Changes in hormones of the hypothalamic-pituitary-gonadal axis in migraine patients

Li, Wei; Diao, Xiaojun; Chen, Chun-Fu; Li, Congcong; Zhang, Yingbo; Li, Yingying

doi:10.1016/j.jocn.2017.11.011

Cited by 21 publications

(30 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…17,18 It is unclear why older patients are more refractory to treatment than younger patients, but considering that after puberty the incidence of migraine becomes significantly higher in females 19,20 and considering that we also found that females were more likely to worsen than males, it could be due to a hormonal effect. Fluctuations in hormone levels throughout the menstrual cycle are associated with headache parameters in females with migraine [21][22][23] and recent pilot data in girls suggest that the stage of pubertal development may impact the effect of sex steroids on headache parameters. 22 Therefore, part of the age effect observed in the present study could be mediated by the hormonal changes that occur with puberty.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Short‐Term Prognosis While in Pediatric Headache Care: An Observational Study

et al. 2019

View full text Add to dashboard Cite

Objectives To characterize the short‐term prognosis of a clinical population of pediatric and young adult patients with migraine and explore predictors of clinical worsening while in care. Methods This was a retrospective study of all migraine patients seen at the Cincinnati Children’s Hospital Headache Center from 09/01/2006 to 12/31/2017, who had at least 1 follow‐up visit within 1‐3 months of the index visit analyzed. Included data were: age, sex, race, primary ICHD diagnosis, chronic migraine, medication overuse, history of status migrainosus, BMI percentile, headache frequency, headache severity, PedMIDAS score, allodynia, preventive treatment type, lifestyle habits, disease duration, depressive and anxiety symptoms. Clinical worsening was defined as an increase in 4 or more headache days per month between the index visit and the follow‐up visit. Results Data for 13,160 visit pairs (index and follow‐up), from 5316 patients, were analyzed. Clinical worsening occurred in only 14.5% (1908/13,160), whereas a reduction in headache frequency was observed in 56.8% of visit intervals (7475/13,160), with 34.8% of the intervals (4580/13,160) showing a reduction of 50% or greater. The change in headache frequency was minimal (increase in 0‐3 headaches/month) in 28.7% of intervals (3737/13,160). In the multivariable model, the odds of worsening were significantly higher with increasing age, female sex, chronic migraine, status migrainosus, depressive symptoms, higher PedMIDAS scores, and use of nutraceuticals, whereas the odds of worsening were lower for summer visits, caffeine drinkers, higher headache frequencies, and use of pharmaceuticals. Conclusions The majority of pediatric patients who receive multimodal interdisciplinary care for migraine improve over time. Our findings highlight a set of clinical features that may help in identifying specific factors that may contribute to an unfavorable short‐term prognosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Predictors of Short‐Term Prognosis While in Pediatric Headache Care: An Observational Study

et al. 2019

View full text Add to dashboard Cite

show abstract

“…They found that levels of progesterone in males and females with migraine in the postmenopausal phase were lower compared to healthy controls. Also, they found significantly higher levels of gonadotropin-releasing hormone (GNRH) in males with migraine, in the follicular phase as well as the luteal phase in females with migraine, and in postmenopausal females with migraine compared to controls (68).…”

