Endogenous Opioids in Cerebrospinal Fluid and Blood in Idiopathic Headache Sufferers




Endogenous opioids and 5-hydroxytryptamine are the main neurotransmitters that regulate nociception, hedonia and autonomia. These functions are simultaneously impaired in idiopathic headaches. Enkephalins, beta-endorphin, and tryptophan (5-HT precursor) were evaluated in CSF and plasma of migraine and cluster headache sufferers. The following results were obtained:(a) decreased levels of CSF enkephalins in migraine attack and cluster headache,(b) increased CSF Tryptophan (TP) in migraine,(c) increased free plasma TP in migraine attack,(d) increased serum beta-endorphin-like-immunore-activity at the end of attack.A possible link between these findings and the impairment of nociception, hedonia and vegetative balance in headache sufferers is here discussed.