Headache Department, Neuroscience Unit, Conci-Carpinella Institute, Santa Rosa 994, Córdoba, Argentina.
Institute of Psychological Investigations, National University of Córdoba, Córdoba, Argentina.
Neurol Sci. 2022 Feb;43(2):1249-1254. doi: 10.1007/s10072-021-05424-7. Epub 2021 Jul 20.
Roughly three percent of episodic migraine patients evolve into the most burdensome chronic form of this condition every year. While some of the determinants behind this transformation are well established, others are still ill defined. Hypothyroidism is a prevalent endocrinological disorder that can both produce a secondary headache or aggravate a pre-existing primary headache disorder such as migraine.
We aimed to re-assess the association between hypothyroidism and chronic migraine controlling for factors such as hormone replacement treatment status and bodyweight.
We retrospectively analyzed the medical records of episodic and chronic migraine patients who consecutively consulted our headache clinic in order to determine the prevalence of adequately treated hypothyroidism in each group. Only patients receiving a stable dose regimen were included. The body mass index and other possibly confounding covariates were also collected.
Data from 111 migraine patients was included for analysis. Most (88.6%) of chronic migraine sufferers were overusing acute medication. Treated hypothyroidism was significantly more prevalent in chronic migraine patients (29.55%) compared to episodic migraine patients (8.96%). This association was independent of the patients' body mass index or other variables.
Alterations of neuronal metabolism, deficient calcitonin release, or focal inflammation causing local hormonal deactivation might explain why hypothyroidism, in spite of levothyroxine replacement therapy, is associated with migraine chronification. Further studies evaluating these factors are warranted.
每年约有 3%的发作性偏头痛患者会发展为这种疾病最严重的慢性形式。虽然这种转变的一些决定因素已经得到很好的证实，但其他因素仍未得到明确界定。甲状腺功能减退症是一种常见的内分泌疾病，它既可以产生继发性头痛，也可以加重偏头痛等原发性头痛疾病。
我们旨在重新评估甲状腺功能减退症与慢性偏头痛之间的关联，同时控制激素替代治疗状况和体重等因素。
我们回顾性分析了连续到我们头痛诊所就诊的发作性和慢性偏头痛患者的病历，以确定每组中经适当治疗的甲状腺功能减退症的患病率。仅纳入接受稳定剂量方案的患者。还收集了体重指数和其他可能的混杂因素。
共纳入 111 例偏头痛患者的数据进行分析。大多数（88.6%）慢性偏头痛患者过度使用急性药物。与发作性偏头痛患者（8.96%）相比，慢性偏头痛患者中经治疗的甲状腺功能减退症更为常见（29.55%）。这种关联独立于患者的体重指数或其他变量。
神经元代谢改变、降钙素释放不足或引起局部激素失活的局灶性炎症可能解释了为什么尽管接受了左甲状腺素替代治疗，甲状腺功能减退症仍与偏头痛慢性化有关。需要进一步研究这些因素。
