High prolactin levels as a worsening factor for migraine

Abstract

IntroductionMigraine is a very complex condition; in fact its physiopathology is not completely clear [1]. It is believed that many neurotransmitters are implicated in this process [2], and hormones have been shown to play a major role in women [3]. Among the neuroendocrinological alterations, disorders of the hypothalamic-hypophysial axis are believed to be implicated in the pathogenesis of primary J Headache Pain (2006) 7:83-89 DOI 10.1007 High prolactin levels as a worsening factor for migraine

Relationship between high prolactine levels and migraine attacks in patients with microprolactinoma

“…This mechanism could also be the reason of increased TSH secretion. Besides, in four patients of the group A, cabergoline therapy induced a modification of headache pattern from migraine to tension-type headache; the same situation was described in two patients of a previous paper [8]. Our data suggest that tension-type headache does not seem to be influenced by hypothalamic–hypophysial axis dysfunction; in fact, in our patients with tension-type headache, PRL levels were unchanged both during headache attacks and after TRH-test.…”

Dopamine: whatʼs new in migraine?

“…The secretion of prolactin from the pituitary gland is controlled by the dopaminergic tuberoinfundibular pathway, whereby progesterone stimulates the dopaminergic arcuate nucleus, which sends dopamine, via the median eminence and portal blood vessels, to inhibit the anterior pituitary gland from secreting prolactin [38]. Six patients with high prolactin serum levels, suffering from headache, were treated with 0.5 mg of the D 2 -like receptor agonist cabergoline twice a week, and their headache improved within a few months [37]. It might therefore be that the increased levels of prolactin in migraineurs are due to decreased levels of, or decreased responsiveness to progesterone or dopamine.…”

“…In terms of a possible dopaminergic role, it is interesting to note that migrainous women were shown to have increased serum levels of prolactin [37]. The secretion of prolactin from the pituitary gland is controlled by the dopaminergic tuberoinfundibular pathway, whereby progesterone stimulates the dopaminergic arcuate nucleus, which sends dopamine, via the median eminence and portal blood vessels, to inhibit the anterior pituitary gland from secreting prolactin [38].…”

Prolactin receptor in regulation of neuronal excitability and channels

“…1,2 The PRL-induced regulation of the nervous system is manifested in such important and relevant processes as maternal behavior, energy balance, food intake, stress and trauma responses, anxiety, neurogenesis, migraine and pain. [3][4][5][6][7][8][9][10][11][12][13][14] To understand this wide spectrum of processes that potentially influences the etiology of a vast array of disease conditions affecting millions of people, it is essential to delineate the specific mechanisms responsible for the PRL control of function in various neuronal circuitries. The aim of the present review is to summarize the current knowledge and recent progress made in understanding mechanisms responsible for PRL-induced regulation of neuronal functions and the channels involved.…”