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Urinary 6-Sulphatoxymelatonin Levels Are Depressed in Chronic Migraine and Several Comorbidities

Authors

  • Marcelo R. Masruha MD, PhD,

    1. From the Department of Neurology and Neurosurgery – Federal University of São Paulo, São Paulo – Brazil (M.R. Masruha, J. Lin, L.C.P. Vilanova, and M.F.P. Peres); Instituto de Ensino e Pesquisa – Hospital Israelita Albert Einstein, São Paulo – Brazil (M.R. Masruha, D.S. de Souza Vieira, E. Zukerman, and M.F.P. Peres); Department of Preventive Medicine – Federal University of São Paulo, São Paulo – Brazil (T.S.C. Minett); Department of Physiology and Biophysics, Institute of Biomedical Sciences – University of São Paulo, São Paulo – Brazil (J. Cipolla-Neto).
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  • Jaime Lin MD,

    1. From the Department of Neurology and Neurosurgery – Federal University of São Paulo, São Paulo – Brazil (M.R. Masruha, J. Lin, L.C.P. Vilanova, and M.F.P. Peres); Instituto de Ensino e Pesquisa – Hospital Israelita Albert Einstein, São Paulo – Brazil (M.R. Masruha, D.S. de Souza Vieira, E. Zukerman, and M.F.P. Peres); Department of Preventive Medicine – Federal University of São Paulo, São Paulo – Brazil (T.S.C. Minett); Department of Physiology and Biophysics, Institute of Biomedical Sciences – University of São Paulo, São Paulo – Brazil (J. Cipolla-Neto).
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  • Domingos S. De Souza Vieira MD, PhD,

    1. From the Department of Neurology and Neurosurgery – Federal University of São Paulo, São Paulo – Brazil (M.R. Masruha, J. Lin, L.C.P. Vilanova, and M.F.P. Peres); Instituto de Ensino e Pesquisa – Hospital Israelita Albert Einstein, São Paulo – Brazil (M.R. Masruha, D.S. de Souza Vieira, E. Zukerman, and M.F.P. Peres); Department of Preventive Medicine – Federal University of São Paulo, São Paulo – Brazil (T.S.C. Minett); Department of Physiology and Biophysics, Institute of Biomedical Sciences – University of São Paulo, São Paulo – Brazil (J. Cipolla-Neto).
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  • Thais S.C. Minett MD, PhD,

    1. From the Department of Neurology and Neurosurgery – Federal University of São Paulo, São Paulo – Brazil (M.R. Masruha, J. Lin, L.C.P. Vilanova, and M.F.P. Peres); Instituto de Ensino e Pesquisa – Hospital Israelita Albert Einstein, São Paulo – Brazil (M.R. Masruha, D.S. de Souza Vieira, E. Zukerman, and M.F.P. Peres); Department of Preventive Medicine – Federal University of São Paulo, São Paulo – Brazil (T.S.C. Minett); Department of Physiology and Biophysics, Institute of Biomedical Sciences – University of São Paulo, São Paulo – Brazil (J. Cipolla-Neto).
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  • José Cipolla-Neto MD, PhD,

    1. From the Department of Neurology and Neurosurgery – Federal University of São Paulo, São Paulo – Brazil (M.R. Masruha, J. Lin, L.C.P. Vilanova, and M.F.P. Peres); Instituto de Ensino e Pesquisa – Hospital Israelita Albert Einstein, São Paulo – Brazil (M.R. Masruha, D.S. de Souza Vieira, E. Zukerman, and M.F.P. Peres); Department of Preventive Medicine – Federal University of São Paulo, São Paulo – Brazil (T.S.C. Minett); Department of Physiology and Biophysics, Institute of Biomedical Sciences – University of São Paulo, São Paulo – Brazil (J. Cipolla-Neto).
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  • Eliova Zukerman MD,