Section: Sex Hormonesmentioning

confidence: 99%

Giving Researchers a Headache – Sex and Gender Differences in Migraine

et al. 2020

View full text Add to dashboard Cite

Migraine is a common neurovascular disorder affecting ∼15% of the general population. Ranking second in the list of years lived with disability (YLD), people living with migraine are greatly impacted by this especially burdensome primary headache disorder. In ∼30% of individuals with migraine, transient neurological symptoms occur (migraine aura) that further increase migraine burden. However, migraine burden is differential with respect to sex. Though one-year prevalences in childhood are similar, starting with puberty, migraine incidence increases at a much higher rate in females than males. Thus, migraine over the life course occurs in women three to four times more often than in men. Attacks are also more severe in women, leading to greater disability and a longer recovery period. The sex disparity in migraine is believed to be partly mediated through fluctuations in ovarian steroid hormones, especially estrogen and progesterone, although the exact mechanisms are not yet completely understood. The release of the neuropeptide calcitonin gene-related peptide (CGRP), followed by activation of the trigeminovascular system, is thought to play a key role in the migraine pathophysiology. Given the burden of migraine and its disproportionate distribution, the underlying cause(s) for the observed differences between sexes in the incidence, frequency, and intensity of migraine attacks must be better understood. Relevant biological as well as behavioral differences must be taken into account. To evaluate the scope of the existing knowledge on the issue of biological sex as well as gender differences in migraine, we conducted a systematized review of the currently available research. The review seeks to harmonize existing knowledge on the topic across the domains of biological/preclinical, clinical, and population-level research, which are traditionally synthesized and interpreted in isolation. Ultimately, we identify knowledge gaps and set priorities for further interdisciplinary and informed research on sex and gender differences as well as gender-specific therapies in migraine.

show abstract

“…A study by Li et al ( 2018 ) analyzing 119 migraineurs, 42 patients with tension-type headache, and 30 healthy controls tried to relate sex hormones with migraine clinical outcomes in men and menopausal, perimenopausal, and reproductive-aged women. In this study, testosterone appeared to be lower in all migraineur women categories when compared to healthy controls, while progesterone appeared to be lower in both men and postmenopausal women.…”

Section: Influence Of Sex Hormones In Migrainementioning

confidence: 99%

“…High estrogen levels in men and reproductive women appear to correlate with the least incapacitating migraine attacks. However, high estrogen levels were positively related to the duration of the migraine episode in post-reproductive women during the luteal phase (Li et al, 2018 ). With several limitations, similar to previous prospective studies, this study suggested a complex role of sex hormones in the etiology of migraine.…”

Section: Influence Of Sex Hormones In Migrainementioning

confidence: 99%

TRP Channels as Potential Targets for Sex-Related Differences in Migraine Pain

Artero-Morales

González-Rodríguez

Ferrer-Montiel

2018

Front. Mol. Biosci.

View full text Add to dashboard Cite

Chronic pain is one of the most debilitating human diseases and represents a social and economic burden for our society. Great efforts are being made to understand the molecular and cellular mechanisms underlying the pathophysiology of pain transduction. It is particularly noteworthy that some types of chronic pain, such as migraine, display a remarkable sex dimorphism, being up to three times more prevalent in women than in men. This gender prevalence in migraine appears to be related to sex differences arising from both gonadal and genetic factors. Indeed, the functionality of the somatosensory, immune, and endothelial systems seems modulated by sex hormones, as well as by X-linked genes differentially expressed during development. Here, we review the current data on the modulation of the somatosensory system functionality by gonadal hormones. Although this is still an area that requires intense investigation, there is evidence suggesting a direct regulation of nociceptor activity by sex hormones at the transcriptional, translational, and functional levels. Data are being accumulated on the effect of sex hormones on TRP channels such as TRPV1 that make pivotal contributions to nociceptor excitability and sensitization in migraine and other chronic pain syndromes. These data suggest that modulation of TRP channels' expression and/or activity by gonadal hormones provide novel pathways for drug intervention that may be useful for targeting the sex dimorphism observed in migraine.

show abstract

Changes in hormones of the hypothalamic-pituitary-gonadal axis in migraine patients

Cited by 21 publications

References 28 publications

Predictors of Short‐Term Prognosis While in Pediatric Headache Care: An Observational Study

Predictors of Short‐Term Prognosis While in Pediatric Headache Care: An Observational Study

Giving Researchers a Headache – Sex and Gender Differences in Migraine

TRP Channels as Potential Targets for Sex-Related Differences in Migraine Pain

Contact Info

Product

Resources

About