质激素释放激素（hCRH）和促甲状腺激素释放激素（TRH）的静脉注射。在给予特定释放激素后90分钟内测量血浆生长激素（GH）、促甲状腺激素（TSH）、促肾上腺皮质激素（ACTH）和皮质醇的浓度。
两组的激素基础浓度相似。与对照组相比，CM-MOH患者对GHRH的GH反应显著降低。TRH仅在试验结束时导致TSH浓度降低。给予hCRH后，病例组的ACTH和皮质醇浓度显著高于对照组。发现疾病持续时间与激素反应改变之间存在显著相关性。
我们的研究表明，CM-MOH患者的促肾上腺皮质激素和生长激素功能均显著受损，并提示激素在慢性偏头痛的发生发展中起作用。