    1. From the Department of Neurology and Neurosurgery – Federal University of São Paulo, São Paulo – Brazil (M.R. Masruha, J. Lin, L.C.P. Vilanova, and M.F.P. Peres); Instituto de Ensino e Pesquisa – Hospital Israelita Albert Einstein, São Paulo – Brazil (M.R. Masruha, D.S. de Souza Vieira, E. Zukerman, and M.F.P. Peres); Department of Preventive Medicine – Federal University of São Paulo, São Paulo – Brazil (T.S.C. Minett); Department of Physiology and Biophysics, Institute of Biomedical Sciences – University of São Paulo, São Paulo – Brazil (J. Cipolla-Neto).
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  • Luiz C.P. Vilanova MD, PhD,

    1. From the Department of Neurology and Neurosurgery – Federal University of São Paulo, São Paulo – Brazil (M.R. Masruha, J. Lin, L.C.P. Vilanova, and M.F.P. Peres); Instituto de Ensino e Pesquisa – Hospital Israelita Albert Einstein, São Paulo – Brazil (M.R. Masruha, D.S. de Souza Vieira, E. Zukerman, and M.F.P. Peres); Department of Preventive Medicine – Federal University of São Paulo, São Paulo – Brazil (T.S.C. Minett); Department of Physiology and Biophysics, Institute of Biomedical Sciences – University of São Paulo, São Paulo – Brazil (J. Cipolla-Neto).
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  • Mario F.P. Peres MD, PhD, FACP

    1. From the Department of Neurology and Neurosurgery – Federal University of São Paulo, São Paulo – Brazil (M.R. Masruha, J. Lin, L.C.P. Vilanova, and M.F.P. Peres); Instituto de Ensino e Pesquisa – Hospital Israelita Albert Einstein, São Paulo – Brazil (M.R. Masruha, D.S. de Souza Vieira, E. Zukerman, and M.F.P. Peres); Department of Preventive Medicine – Federal University of São Paulo, São Paulo – Brazil (T.S.C. Minett); Department of Physiology and Biophysics, Institute of Biomedical Sciences – University of São Paulo, São Paulo – Brazil (J. Cipolla-Neto).
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  • Funding Source: This study was sponsored by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP).

  • Conflict of Interest: The authors report no conflicts of interest.

M.F.P. Peres, Instituto Israelita de Ensino e Pesquisa Albert Einstein, R Joaquim Eugenio de Lima, 811 cj 708 – São Paulo – Brazil, 01403-001.

Abstract

(Headache 2010;50:413-419)

Objective.— To assess urinary 6-sulphatoxymelatonin levels in a large consecutive series of patients with migraine and several comorbidities (chronic fatigue, fibromyalgia, insomnia, anxiety, and depression) as compared with controls.

Background.— Urine analysis is widely used as a measure of melatonin secretion, as it is correlated with the nocturnal profile of plasma melatonin secretion. Melatonin has critical functions in human physiology and substantial evidence points to its importance in the regulation of circadian rhythms, sleep, and headache disorders.

Methods.— Urine samples were collected into a single plastic container over a 12-hour period from 8:00 pm to 8:00 am of the next day, and 6-sulphatoxymelatonin was measured by quantitative ELISA. All of the patients were given a detailed questionnaire about headaches and additionally answered the following questionnaires: Chalder fatigue questionnaire, Epworth somnolence questionnaire, State-Trait Anxiety Inventory, and the Beck Depression Inventory.

Results.— A total of 220 subjects were evaluated – 73 (33%) had episodic migraine, 73 (33%) had chronic migraine, and 74 (34%) were enrolled as control subjects. There was a strong correlation between the concentration of 6-sulphatoxymelatonin detected and chronic migraine. Regarding the comorbidities, this study objectively demonstrates an inverse relationship between 6-sulphatoxymelatonin levels and depression, anxiety, and fatigue.

Conclusions.— To our knowledge, this is the first study to evaluate the relationship between the urinary concentration of melatonin and migraine comorbidities. These results support hypothalamic involvement in migraine pathophysiology.

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