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Endocrine Function Is Altered in Chronic Migraine Patients with Medication-Overuse


  • Innocenzo Rainero MD, PhD,

  • Margherita Ferrero MD,

  • Elisa Rubino MD,

  • Walter Valfrè MD,

  • Michela Pellegrino MD,

  • Emanuela Arvat MD,

  • Roberta Giordano MD,

  • Ezio Ghigo MD,

  • Paolo Limone MD,

  • Lorenzo Pinessi MD

  • From the Neurology III—Headache Center, Department of Neuroscience (Drs. Rainero, Ferrero, Rubino, Valfrè, Pinessi); Division of Endocrinology and Metabolism, Department of Internal Medicine (Drs. Pellegrino, Arvat, Giordano, Ghigo); and Division of Endocrinology, Mauriziano “Umberto I” Hospital, Torino, Italy (Dr. Limone).

Address all correspondence to Dr. Innocenzo Rainero, Neurology III—Headache Center, Department of Neuroscience, University of Turin, Via Cherasco 15, 10126 Torino, Italy.


Objective.—To evaluate the effects of analgesic overuse on endocrine function in patients with chronic migraine and medication-overuse headache (CM-MOH).

Background.—Chronic migraine is frequently associated with an overuse of symptomatic medications. Drugs currently used in acute migraine attacks are associated with several endocrine effects. At present, the endocrine effects of medication overuse in chronic migraine patients are unknown.

Methods.—Eighteen patients with CM-MOH, diagnosed according to the ICHD-II criteria, and 18 healthy controls received an intravenous administration of GHRH, hCRH, and TRH. Plasma concentrations of GH, TSH, ACTH, and cortisol were measured for a 90-minute period after administration of the specific releasing hormones.

Results.—Hormonal basal concentrations were similar in both groups. GH response to GHRH was significantly reduced in patients with CM-MOH in comparison with controls. TRH induced a reduction of TSH concentrations only at the end of the test. After hCRH administration, ACTH and cortisol concentrations were significantly higher in cases than in controls. A significant correlation between duration of the disease and altered hormonal response was found.

Conclusions.—Our study shows that both corticotropic and somatotropic functions are significantly impaired in CM-MOH patients and suggests a role for hormones in the development of chronic migraine.