Current understanding of pineal gland structure and function in headache

Peres, Mario F. P.; Valênça, Marcelo Moraes; Amaral, Fernanda Gaspar do; Cipolla‐Neto, José

doi:10.1177/0333102419868187

Cited by 11 publications

(13 citation statements)

References 120 publications

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“…Third, the reviewed studies were conducted at different geographical locations and therefore only few studies were comparable regarding the ratio of light to dark hours of the day throughout the year. Melatonin production is the internal representative of the external photoperiod and hereby functions as a chronobiotic hormonal signal controlling both the circadian and circannual rhythms [ 54 ]. Thus, only studies with close proximity of geographical location should be compared regarding seasonal variation of migraine to exclude limitations due to different endogenous clock settings.…”

Section: Discussionmentioning

confidence: 99%

The chronobiology of migraine: a systematic review

et al. 2021

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Background The paroxysmal nature of migraine is a hallmark of the disease. Some patients report increased attack frequency at certain seasons or towards the end of the week, while others experience diurnal variations of migraine attack onset. This systematic review investigates the chronobiology of migraine and its relation to the periodicity of attacks in existing literature to further understand the oscillating nature of migraine. Main body PubMed and Embase were systematically searched and screened for eligible articles with outcome measures relating to a circadian, weekly or seasonal distribution of migraine attacks. We found that the majority of studies reported morning hours (6 am–12 pm) as the peak time of onset for migraine attacks. More studies reported Saturday as weekly peak day of attack. There was no clear seasonal variation of migraine due to methodological differences (primarily related to location), however four out of five studies conducted in Norway reported the same yearly peak time indicating a possible seasonal periodicity phenomenon of migraine. Conclusions The findings of the current review suggest a possible role of chronobiologic rhythms to the periodicity of migraine attacks. Future studies are, however, still needed to provide more knowledge of the oscillating nature of migraine.

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Section: Discussionmentioning

confidence: 99%

The chronobiology of migraine: a systematic review

et al. 2021

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“…MT’s antinociceptive impact has been previously recognized in neuropathic 53 and inflammatory 54 pain animal models. It is hypothesized that its analgesic properties originate from its effect on the MT1 and MT2, opioid, GABA, adrenergic, muscarinic, and nicotinic receptors 55 . Furthermore, MT reduces the production of vasoactive substances such as the calcitonin gene–related peptide (CGRP), while it possesses antioxidant and anti‐inflammatory effects 56 .…”

Section: Discussionmentioning

confidence: 99%

Meta‐analysis of melatonin levels in cluster headache—Review of clinical implications

et al. 2020

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Cluster headache (CH) has been associated with circadian disturbances. The present systematic review examined available evidence for the utilization of melatonin (MT) in CH prophylaxis. First, case‐control studies assessing nocturnal MT or its urine‐expelled metabolite 6‐sulfatoxymelatonin (aMT6s) in CH individuals and healthy controls (HC) were reviewed and meta‐analyzed. Secondly, the results from randomized controlled trials (RCTs) and non‐randomized studies evaluating MT’s use in the prevention of CH were discussed. Literature search included MEDLINE, EMBASE, CENTRAL, PsycINFO, trial registries, Google Scholar, and OpenGrey. Bouts and remissions were assessed separately. Ten case‐control studies (adult participants) were retrieved. Seven evaluated serum MT; meta‐analysis involved only three of them (due to deficient reporting, n: bout = 31, remission = 38, HC = 31). Results were compatible with lower nocturnal serum MT levels during bouts [bout‐HC; FE‐MD = −29.89 pg/mL, 95% CI = (−46.00, −13.78), remission‐HC; FE‐MD = −2.40 pg/mL, 95% CI = (−16.57, 21.38), bout‐remission; RE‐MD = −32.10 pg/mL, 95% CI = (−56.78, −7.42)]. Nocturnal urinary melatonin was appraised in two studies, but reporting issues impeded the capitalization of the results. Nocturnal urine aMT6s was evaluated by two studies (n: bout = 29, remission = 22, HC = 20), and pooled results were indicative of lower aMT6s concentration in CH individuals during both active and inactive periods [bout‐HC; FE‐MD = −9.63 μg/nocturnal urine collection, 95% CI = (−14.40, −4.85), remission‐HC; FE‐MD = −9.12 μg/nocturnal urine collection, 95% CI = (−14.63,‐3.62), bout‐remission; FE‐MD = −0.58 μg/nocturnal urine collection, 95% CI = (−4.58, 3.42)]. Regarding CH prophylaxis, one RCT and two non‐randomized trials were retrieved, involving a total of 41 adult CH individuals (11—episodic, 31—chronic) and rendering the deduction of any conclusions precarious. Overall, available data for the role use of MT in CH are insufficient and inconclusive. Complementary studies evaluating endogenous MT concentrations and MT administration to patients with CH are warranted.

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“…For example, regular exercise is thought to promote anti-inflammatory effects 21 , regulate the hypothalamic-pituitary-adrenal axis mediating habituation of stress response [22][23][24] , which are akin with the recent evidence of exercise-mediate anxiolysis and lower pro-inflammatory cytokines in migraine women 7 . Also, aerobic exercise may improve sleep quality, and therefore could prevent sleep deprivation-triggered attacks, by changing melatonin production 25,26 , which in its turn represent a endogenous molecule thought to play a role in the pathomechanisms of migraine disorders 27 . A recent study showed that aerobic exercise helped to reduce neck pain in a particular subpopulation of patients presenting with both migraine and tension-type headaches 28 .…”

Section: Discussionmentioning

confidence: 99%

Aerobic exercise training for migraine prevention: A trigger-based analysis

Oliveira¹,

Swerts²,

Peres³

2019

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Background: Although aerobic exercise has been recommended for migraine management, no study has yet explored the effects of regular aerobic exercise on migraine triggers profile. Objective: To evaluate the effects of a 12-week aerobic exercise intervention on migraine triggers profile. Methods: We conducted a secondary, post hoc analysis of a randomized, controlled clinical trial. Triggers were recorded in a paper-based headache diary with a formal list including 8 common migraine triggers. Results: Twenty-five patients concluded the protocol and were analysed (exercise: n = 12; waitlist: n = 13). In the whole cohort, the most common triggers were stress/irritability (60 %), sleep deprivation (60 %), fasting (28 %), and foods (28 %). Most patients (52 %) had ≥ 3 triggers. The exercise group showed a higher baseline proportion of patients with ≥ 3 triggers (69 %) compared to waitlist group (25 %) (p = 0.041). After intervention period, there was no difference in the proportion of patients with ≥ 3 triggers between waitlist (16.6 %) and exercise (30 %) groups (p = 0.502). The exercise group showed greater numeric reductions (from group’s sum) than waitlist group for triggers stress/irritability (-14 vs -9), fatigue (-12 vs -6), and menstruation (-9 vs -5). This seemed to reflect the reduced number of attacks in the exercise group [mean (CI95 %): -2.5 (-3.7, -1), p = 0.002] vs waitlist [0.9 (2.4, -0.8), p = 0.341]. Conclusion: Tracking migraine triggers during exercise interventions may help to unravel specific clinical effects of regular exercise. Trial registration: #NCT01972607.

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Current understanding of pineal gland structure and function in headache

Cited by 11 publications

References 120 publications

The chronobiology of migraine: a systematic review

The chronobiology of migraine: a systematic review

Meta‐analysis of melatonin levels in cluster headache—Review of clinical implications

Aerobic exercise training for migraine prevention: A trigger-based analysis

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